Auranofin

CLINICAL USE

Active progressive rheumatoid arthritis in adults when NSAIDs inadequate alone

DOSE IN NORMAL RENAL FUNCTION

6 mg daily (maximum 9 mg in 3 divided doses)

PHARMACOKINETICS

Molecular weight :678.5

%Protein binding :60

%Excreted unchanged in urine : 9–17 (approx 60% of absorbed gold)

Volume of distribution (L/kg) :No data

half-life – normal/ESRD (hrs) :26 days/ –

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : 3–6 mg daily

10 to 20 : 3 mg daily

<10 : Avoid

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in GFR <10 mL/min

HD :Not dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Not dialysed. Dose as in GFR=10–20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsNone known

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

–

Comments

Take with or after food Start initially with morning and evening dose; if well tolerated, can take dose once a day

OTHER INFORMATION

Warn patients to tell the doctor immediately if any of the following develop: sore throat, mouth ulcers, bruising, fever, malaise, rash, diarrhoea or non-specific illness

Blood tests should be carried out monthly, and treatment should be withdrawn if the platelets fall below 100 000/mm3, or if signs and symptoms suggestive of thrombocytopenia appear

Gold can produce nephrotic syndrome or less severe glomerular disease with proteinuria and haematuria, which are usually mild and transient. If persistent or clinically significant proteinuria develops, treatment with gold should be discontinued. Minor transient changes in renal function may also occur

Urine tests should be carried out monthly to test for proteinuria and haematuria

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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