Auranofin, Oral

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KEY POINTS

• This medicine is taken by mouth to treat rheumatoid arthritis.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antirheumatic

Generic and brand names: auranofin, oral; Ridaura

What is this medicine used for?

This medicine is taken by mouth to treat rheumatoid arthritis.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine or to gold
• A blockage in the intestines, Crohn's disease, or ulcerative colitis
• A blood disorder such as anemia
• A weakened immune system from cancer treatment, diseases such as HIV/AIDS, or from taking steroid medicines or medicines to prevent organ transplant rejection
• Breathing problems or lung disease
• Dermatitis or other skin disease
• Diabetes
• Heart disease
• Kidney or liver disease
• Lupus

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

This is a very strong medicine. Only healthcare providers experienced with this drug should prescribe it. Make sure you understand what the risks and benefits of treatment are.

Check the label on the medicine for directions about your specific dose. Take this medicine for as long as your healthcare provider tells you to, even if you start to feel better. If you stop taking this medicine, your pain will return. Do not take more or less of this medicine, or take it more often than prescribed. Your healthcare provider may have you take other medicines with this one. Follow all directions carefully.

Check with your healthcare provider before using this medicine in children under age 18.

Take this medicine after meals or a snack.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: painful urination, fever, sores in your mouth, nausea, vomiting, diarrhea, rash, itching, confusion, numbness or tingling in your hands or feet.

What should I watch out for?

This medicine contains gold and can cause gold toxicity. Contact your healthcare provider right away if you have signs of an infection (such as lasting sore throat or fever), unusual tiredness or weakness, unusual bruising or bleeding, dark or pink-reddish urine, black or tarry stools, itching, rash, mouth sores or irritation, or constant or severe diarrhea.

You need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

This medicine may make you more sensitive to the sun than you normally are. Wear protective clothing, a hat, and sunscreen lotion when you need to be outdoors. Do not use a sunlamp. The sun or ultraviolet light may cause your skin to turn gray or blue where it has been exposed to the sun.

This medicine may cause mouth sores. Use a soft bristle brush or mouth swab to brush your teeth.

Contact your healthcare provider if your condition does not improve after 3 to 4 months or if it gets worse.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Unusual bruising or bleeding; metallic taste or sores in mouth or throat; swelling or soreness of tongue; skin rash or itching; dark or pink-reddish urine; chills and fever; sore throat; cough; trouble breathing; tingling or numbness in the hands or feet; black or tarry bowel movements; unusual tiredness or weakness; constant or severe diarrhea; severe stomach pain, nausea, or vomiting; yellowing of the skin or eyes; eye pain, swelling, or irritation; vision changes.

Other: Mild diarrhea, nausea, vomiting, stomach pain, loss of appetite, gas, constipation, hair loss.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Cancer medicines such as cisplatin, doxorubicin (Doxil), hydroxyurea (Droxia, Hydrea), vinblastine, and vincristine (Marqibo)
• Corticosteroids such as betamethasone, cortisone, dexamethasone, fludrocortisone, hydrocortisone (A-Hydrocort, Cortef), methylprednisolone (Medrol, Solu-Medrol), prednisolone (Omnipred, Orapred, Prelone), prednisone (Prednisone Intensol), and triamcinolone (Aristospan, Kenalog)
• Hydroxychloroquine (Plaquenil)
• Immunosuppressants such as azathioprine (Azasan, Imuran), cyclosporine (Gengraf, Neoral, Sandimmune), mycophenolate (CellCept, Myfortic), sirolimus (Rapamune), and tacrolimus (Astagraf, Prograf, Protopic)
• Methotrexate (Otrexup, Rasuvo, Rheumatrex, Trexall)
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Cambia, Voltaren, Zipsor), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Penicillamine (Cuprimine, Depen)
• Phenytoin (Dilantin, Phenytek)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.