Gold in rheumatoid arthritis
When using gold in RA, the following should be noted:
- therapeutic effects of gold salts develop slowly - maximum response is reached after 4-6 months treatment
- i.m. gold:
- a 10mg test dose is first given - this is necessary to exclude hypersensitivity
- test dose followed by 50mg i.m. weekly until response occurs
- change in dosage interval is undertaken 3-monthly because of lead-time in clinical response to change in dose
- if no response after 1000mg total dose then treatment should be discontinued
- if response to gold i.m. then:
- monthly doses while arthritis persists
- maintain for 5 years after complete remission
- oral gold:
- dose:
- initial 3mg/daily for 4 weeks
- maintenance 3mg bd
- if no response to can be increased to 3mg tds
- dose:
- oral preparation has fewer side effects than i.m.
- most common side effect is diarrhoea
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