aurothioglucose, Solganal

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GENERIC NAME: aurothioglucose

BRAND NAME: Solganal

DRUG CLASS AND MECHANISM: Aurothioglucose is a gold-containing chemical (salt) used for treating rheumatoid arthritis. Other gold salts available include injectable gold sodium thiomalate (Myochrysine), and capsules, auranofin (Ridaura). It is not well understood exactly how gold salts work. In patients with inflammatory arthritis, such as adult and juvenile rheumatoid arthritis, gold salts can decrease the inflammation of the joint lining. This effect prevents the inflammation from destroying the bone and cartilage surrounding the joints and prevents or slows the development of deformities of the joints. Because of their ability to prevent deformities, gold salts are referred to as disease modifying anti-rheumatic drugs (DMARDs). Gold salts also may be referred to as second-line drugs because they are often considered when the arthritis persists in spite of the use of anti-inflammatory drugs (NSAIDs and corticosteroids). The term, second-line, however, is misleading since in general anti-inflammatory drugs and DMARDs are used together since they have different mechanisms of action and have additive effects. DMARDs like aurothioglucose may take weeks to months to become effective.



PREPARATIONS: Injectable suspension: 50 mg/ml.

STORAGE: Aurothioglucose should be stored at room temperature between 59 and 86 F (15-30 C) away from light and moisture and should not be frozen.

PRESCRIBED FOR: Aurothioglucose is used in the treatment of active, progressive, or destructive forms of inflammatory arthritis, such as adult and juvenile rheumatoid arthritis. Off label (non-FDA approved) uses include Felty's Syndrome (a rare disorder that includes rheumatoid arthritis, a swollen spleen, and decreased white blood cell count) and psoriatic arthritis.

DOSING: The usual initial adult dose is 10 mg followed by 25 mg for the second and third doses, then 50 mg weekly until 0.8 to1 g has been administered. The usual dose for children is one-fourth of the adult dose of aurothioglucose, exceeding 25 mg per dose.

DRUG INTERACTIONS: The concurrent use of penicillamine (Cuprimine, Depen) and aurothioglucose should be avoided as the combination decreases the levels and efficacy of both drugs due to chelation (binding) of the gold salt to the penicillamine.

PREGNANCY: There are no adequate and well-controlled studies in pregnant women. Aurothioglucose should be used during pregnancy only if the potential benefit to the mother justifies the potential risk to the fetus.

NURSING MOTHERS: Aurothioglucose has been found in the breast milk of women. Due to the potential for serious adverse reactions in nursing infants, decisions should be made whether to discontinue nursing or to discontinue the drug.

SIDE EFFECTS: The most common adverse reaction to aurothioglucose is dermatitis (skin inflammation), pruritus (itching), stomatitis (inflammation affecting the structures in the mouth such as cheeks, gums, tongue, lips, throat).

Reference: FDA Prescribing Information

Last Editorial Review: 9/11/2009

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