Hazardous agent. May cause retinoic-acid-acute promyelocytic leukemia syndrome or APL differentiation syndrome (dyspnea, fever, weight gain, pulmonary infiltrates, and pleural or pericardial effusions) in acute promyelocytic leukemia. Risk of hyperleukocytosis. May prolong the QT interval. May lead to torsade de pointes or complete AV block. May produce electrolyte imbalances. Use with caution in renal impairment (renal excretion).