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auranofin [gold] (Ridaura)

Tradename: Ridaura. [gold]. Indications: - rheumatoid arthritis, active state, - not responding to other agents - Felty's syndrome [4] - Still's disease [4] - psoriatic arthritis Dosage: Rheumatoid arthritis: 1) starting dose: 3 mg PO QD. 2) 3 mg PO BID or 6 mg QD, max 9 mg QD divided TID 3) discontinue if no response after 3 months on maximum dose Tabs: 3 mg (29% gold). Pharmacokinetics: - therapeutic effects may not be apparent for 3-4 months Monitor: 1) complete blood count (CBC) 2) urine for proteinuria & hematuria Adverse effects: 1) common (> 10%) - dermatitis/skin allergy - stomatitis - proteinuria (nephrotic syndrome) 2) less common (1-10%) - hives, alopecia, eosinophilia, leukopenia, thrombocytopenia, glossitis, hematuria 3) uncommon (< 1%) - angioedema, peripheral neuropathy, dysphagia, ulcerative colitis, GI hemorrhage, agranulocytosis, aplastic anemia, hepatotoxicity, gingivitis, metallic taste, interstitial pneumonitis 4) other [2] - diarrhea - abdominal pain - gray-blue pigmentation Use with caution in patients with: 1) hepatic or renal disease 2) diabetes 3) congestive heart failure 4) blood dyscrasias 5) hypertension 6) compromised cerebral or cardiovascular function Drug interactions: - may increase phenytoin levels Mechanism of action: 1) supresses of prevents arthritis & synovitis 2) taken up by macrophages resulting in inhibition of phagocytosis & perhaps lysosomal activity 3) decreases serum levels of rheumatoid factor & immunoglobulins 4) may decrease synovial inflammation & retard cartilage & bone destruction

Related

gold [Au]

General

disease-modifying antirheumatic agent (DMARD)

Properties

MISC-INFO: elimination route KIDNEY FECES 1/2life 26 DAYS protein-binding 60% pregnancy-category C safety in lactation -

Database Correlations

PUBCHEM cid=433055

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  3. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  4. Deprecated Reference