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sodium aurothiomalate

M01CB01

Forms & Strengths

Injection: 10 mg/0.5 mL solution in single-dose ampoule
Injection: 50 mg/0.5 mL solution in single-dose ampoule

Adult Dosing

Rheumatoid arthritis: Test dose of 10 mg intramuscularly, followed by 20 mg at week 2, then 50 mg weekly thereafter until clinical improvement is observed
Maintenance: 50 mg every 2-3 weeks once remission or maximal response is achieved

Pediatric Dosing

Juvenile idiopathic arthritis: 1 mg/kg body weight intramuscularly, up to a maximum single dose of 50 mg, administered weekly using the same escalation schedule as adults

Indications

Active progressive rheumatoid arthritis
Juvenile idiopathic arthritis unresponsive to NSAIDs

Mechanism of Action

Gold salt that inhibits phagocytosis and lysosomal enzyme activity in macrophages
Suppresses prostaglandin synthesis and modulates cellular and humoral immune responses, reducing inflammation and joint destruction

Contraindications

History of severe toxicity (e.g., exfoliative dermatitis, bone marrow aplasia) to gold compounds
Severe renal impairment
Severe hepatic impairment
Systemic lupus erythematosus
Pregnancy and lactation

Adverse Reactions

Stomatitis, gingivitis, and taste disturbances
Dermatitis, pruritus, and photosensitivity
Proteinuria, nephrotic syndrome, and glomerulitis
Bone marrow suppression, leukopenia, thrombocytopenia, and aplastic anemia
Nitritoid reactions (flushing, dizziness, syncope following injection)

Drug Interactions

Increased risk of severe renal toxicity and blood dyscrasias when co-administered with penicillamine, immunosuppressants, or antimalarials
Potential enhancement of myelosuppression with cytotoxic drugs
ACE inhibitors may increase the risk of nitritoid reactions

Curated Content: Needs Vetting Before Put to Clinical Use