Clinical author's note Michael Stewart 22/07/2019: Myocrisin® injection was discontinued in the UK in June 2019. At the time of review there are no branded or generic products containing sodium aurothiomalate available in the UK. The medicine may still be available in other countries. This medicine leaflet is based on medical information available in the UK at the time of writing. Please also refer to the manufacturer's information supplied with your medicine.
Sodium aurothiomalate is given by injection into a muscle. You will be given the injections in a specialist clinic by a doctor or nurse.
It is important that you have the injections regularly. If you miss an appointment, contact your clinic to make another appointment as soon as possible.
The injections may cause your skin to become more sensitive to sunlight than usual. Protect your skin from sunlight, even on bright but cloudy days. Do not use sunbeds.
If you develop any side-effects from this treatment, discuss them with your doctor.
About sodium aurothiomalate
|Type of medicine||Disease-modifying antirheumatic drug (DMARD)|
|Used for||Rheumatoid arthritis|
|Also called||Gold sodium thiomalate (in US); Myocrisin®|
|Available as||Intramuscular injection|
Rheumatoid arthritis (RA) is thought to be an autoimmune disease. Your immune system normally makes antibodies to protect you from germs such as bacteria and viruses. In people with autoimmune diseases, the immune system makes antibodies that attack the tissues of the body, although it is not clear why this happens. Sodium aurothiomalate belongs to a group of medicines known as disease-modifying antirheumatic drugs (DMARDs) and works by suppressing your immune system. It helps to stop your immune system from attacking the tissues of your body and it reduces the damaging effect of the disease on your joints. It is sometimes referred to as 'gold therapy'.
Before having sodium aurothiomalate
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start having sodium aurothiomalate injections it is important that your doctor or pharmacist knows:
- If you are pregnant, trying for a baby or breastfeeding.
- If you have ever had eczema, dermatitis, or a severe itchy skin condition.
- If you have any problems with your breathing.
- If you have liver or kidney problems.
- If you have ever had a problem with your bowels, called colitis.
- If you have ever had a blood or bone marrow disorder.
- If you have been told you have systemic lupus erythematosus. This is also an autoimmune disease causing inflammation.
- If you have porphyria, a rare inherited blood condition.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How are sodium aurothiomalate injections given?
- Before you start this treatment, ask to read the manufacturer's printed information leaflet from inside the pack. The leaflet will give you more information about sodium aurothiomalate injections and a full list of side-effects which you may experience from having it.
- Sodium aurothiomalate injections will be given to you by a doctor or nurse who is a specialist. It is given by injection into a muscle.
- If you haven't had an injection of sodium aurothiomalate before, you will be given a small dose as a test before you are given a normal dose. This is to see how well you tolerate the injection.
- You will be started on a course of regular weekly injections. The usual starting dose is 50 mg. If you respond well to the treatment, the time between your injections will be increased after some months to every two weeks, then every three weeks, and then every four weeks. Treatment with sodium aurothiomalate may be continued for several years.
- It is important that you have the injections regularly. If you miss an appointment for an injection, you should contact your clinic to make another appointment as soon as possible.
Getting the most from your treatment
- It is important that you keep your regular appointments with your hospital clinic for your injections. Your progress will also be monitored during these regular clinic visits, and your doctor will arrange for you to have regular blood and urine tests. Once a year your doctor will arrange for you to have a chest X-ray to make sure your lungs are working properly. This is because the injections can affect your breathing.
- You should expect that sodium aurothiomalate will build up its effect gradually. This means that you may not notice the full benefit until after 2-6 months of treatment.
- Many people receiving sodium aurothiomalate are also prescribed an anti-inflammatory painkiller for several weeks until it starts to work. Once working, the dose of the anti-inflammatory tablet can be reduced or even stopped. Although painkillers ease the symptoms of rheumatoid arthritis, they do not alter the progression of the disease or prevent joint damage. You do not need to take them if your symptoms settle with the sodium aurothiomalate injections.
- Sodium aurothiomalate can cause your skin to become discoloured if it is exposed to direct sunlight. On bright days, wear suitable clothing to cover as much of your skin as possible, and use a sunscreen with a high sun protection factor. Do not use sunbeds.
- As far as possible, try to keep active. The muscles around your joints will become weak if they are not used. Regular exercise may also help to reduce pain and improve joint function.
- If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
- If you buy any medicines, always check with a pharmacist that they are suitable to take alongside your other medicines.
Can sodium aurothiomalate cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
|Sodium aurothiomalate side-effects ||What can I do if I experience this?|
|An itchy skin rash||Tell your doctor about this. Although it may soon pass, your doctor will want to make sure it is not a sign of a serious problem|
|Loss of hair||If this causes concern, let your doctor know|
Important: your doctor will discuss with you the possibility of rare but serious unwanted side-effects from this treatment. Contact your doctor straightaway if you develop any of the following:
- A severe or blistering skin rash, or any signs of an allergic reaction.
- Feeling breathless, dry cough, chest pain.
- Stomach pains and loose, watery stools (diarrhoea), with or without blood present.
- Sore throat, a high temperature, unexplained bruising or bleeding, mouth ulcers, a metallic taste in your mouth, or if you feel generally unwell or tired.
- Any yellowing of your skin or the whites of the eyes.
- Any numbness or loss of feeling or movement, particularly in your legs.
- Difficulty concentrating on things or difficulty controlling your movements.
- Swollen ankles or weight gain.
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store sodium aurothiomalate
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Myocrisin® 2% and 10% Injection; Sanofi, The electronic Medicines Compendium. Dated January 2019.
British National Formulary, 77th Edition (Mar 2019); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.