Trade Name(s):

Myochrisine, Solganal

Available

50 mg/mL solution

Dose

10 mg intramuscular injection for the first dose, followed by 25 mg weekly injections for the second and third doses; the dose is increased to 50 mg weekly if tolerated until a total dose of 1 gram is reached or until improvement is seen; 50 mg can then be given every 2 to 4 weeks

Indications

Treatment of rheumatoid arthritis

Side Effects

Mouth sores, altered taste, rash, lowered blood counts (esp. platelets), protein in the urine, kidney damage, elevation of liver enzymes, and rare lung damage

Monitoring

Blood counts and urine test monthly; consider liver and kidney function tests every 1 to 3 months

Important Points to Know

Injections must be given in a supervised office setting to monitor for drug reactions. The effects of therapy may not be seen for 4 to 6 months. Gold is also available in oral form (auranofin), and while this preparation is less toxic, it also seems to be less effective and poorly tolerated due to nausea and diarrhea.

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