Included in the formulation
АТХ:L.04.A Immunosuppressive drugs
Pharmacodynamics:Assume the inhibition of sulfhydryl enzyme systems.It is believed that gold preparations suppress the immune response, disrupting the maturation and function of macrophages and T-lymphocytes, against their background, the concentrations of immunoglobulins and rheumatoid factor decrease. As a result, the inflammation of the synovium in the active stage of rheumatoid arthritis is suppressed. In vitro inhibition of prostaglandin synthesis.
Pharmacokinetics:The connection with plasma proteins is high. Biotransformation in the liver has not been studied, the drug does not decompose to elemental gold. Half-life long, depends on the dose and duration of therapy. Elimination of the kidneys 60-90% (slowly), with faeces 10-40%.
Indications:Rheumatoid arthritis, juvenile rheumatoid arthritis, psoriatic arthritis.
XIII.M05-M14.M06.9 Rheumatoid arthritis, unspecified
XIII.M05-M14.M06.8 Other specified rheumatoid arthritis
XIII.M05-M14.M06.0 Seronegative rheumatoid arthritis
XIII.M05-M14.M06 Other rheumatoid arthritis
XIII.M05-M14.M05.9 Seropositive rheumatoid arthritis, unspecified
XIII.M05-M14.M05.8 Other seropositive rheumatoid arthritis
XIII.M05-M14.M05.3 Rheumatoid arthritis with involvement of other organs and systems
XIII.M05-M14.M05 Seropositive rheumatoid arthritis
XIII.M05-M14.M08.0 Juvenile rheumatoid arthritis
Contraindications:Hypersensitivity, polyvalent allergy, anemia, pancytopenia, impaired renal function, severe liver damage, active form of pulmonary tuberculosis, collagenosis (systemic lupus erythematosus, nodular periarteritis, scleroderma, dermatomyositis), ulcerative colitis complicated forms of diabetes mellitus
, pregnancy, breast-feeding.
Carefully:Children under 18 years. Elderly age, renal and hepatic insufficiency.
Pregnancy and lactation:Category of recommendations FDA C.
Qualitative and well-controlled studies on humans have not been conducted. Has a teratogenic effect in animals. Do not apply! Gold penetrates into breast milk. Violations are not registered. Do not apply!
Dosing and Administration:Deeply intramuscular. Saturation period: 2 injections per week, 1 to 3 injections are administered 10 mg each, from the 4th to the 6th injection 20 mg, from the 7th injection either twice a week 50 mg each, or once a week, 100 mg. This dose should be maintained until the clinical effect is achieved, but not exceeding the total dose of 1600 mg (maximum 2000 mg). The period of maintenance therapy: 100 mg of the drug once a month or 50 mg once every 2 weeks.This treatment can last for months and years. Children are prescribed 0.7-1 mg / kg per week until the saturation phase is reached. In the phase of maintenance therapy, the drug is administered at a dose of 1 mg / kg 1-2 times per month.
Side effects:In the period of active therapy: tachyarrhythmia, ECG changes in the type of myocardial ischemia, skin rash, headache, fever, decreased blood pressure, nausea, abdominal pain. During maintenance therapy: stomatitis, alopecia, proteinuria (rarely nephrotic syndrome), liver dysfunction, cholestasis, disorders of hemopoiesis (thrombocytopenia, leukopenia, anemia), photosensitivity, dermatitis, skin itching.
Overdose:Severe side effects.
Treatment is symptomatic. With serious dermatitis, stomatitis, pulmonary and other manifestations - glucocorticoids (10-100 mg / day), dimercaprol.
Interaction:Penicillamine - an increased risk of developing serious hematologic and renal side effects, joint use is contraindicated.
Means that inhibit hematopoiesis, hepatotoxic and nephrotoxic drugs - enhance the toxic effects of gold preparations.
Special instructions:It is not recommended to be used in combination with aminoquinolines, d-penicillamine, small immunosuppressants, sulfasalazine.