Auranofin

Auranofin Brand Name– Ridaura

What is Auranofin

Auranofin is a disease-modifying antirheumatic drug (DMARD) used to treat early active cases of rheumatoid arthritis (RA) and is the only gold compound available for oral administration.

Auranofin is less effective against advanced, chronic cases of RA, as it does not reverse prior structural deformities from the disease.

Initiation of a DMARD within 3 months of RA diagnosis is recommended.

Periodic assessment of disease activity is advised; auranofin usually requires 3—6 months to achieve full therapeutic response.

If ongoing, active disease is present after 3 months of maximal therapy, addition of another DMARD or initiation of a different DMARD is recommended in methotrexate-naive patients.

Addition of another DMARD, initiation of a different DMARD, or initiation of a biologic is recommended for patients with a suboptimal response to methotrexate.

Indications

  • rheumatoid arthritis

For the treatment of active rheumatoid arthritis in patients who have had an insufficient therapeutic response to or are intolerant of an adequate trial of full doses of at least one nonsteroidal anti-inflammatory drug

Side Effects

  1. abdominal pain
  2. agranulocytosis
  3. alopecia
  4. anemia
  5. angioedema
  6. anorexia
  7. aplastic anemia
  8. azotemia
  9. bleeding
  10. bullous rash
  11. chest pain (unspecified)
  12. cholestasis
  13. colitis
  14. conjunctivitis
  15. constipation
  16. cough
  17. diaphoresis
  18. diarrhea
  19. dizziness
  20. dysgeusia
  21. dyspepsia
  22. dysphagia
  23. dyspnea
  24. ecchymosis
  25. elevated hepatic enzymes
  26. enterocolitis
  27. eosinophilia
  28. exfoliative dermatitis
  29. fever
  30. flatulence
  31. flushing
  32. GI bleeding
  33. gingivitis
  34. glomerulonephritis
  35. glossitis
  36. gold toxicity
  37. hematuria
  38. hypotension
  39. interstitial nephritis
  40. jaundice
  41. leukopenia
  42. maculopapular rash
  43. melena
  44. metallic taste
  45. nausea
  46. nephrotic syndrome
  47. nephrotoxicity
  48. neutropenia
  49. neutropenia
  50. oral ulceration
  51. palpitations
  52. pancytopenia
  53. peripheral neuropathy
  54. petechiae
  55. pneumonitis
  56. proteinuria
  57. pruritus
  58. pulmonary fibrosis
  59. purpura
  60. rash
  61. red cell aplasia
  62. sinus tachycardia
  63. skin discoloration
  64. stomatitis
  65. syncope
  66. thrombocytopenia
  67. urticaria
  68. vomiting
  69. weakness
  70. wheezing

Monitoring Parameters

  • CBC with differential
  • LFTs
  • urinalysis

Contraindications

  • agranulocytosis
  • anemia
  • benzyl alcohol hypersensitivity
  • bleeding
  • bone marrow suppression
  • breast-feeding
  • children
  • diarrhea
  • exfoliative dermatitis
  • gold toxicity
  • hematological disease
  • hematuria
  • hepatic disease
  • infants
  • inflammatory bowel disease
  • lactase deficiency
  • leukopenia
  • necrotizing enterocolitis
  • neutropenia
  • pregnancy
  • proteinuria
  • pulmonary fibrosis
  • renal disease
  • renal failure
  • renal impairment
  • requires an experienced clinician
  • serious rash
  • stomatitis
  • sunlight (UV) exposure
  • thrombocytopenia

Interactions

  • Amikacin
  • Aminoglycosides
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Angiotensin-converting enzyme inhibitors
  • Benazepril
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Captopril
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbamazepine
  • Celecoxib
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diflunisal
  • Dimercaprol
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Enalapril, Enalaprilat
  • Enalapril; Felodipine
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Esomeprazole; Naproxen
  • Etodolac
  • Famotidine; Ibuprofen
  • Fenoprofen
  • Flurbiprofen
  • Foscarnet
  • Fosinopril
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Gentamicin
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrocodone; Ibuprofen
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Indomethacin
  • Kanamycin
  • Ketoprofen
  • Ketorolac
  • Lansoprazole; Naproxen
  • Lisinopril
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Moexipril
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nonsteroidal antiinflammatory drugs
  • Oxaprozin
  • Paromomycin
  • Penicillamine
  • Perindopril
  • Perindopril; Amlodipine
  • Pexidartinib
  • Phenytoin
  • Piroxicam
  • Plazomicin
  • Quinapril
  • Ramipril
  • Riluzole
  • Rituximab
  • Rituximab; Hyaluronidase
  • Rofecoxib
  • Streptomycin
  • Sulindac
  • Tobramycin
  • Tolmetin
  • Trandolapril
  • Trandolapril; Verapamil
  • Valdecoxib
  • Vancomycin
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