Action plan for side effects
If blood dyscrasia:
- rash or mouth ulcers
- WBC < 3500
- platelets < 150,000 stop gold and inform rheumatologist.
If proteinuria or haematuria "+" on two or more occasions:
- inform rheumatologist
- perform MSU and 24-hour urinary protein collection
If eosinophilia occurs:
- reduce Gold dose or frequency and observe patient more carefully
- note that eosinophilia may precede skin rash
Oral gold has fewer side effects than i.m. The most common side effect is diarrhoea, reduced by taking bulking agents such as bran.
Source: Dr Watts, Rheumatologist, Ipswich, Suffolk
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