Gold by intramuscular injection

Gold is a type of drug known as a disease-modifying anti-rheumatic drug, or DMARD. These drugs have the effect of dampening down the underlying disease process, rather than simply treating symptoms.

What is injected is a compound that contains gold – it is not pure gold! The full name for this gold preparation is sodium aurothiomalate (brand name Myocrisin). It is given by intramuscular injection (injection into a muscle).

Why are gold injections prescribed?

Intramuscular gold injections can reduce 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 and how do I have gold injections?

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 reduce their 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 will be advised to wait in the clinic for 30 minutes before leaving, to be sure that all is well.

How long do gold injections take to work?

Gold injections do not work immediately. It may be 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. You should tell your doctor or rheumatology nurse specialist immediately if you develop any of the following after starting gold:

  • a sore throat

  • a fever

  • any other symptoms of infection

  • bruising or bleeding

  • a rash
  • breathlessness
  • mouth ulcers
  • altered taste
  • any other new symptoms or anything else that concerns you.

If any of the symptoms listed above are severe, you should not have any more gold injections and you should see your doctor 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. Your doctor will discuss these other options with you.

Will 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, and you should 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.

Can I take other medicines along 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), you may be at a slightly increased risk of having an allergic reaction to gold injections. Therefore if you are already 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 can 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.

What about immunisations?

You can have immunisations while on gold injections.

Can I drink alcohol while on gold injections?

There is no particular reason to avoid alcohol while on gold injections.

Do gold injections affect fertility or 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 if you are on gold injections. The drug may pass into the breast milk and could be harmful to your baby.

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 this content is correct at time of publication, but remember that information about drugs may change. This page is for general education only and does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet that comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects that may be relevant in your particular case.

Our drug information is revised annually and published at the start of the year.

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