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gold sodium thiomalate; aurothiomalate (Myochrysine, Chrysothios)

Tradename: Myochrysine. Indications: - progressive rheumatoid arthritis - psoriatic arthritis [2] Dosage: 1) adults - 10 mg IM 1st week (test dose) - 25-50 mg/week IM until cumulative dose of 1000 mg - 25-50 mg IM every 2-3 weeks for 2-20 weeks - thereafter 25-50 mg IM every 3-4 weeks - Veterans administration uses doses at least as large as 75 mg weekly 2) children - 10 mg IM 1st week (test dose) - 1 mg/kg IM for 20 weeks - NOT to exceed 50 mg/injection - maintenance: 1 mg/kg IM at 2-4 week intervals Injection (50% gold): 25 mg/mL (1 mL); 50 mg/mL (1 mL, 10 mL) Pharmacokinetics: - administration for 2-4 months generally required before clinical improvement is noted Monitor: - CBC no more than 4 days prior to injection; gold should not be administered if platelet count is < 140,000/uL, WBC < 4000/uL, hemoglobin < 8 g/dL - urinalysis no more than 4 days prior to injection; gold should not be administered if > trace protein - basic chemistry panel & liver panel every 8-12 weeks - do not inject if symptoms of adverse effects [2] Adverse effects: 1) common (> 10%) - itching, rash, stomatitis, conjunctivitis, gingivitis, glossitis 2) less common (1-10%) - hives, alopecia, eosinophilia, leukopenia, thrombocytopenia, hematuria, proteinuria 3) uncommon (< 1%) - angioedema, peripheral neuropathy, difficulty swallowing, ulcerative enterocolitis, GI hemorrhage, agranulocytosis, anemia, aplastic anemia, hepatotoxicity, metallic taste, interstitial pneumonitis, gray to blue pigmentation

Related

gold [Au]

General

disease-modifying antirheumatic agent (DMARD)

Properties

MISC-INFO: elimination route KIDNEY FECES 1/2life 3-27 DAYS protein-binding 99% pregnancy-category C safety in lactation -

Database Correlations

PUBCHEM correlations

References

  1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  2. Deprecated Reference
  3. Department of Veterans Affairs, VA National Formulary