Sodium Aurothiomalate
Mechanism :
Unknown. May decrease prostaglandin synthesis or may alter cellular mechanisms by inhibiting sulfhydryl systems.
Indication :
- Adjunctive treatment of active rheumatoid arthritis
Contraindications :
Hypersensitivity to gold compounds or any component of the formulation; history of severe toxicity to gold compounds or heavy metals; systemic lupus erythematosus; severe debilitation.
Dosing :
Give a test dose of 10 mg IM. Then give 1 mg/kg IM every week (Maximum: 50 mg/injection) until signs of remission appear then increase the intervals between injections to two weeks. With full remission increase the interval to 3-4 weeks. In the absence of signs of remission after twenty weeks consider raising the dose slightly or changing to another therapy. If patients respond, maintenance therapy should be continued with 3-4 weeks interval for 1-5 years.
Adverse Effect :
Bradycardia, syncope, vasomotor symptoms, confusion, Guillain-Barre syndrome, hallucination, metallic taste, peripheral neuropathy, seizure, alopecia, dermatitis, onycholysis, pruritus, anorexia, abdominal cramps, cholestasis, diarrhea, hematuria, nephrotic syndrome, proteinuria, agranulocytosis, aplastic anemia, eosinophilia, leukopenia, purpura, thrombocytopenia, anaphylactoid reaction, anaphylaxis, angioedema, tongue edema, hepatitis, hepatotoxicity, jaundice, conjunctivitis, corneal ulcer, iritis, dyspnea, interstitial pneumonitis, pulmonary fibrosis.
Interaction :
Angiotensin-Converting Enzyme Inhibitors: May enhance the adverse/toxic effect.
Hepatic Dose :
contraindicated in severe impairment.