Gold Compounds - How Does Gold Compounds Works?

Type of Drug:

Antirheumatic agents.

How the Drug Works:

The exact merchanism of action of gold compounds is unknown. They suppress or prevent joint swelling and retard cartilage and bone destruction, but do not cure rheumatoid arthritis.

Therapeutic effects from gold compounds occur slowly. Early improvement, often limited to reduction in morning stiffness, may begin after 6 to 8 weeks of treatment, but other beneficial effects may not be observed until after months of therapy.

Uses:

To treat early active adult or juvenile rheumatoid arthritis not adequately controlled by other therapies (eg, NSAIDs).

Unlabeled Uses: Occasionally doctors may prescribe gold compounds for pemphigus and psoriatic arthritis.

Precautions:

Injection reaction: Increased joint pain may occur for 1 or 2 days after ejection. They usually subside after the first few injections. These reacllon are usually mild, but occasionally may be so severe that treatment It; stopped prematurely.

Use of other antirheumatic drugs: Use of salicylates, aspirin, NSAIDs, systemic corticosteroids may be continued when gold injection theory is started. After improvement begins, slowly discontinue pain rollovers and NSAIDs as symptoms permit. Safety of arranging with able gold or high doses of corticosteroids has not been establisllod. salts should not be used concomitantly with penicillamine or hydroxy chloroquine. See Drug Interactions.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Gold therapy is generally contraindicated in pregnant patients. Use only if clearly needed and potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: Gold appears in breast milk. A decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness of auranofin and gold sodium have been established. Safety and effectiveness of aurothioglucoso it children younger than 6 years of age have not been established.

Elderly: Tolerance to gold usually decreases with advancing age.

Lab Tests: Lab tests will be required during treatment. Tests include complete blood cell and platelet counts, urinalysis, and kidney and liver functional All women of child-bearing potential must have a pregnancy test before treatment begins to rule out the possibility of pregnancy.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are take any over-the-counter or prescription medications or dietary supplements with gold compounds. Doses of one or both drugs need to be modified or a different drug may need to be prescribe following drugs and drug classes interact with gold compounds:

Antimalarials (eg, hydroxychloroquine)

Immunosuppressive agents (eg, azathioprine, cyclophosphamide, methotrexate)

Penicillamine (eg, depen)

Phenytoin (eg, dilantin) (auranofine only)

Side Effects:

Every drug is capable of producing side effects. Many gold compound users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Indigestion; nausea; vomiting; diarrhea; constipation; stomach cramps; appetite loss; gas; dark or loose stools; mouth inflammation or ulcers.

Skin: Rash; itching; hives; redness; unusual bruising.Oher: Blood in the urine; skin inflammation; metallic taste; abnormal blood cell counts; abnormal liver or kidney function tests; anemia; yellowing of the skin or eyes.

Guidelines for Use:

Dosage will be individualized. Do not exceed the recommended dosage.

Injectable gold products - The appropriate dose will be prepared and administered by your health care provider.

Notify your doctor immediately if any of the following occurs: Rash, mouth inflammation, persistent diarrhea, sore mouth, indigestion, metallic taste, unusual bleeding or bruising, itching, blood in the urine, fainting, slow heartbeat, thickening of the tongue, difficulty swallowing or breathing, yellowing of the skin or eyes.

Notify your doctor immediately if you suspect you have become pregnant during therapy. All women of child-bearing potential must have a pregnancy test before treatment begins to rule out the possibility of pregnancy.

Increased joint pain may occur for 1 or 2 days after injection. This usually subsides after the first few injections.

Observe good oral hygiene during therapy.

Improvement of symptoms is not immediate. Improvement may be seen after 6 to 8 weeks of treatment, although it has not been seen in some patients for up to several months.

Lab tests and exams will be required to monitor therapy. Be sure to keep appointments.

Store at room temperature (59 0 to 86A°F). Protect from light.