gold sodium thiomalate; aurothiomalate, Myochrysine

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Pharmacy Author: Annette (Gbemudu) Ogbru, PharmD, MBA
    Annette (Gbemudu) Ogbru, PharmD, MBA

    Dr. Gbemudu received her B.S. in Biochemistry from Nova Southeastern University, her PharmD degree from University of Maryland, and MBA degree from University of Baltimore. She completed a one year post-doctoral fellowship with Rutgers University and Bristol Myers Squibb.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

Get a Grip on Rheumatoid Arthritis

What is aurothiomalate, and how does it work (mechanism of action)?

Gold sodium thiomalate is a gold-containing chemical (salt) used in treating rheumatoid arthritis. Other gold salts available include injectable aurothioglucose (Solganal) and oral 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 decrease the inflammation of the joint lining and also prevent the inflammation from destroying the bone and cartilage surrounding the joint. Because they prevent destruction of joints (in contrast to antiinflammatory drugs that just treat symptoms and signs of arthritis but do not prevent the destruction) gold thiomalate is known as a disease-modifying antirheumatic drug (DMARD). 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 antiinflammatory drugs (NSAIDs and corticosteroids) which are not DMARDs. The term, second line, may be misleading, however, since anti-inflammatory drugs and DMARDs in general should be used together because of their different mechanisms of action and additive effects.

What brand names are available for aurothiomalate?

Myochrysine

Is aurothiomalate available as a generic drug?

GENERIC AVAILABLE: No

Do I need a prescription for aurothiomalate?

Yes

What are the side effects of aurothiomalate?

The most common adverse reactions to gold sodium thiomalate are:

Because gold sodium thiomalate can cause bone marrow problems, all patients require regular monitoring with blood and urine tests.

Quick GuideRheumatoid Arthritis (RA) Symptoms & Treatment

Rheumatoid Arthritis (RA) Symptoms & Treatment

What is the dosage for aurothiomalate?

The usual initial adult dose is 10 mg by intramuscular injection followed by 25 mg for the second dose, then 25 to 50 mg weekly until gold toxicity or substantial clinical improvement occurs, or a cumulative dose of 1 g has been administered.

The usual dose for children is based on the weight of the child and is proportional to the adult dose. The maximum single dose for children younger than 12 years of age is 50 mg. After an initial test dose of 10 mg, one dosage regimen recommended for children is 1 mg/kg per week.

Which drugs or supplements interact with aurothiomalate?

The concurrent use of penicillamine (Cuprimine, Depen) and gold sodium thiomalate should be avoided as the combination decreases the levels and efficacy of both drugs due to chelation (binding of the gold salt with penicillamine). Gold sodium thiomalate should not be used in combination with atovaquone/proguanil (Malarone), an antimalarial drug, as the combination may increase the risk of serious blood abnormalities. (Either drug alone may have such effects, but the combination is more likely to cause them, i.e., the toxicity is additive.) Nitritoid reactions (symptoms include facial flushing, nausea, vomiting, and hypotension or seriously low blood pressure) may occur when injectable gold (sodium aurothiomalate), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors, such as enalapril (Vasotec), lisinopril Cozaar), captopril (Capoten), ramipril (Altace) and others.

Is aurothiomalate safe to take if I'm pregnant or breastfeeding?

There are no adequate studies in pregnant women. Gold sodium thiomalate should be used during pregnancy only if the benefit to the mother justifies the potential risk to the fetus.

Gold sodium thiomalate has been found in the breast milk of nursing mothers. Due to the potential for serious adverse reactions in nursing infants, decisions should be made whether to discontinue nursing or to discontinue the drug.

What else should I know about aurothiomalate?

What preparations of aurothiomalate are available?

Injectable solution: 25 and 50 mg/ml.

How should I keep aurothiomalate stored?

Gold sodium thiomalate should be stored at 20 C to 25 C (68 F to 77 F) and protected from light.

Reference: FDA Prescribing Information

Quick GuideRheumatoid Arthritis (RA) Symptoms & Treatment

Rheumatoid Arthritis (RA) Symptoms & Treatment

Summary

Gold sodium thiomalate; aurothiomalate (Myochrysine) is a drug prescribed for the treatment of adult and juvenile rheumatoid arthritis, psoriatic arthritis, and Felty's syndrome. Side effects, drug interactions, warnings and precautions, and patient information should be reviewed prior to taking any medication.

Treatment & Diagnosis

Medications & Supplements

Prevention & Wellness

Subscribe to MedicineNet's Arthritis Newsletter

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

FDA Logo

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.

Reviewed on 7/9/2015
References
Reference: FDA Prescribing Information

Health Solutions From Our Sponsors