Gold by Intramuscular Injection
A DRUG Information Sheet
The full name for the gold preparation given by injection into a muscle is sodium aurothiomalate (brand name Myocrisin).
Why am I being prescribed gold?
Intramuscular gold injections can reduce the inflammation in the joints of people with rheumatoid arthritis and decrease pain, swelling and stiffness. Sometimes gold is also used to treat other rheumatic diseases, such as psoriatic arthritis.
When should I have gold injections, and what dose will I be given?
Initially, gold injections are given once a week, either at your GP's surgery or at the hospital. They are usually given into your buttock. Usually your doctor will recommend a small test dose, to make sure that you do not have any immediate reaction to gold. You will then be given weekly injections of up to 50 mg. If you benefit from the gold injections your doctor may be able to reduce their dose or frequency to either once a fortnight or once a month. Some people remain on gold for many years, with the frequency of their injections adjusted according to the severity of their symptoms.
Very rarely, people may react to gold injections. Therefore after the first gold injection you should wait in the clinic for 30 minutes before leaving, to be sure that all is well.
How long will the gold injections take to work?
Gold injections do not work immediately. It may take at least 12 weeks before you notice any benefit.
What are the possible risks or side-effects?
Gold can cause problems with the blood, kidneys or skin. If you develop a rash, mouth ulcers, altered taste, sore throat, fever, bruising, bleeding, breathlessness or any other symptoms you should tell your doctor or rheumatology nurse specialist immediately.
What other treatments could be used instead of gold injections?
A number of other drugs are used in the treatment of rheumatoid arthritis and related conditions (see arc leaflet 'Drugs and Arthritis'). Your doctor will discuss these other options with you.
Do I need any special checks while on gold injections?
Some of the side-effects of gold injections can be picked up at a very early stage by regular checks on your blood and urine and checking for any sign of a rash. It is very important to have these checks. You may be asked to keep a record booklet with your blood and urine test results. Bring this with you when you visit your GP or the hospital. Always make sure that this record booklet is up to date before having your next gold injection. You must not have gold injections unless you are having regular checks.
May I take other medicines while I am being treated with gold injections?
You should discuss any new medications with your doctor before starting them, and you should always tell any other doctor treating you that you are having gold injections.
If you are on an angiotensin converting enzyme (ACE) inhibitor, a family of drugs used in the treatment of high blood pressure and heart disease (examples include captopril and lisinopril), then you may be at a slightly increased risk of having an allergic reaction to gold. Therefore if you are on an ACE inhibitor, or commence one after being established on regular gold injections, you should discuss this with your doctor.
Gold is not a painkiller. If you are already on a non-steroidal anti-inflammatory drug (NSAID) or painkillers you may carry on taking these as well as the gold injections, unless your doctor advises otherwise.
Do not take over-the-counter preparations or herbal remedies without discussing this first with your doctor, rheumatology nurse or pharmacist.
Can I have immunisations while on gold injections?
Yes, you can have immunisations while being treated with gold injections.
May I drink alcohol while on gold injections?
There is no particular reason for you to avoid alcohol while on gold injections.
Do gold injections affect pregnancy?
Gold injections are not advisable during pregnancy. If you are planning a family or if you become pregnant while on treatment you should discuss this with your doctor as soon as possible.
What about breastfeeding?
You should not breastfeed while you are receiving gold injections.
Where can I obtain further information?
If you would like any further information about gold injections, or if you have any concerns about your treatment, you should discuss this with your doctor, rheumatology nurse or pharmacist.
Remember to keep all medicines out of reach of children.
PLEASE NOTE: We have made every effort to ensure that the content of this information sheet is correct at time of going to press, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.
