Gold - Treatment Information Sheet
Gold Treatments
- oral - Auranofin (Ridaura)
- intramuscular - Sodium Aurothimolate (Myocrisin)
Dose
Auranofin
Commence at 3mg daily
Increase, if tolerated, to 3mg bd after about 1 week.
Commonest problem is diarrhoea. Some change in bowel habit happens
in up to 30%. If tolerable, leave individual on the drug. If frequency
of bowel action is not acceptable stop Auranofin.
Dose
Myocrisin
- Give test dose of 10mg to check for allergy, usually skin reaction.
- Then give 50mg im at weekly intervals until total dose of gold
given equates to 510mg
- Then give 50mg im at 2 weekly intervals until individual received
1010mg total dose.
- Continue with 50mg im monthly
Important interactions
Do not use with other myelosuppressive drugs
Monitoring
IM myocrisin - with each injection please check:
Blood: Full blood count at each injection
ESR or plasma viscosity (not mandatory but helps to monitor disease)
Urine: Blood and protein
When to act on results:
Contact Rheumatolgy Unit help line on ext 2314
See - Services- Rheumatology
- If total WCC or absolute neutrophil count falls -
- from within normal range to below the lower range value.
- for 3 consecutive tests (even within the normal range when
absolute value falls by 3x10-9 cells cm-2).
- If platelets fall -
- from within normal range to below the lower range value.
- for 3 consecutive tests (even within the normal range when absolute
value falls by 100x10-9 cells cm-2).
- Urine:
If urine shows 1+ of blood or protein ignore and recheck when
next due If urine shows 2++ or 3+++ of blood or urine STOP gold
either IM or Oral. Check MSSU. Treat infection if present: recheck
urine by dipstick and recommence gold if possible
- Skin:
If skin reaction stop Gold until rash settled and re-challenge
with test dose (Auranofin 3mg or 10mg myocrisin). If rash does
not settle in 1 month it is most unlikely to be due to the gold.
Document Information
Expiry Date: 11/04/04
Author: Kennedy Tom Dr
Organisation: Arrowe Park Hospital
|
