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(C) Vancouver
General Hospital.
This monograph may not be reproduced without permission.
For further information, please contact a Pharmacist. |
NAME OF DRUG
aurothiomalate sodium
CLASSIFICATION
Rheumatoid arthritis therapy
ALTERNATE NAME
MYOCHRYSINE
INDICATIONS
- treatment of rheumatoid arthritis
RECONSTITUTION AND STABILITY
- protect from light
- stable at room temperature
- DO NOT USE if solution has darkened beyond a pale yellow colour or if particulate matter
present
COMPATIBILITY
- incompatible with other drugs
ROUTES OF ADMINISTRATION
- IM only; preferably in gluteal muscle
- DO NOT GIVE IV
VH & HSC ADMINISTRATION POLICY
DOSAGE
- 10 mg in the first week, 25 mg in the second and third weeks and 25-50 mg weekly
thereafter until optimum response or remission.
- Maintenance dose - 25-50 mg every 1-4 weeks; lower doses are also effective in many
patients.
- Dosage may be individualized based on clinical response and side effects.
- If no response is observed after a cumulative dose of 1000 mg, the drug should be
discontinued; however some rheumatologists may continue to a total dose of 2000mg.
- May mix IM dosage with lidocaine to reduce pain at injection site
- withdraw dose of aurothiomalate in syringe first, then add 0.1mL lidocaine 1%
POTENTIAL HAZARDS OF PARENTERAL ADMINISTRATION
- hypersensitivity reactions and anaphylaxis may occur up to 10 minutes after
administration
IMPORTANT IMPLICATIONS
- adverse effects include gastrointestinal disturbances, skin and mucous membrane
reactions, blood dyscrasias (eosinophilia, thrombocytopenia, aplastic anemia,
neutropenia), nephrotoxicity, hepatotoxicity, and ocular reactions
- concurrent use with D-penicillamine or other potential bone marrow toxic and/or
nephrotoxic drugs may increase the potential for serious hematologic and/or renal adverse
reactions
- frequent urinalysis, blood counts and kidney and liver function tests should be
performed
- patients should avoid exposure to sunlight due to photosensitization
- contraindicated in patients with renal or hepatic impairment, history of infectious
hepatitis, hematological disorders, diabetes, advanced cardiovascular disease
- use with extreme caution in patients with SLE or significant dermatitis including eczema
and urticaria
- the patient should remain supine for 10 minutes after the injection and observed for a
further 20 minutes after injection
Rev. April 1998