Gold (Myochrysine®, Solganol®)

Gold shots may control joint inflammation in people with rheumatoid arthritis when other medications are inadequate.

A trial of intramuscular (IM) gold consists of 1,000 mg. Doses of 50 mg are injected over a four-month period. If improvement has occurred and there are no significant side effects, the dosage interval is reduced gradually to every two weeks for two months, every three weeks for three months, and every month thereafter. If improvement persists, the medication is continued indefinitely. Sometimes the interval between doses is lengthened even further.

• Skin rash, which generally itches, is red or pink and looks like hives.This rash is relatively common.
• Mouth ulcers, which are painful and occur occasionally.
• Decreased white blood cell, red blood cell or platelet counts, which rarely occur and usually improve after the medicine is stopped.Very rarely, more serious long-term decreases may occur.
• Increased urine protein excretion happens sometimes, generally occurring without any specific symptoms.

Laboratory tests are obtained every week for the first 10 weeks, then after every other injection. Often, tests are required before injections for the first month or so, but afterward injections can be given before having labs drawn. The tests consist of simple red blood cell, white blood cell and platelet counts, plus a urinalysis to measure protein loss.

If small changes in the laboratory results occur, simply holding a dose or decreasing the amount of gold given for a time often lead to resolving the problem and the medication can be continued.

It is important to inform the nurse or doctor if any skin rashes occur, even relatively minor ones, before the injection is given, since withholding that injection may avoid a more serious problem.