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February 10, 2012

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.

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




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  • Related Diseases & Conditions

    • Rheumatoid Arthritis
      • Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
    • Arthritis
      • Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout, and pseudogout.
    • Psoriatic Arthritis
      • Psoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms include painful, stiff, and swollen joints, tendinitis, and organ inflammation. Treatment involves antiinflammatory medications and exercise.
    • Juvenile Arthritis (Juvenile Rheumatoid Arthritis)
      • Juvenile arthritis (juvenile rheumatoid arthritis or JRA) annually affects one child in every thousand. There are three types of JRA: pauciarticular (less than four joints affected), polyarticular (more than four joints affected), and systemic-onset (inflamed joints with high fevers and rash). Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
    • Felty's Syndrome
      • Felty's syndrome is a complication of long-term rheumatoid arthritis. Felty's syndrome is defined by the presence of three conditions: rheumatoid arthritis, an enlarged spleen, and an abnormally low white blood count. Treatment of Felty's syndrome is not always required; however, treatment for patients with infections is available.
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aurothioglucose, Solganal

What is Felty's syndrome?

Felty's syndrome is a complication of long-standing rheumatoid arthritis. Felty's syndrome is defined by the presence of three conditions: rheumatoid arthritis, an enlarged spleen (splenomegaly), and an abnormally low white blood count. Felty's syndrome is uncommon. It affects less than 1% of patients with rheumatoid arthritis.

What are the symptoms of Felty's syndrome?

Some patients with Felty's syndrome have more infections, such as pneumonia or skin infections, than the average person. This increased susceptibility to infections is attributed to the low white blood counts that are characteristic of Felty's syndrome. Ulcers in the skin over the legs can complicate Felty's syndrome.

What causes Felty's syndrome?

The cause of Felty's syndrome is not known. Some patients with rheumatoid arthritis develop Felty's syndrome but most do not. White blood cells are prod...

Read the Felty's Syndrome article »







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