Realgar/Indigo naturalis

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Realgar/Indigo naturalis
Combination of
RealgarArsenic compound
Indigo naturalisTraditional Chinese medicine
Clinical data
Other namesRIF oral arsenic formulation, Compound Huangdai
Routes of
By mouth
Legal status
Legal status
  • US: Not FDA approved
E number{{#property:P628}}
CompTox Dashboard (EPA)
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Realgar/Indigo naturalis (RIF), also known as Compound Huangdai, is a medication used to treat acute promyelocytic leukemia.[2] Effectiveness appears similar to arsenic trioxide.[2] It is generally used together with all-trans-retinoic acid (ATRA).[2] It is taken by mouth.[3]

Side effects may include abdominal pain and rash.[2] It is made up of a combination of realgar (tetra-arsenic tetra-sulfide), Indigo naturalis, root of Salvia miltiorrhiza, and root of Pseudostellaria heterophylla.[2] It works by breaking down the cancer protein retinoic acid receptor alpha.[4]

Realgar-Indigo naturalis was developed in the 1980s and approved for medical use in China in 2009.[2][5] It is on the World Health Organization's List of Essential Medicines.[3] It is made in China and was originally a herbal remedy.[2] It is not very expensive.[2] It is not approved in either the United States or Europe as of 2019.[2]


The defined daily dose is not established.[1]


  1. 1.0 1.1 "WHOCC - ATC/DDD Index". Retrieved 10 September 2020.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 "Proposal for the inclusion of arsenic therapies in the WHO Model list of ESSENTIAL MEDICINES for the treatment of acute promyelocytic leukemia" (PDF). WHO. Retrieved 15 November 2019.
  3. 3.0 3.1 World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  4. "realgar-Indigo naturalis formulation". National Cancer Institute. 2 February 2011. Retrieved 15 November 2019.
  5. Ghosh, Dilip; Smarta, R. B. (2016). Pharmaceuticals to Nutraceuticals: A Shift in Disease Prevention. CRC Press. p. PT41. ISBN 9781315354934.

External links