auranofin, Ridaura (cont.)

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STORAGE: Auranofin should be stored between 15 C and 30 C (59 F 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 or 6 mg once a day. The dose may be increased to 3 mg three times daily after three months.

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. Stomach pain, nausea, weight loss, and skin inflammation can occur. 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. Hair loss, anemia, and reduced number of white blood cells or platelets have also been reported.

Reference: FDA Prescribing Information

Last Editorial Review: 9/10/2012

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