Medications and Drugs
Pharmacy Author: Annette Gbemudu-Ogbru, PharmD, MBA
Medical and Pharmacy Editor: Jay W. Marks, MD
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.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
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
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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