Medications and Drugs
Pharmacy Author: Annette Gbemudu-Ogbru, PharmD, MBA
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: auranofin
BRAND NAME: Ridaura
DRUG CLASS AND MECHANISM: Auranofin is an oral, gold-containing chemical
(salt) used for treating rheumatoid arthritis. Other gold salts available are
injectable and include aurothioglucose (Solganal) and
gold sodium thiomalate
(Myochrysine). It is not well understood exactly how gold salts work. In
patients with inflammatory arthritis, such as adult and
juvenile rheumatoid
arthritis, gold salts decrease the inflammation of the lining of the joint. They
prevent the inflammation from destroying the bone and cartilage surrounding the
joint and deformities of the joints. Because of its ability to prevent or slow
deformities of the joints, auranofin is considered a disease modifying
anti-rheumatic drug (DMARD). Gold salts also are called second-line drugs
because they often are considered when arthritis persists in spite of the use of
antiinflammatory drugs (NSAIDs and corticosteroids). The term second-line is
misleading since anti-inflammatory drugs and DMARDs have different mechanisms of
action and in general are used together for their additive effects. DMARDs may
take weeks to months to become effective. Auranofin was FDA approved in May
1985.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Capsule: 3 mg.
STORAGE: Auranofin should be store between 15 and 30 C (59 and 86 F) and
dispensed in a tight, light-resistant container
PRESCRIBED FOR: Auranofin is used in the treatment of active, progressive or
destructive forms of inflammatory arthritis, such as rheumatoid arthritis. Off
label uses include Felty's Syndrome (a rare disorder that includes rheumatoid
arthritis, a swollen spleen, and decreased white blood cell count),
psoriatic
arthritis and juvenile rheumatoid arthritis.
DOSING: The usual adult dosage of auranofin is 3 mg twice daily.
DRUG INTERACTIONS: The concurrent use of auranofin and phenytoin (Dilantin),
an antiepileptic drug, may increase phenytoin blood levels, which may lead to
phenytoin toxicity for unclear reasons. The concurrent use of penicillamine
(Cuprimine, Depen) and gold salts may result in blood cell or kidney toxicity
since both drugs are toxic to the blood cells and kidney. The auranofin should
not be used with atovaquone/proguanil (Malarone) an antimalarial drug, as the
combination may increase the risk of toxicity to blood cells.
PREGNANCY: There are no adequate studies in
pregnant women. Use of auranofin
in pregnant women is not recommended.
NURSING MOTHERS: Auranofin has been found in the
breast milk of nursing
mothers. Nursing during auranofin therapy is not recommended.
SIDE EFFECTS: The most common side effect of auranofin is loose stools or
diarrhea. Another side effect is inflamed skin; an itching sensation can be an
early warning sign of a skin reaction, such as a rash. Auranofin also can cause
a metallic taste and mouth sores, though less frequently than injectable gold
salts. Because gold salts can cause serious kidney and bone marrow problems, all
patients require monitoring with regular testing of blood and urine.
Reference: FDA Prescribing Information
Last Editorial Review: 9/2/2009
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
- Rheumatoid Arthritis - Learn more about rheumatoid arthritis, an autoimmune disease that causes chronic joint inflammation, which has symptoms that include stiffness, fever, muscle and joint aches, loss of appetite, and fatigue. Treatment of rheumatoid arthritis incorporates the use of first-line drugs (aspirin and corticosteroids for pain and inflammation) and second-line drugs (methotrexate and hydroxychloroquine to prevent joint destruction and promote remission).
- Drugs: What You Should Know About Your Drugs - Find out what you should know about your drugs such as side effects, warnings and precautions, storage information, and if a generic version is as good as the brand name.
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