AdultPediatricDosage Forms & Strengths capsule 3mg Rheumatoid Arthritis Indicated for active rheumatoid arthritis in patients who have failed adequate trials of NSAIDs 6 mg PO qDay or divided BID; may increase to 9 mg/day divided TID after 3 months; if no response after 3 months, discontinue drugDosage Forms & Strengths capsule 3mg Juvenile Idiopathic Arthritis (Off-label) Data are limited 0.1 mg/kg/day PO in divided doses Maintenance: 0.15 mg/kg PO qDay or divided BID; not to exceed 0.2 mg/kg/day PO qDay divided BIDInteraction CheckerEnter a drug name and auranofinNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (0)Serious - Use Alternative (6)influenza virus vaccine quadrivalent, adjuvantedauranofin decreases effects of influenza virus vaccine quadrivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.influenza virus vaccine trivalent, adjuvantedauranofin decreases effects of influenza virus vaccine trivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.pexidartinibauranofin and pexidartinib both increase Other (see comment). Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.pretomanidauranofin, pretomanid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.selinexorselinexor, auranofin. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.tofacitinibauranofin, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.Monitor Closely (6)cholera vaccineauranofin decreases effects of cholera vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs and corticosteroids (used in greater than physiologic doses), may reduce the immune response to cholera vaccine.meningococcal group B vaccineauranofin decreases effects of meningococcal group B vaccine by pharmacodynamic antagonism. Use Caution/Monitor. Individuals with altered immunocompetence may have reduced immune responses to the vaccine.ocrelizumabauranofin and ocrelizumab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Coadministration of ocrelizumab with high doses of corticosteroids is expected to increase the risk of immunosuppression.ofatumumab SCofatumumab SC, auranofin. Either increases effects of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with coadministration. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC.olaparibauranofin and olaparib both increase pharmacodynamic synergism. Use Caution/Monitor. Coadministration with other other myelosuppressive anticancer agents, including DNA damaging agents, may potentiate and prolongate the myelosuppressive toxicity. sipuleucel-Tauranofin decreases effects of sipuleucel-T by pharmacodynamic antagonism. Modify Therapy/Monitor Closely.Minor (3)ethotoinauranofin increases levels of ethotoin by unspecified interaction mechanism. Minor/Significance Unknown.fosphenytoinauranofin increases levels of fosphenytoin by unspecified interaction mechanism. Minor/Significance Unknown.phenytoinauranofin increases levels of phenytoin by unspecified interaction mechanism. Minor/Significance Unknown.cholera vaccineMonitor Closely (1)auranofin decreases effects of cholera vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs and corticosteroids (used in greater than physiologic doses), may reduce the immune response to cholera vaccine.ethotoinMinor (1)auranofin increases levels of ethotoin by unspecified interaction mechanism. Minor/Significance Unknown.fosphenytoinMinor (1)auranofin increases levels of fosphenytoin by unspecified interaction mechanism. Minor/Significance Unknown.influenza virus vaccine quadrivalent, adjuvantedSerious - Use Alternative (1)auranofin decreases effects of influenza virus vaccine quadrivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.influenza virus vaccine trivalent, adjuvantedSerious - Use Alternative (1)auranofin decreases effects of influenza virus vaccine trivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.meningococcal group B vaccineMonitor Closely (1)auranofin decreases effects of meningococcal group B vaccine by pharmacodynamic antagonism. Use Caution/Monitor. Individuals with altered immunocompetence may have reduced immune responses to the vaccine.ocrelizumabMonitor Closely (1)auranofin and ocrelizumab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Coadministration of ocrelizumab with high doses of corticosteroids is expected to increase the risk of immunosuppression.ofatumumab SCMonitor Closely (1)ofatumumab SC, auranofin. Either increases effects of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with coadministration. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC.olaparibMonitor Closely (1)auranofin and olaparib both increase pharmacodynamic synergism. Use Caution/Monitor. Coadministration with other other myelosuppressive anticancer agents, including DNA damaging agents, may potentiate and prolongate the myelosuppressive toxicity. pexidartinibSerious - Use Alternative (1)auranofin and pexidartinib both increase Other (see comment). Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.phenytoinMinor (1)auranofin increases levels of phenytoin by unspecified interaction mechanism. Minor/Significance Unknown.pretomanidSerious - Use Alternative (1)auranofin, pretomanid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.selinexorSerious - Use Alternative (1)selinexor, auranofin. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.sipuleucel-TMonitor Closely (1)auranofin decreases effects of sipuleucel-T by pharmacodynamic antagonism. Modify Therapy/Monitor Closely.tofacitinibSerious - Use Alternative (1)auranofin, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. >10% Diarrhea (47%) Rash (24%) Pruritus (17%) Abd pain (14%) Stomatitis (13%) 1-10% Nausea (10%) Anorexia (3-9%) Conjunctivitis (3-9%) Dyspepsia (3-9%) Flatulence (3-9%) Proteinuria (3-9%) Alopecia (1-3%) Anemia (1-3%) Constipation (1-3%) Eosinophilia (1-3%) Elevated liver enzymes (1-3%) Glossitis (1-3%) Hematuria (1-3%) Leukopenia (1-3%) Thrombocytopenia (1-3%) Urticaria (1-3%) Black Box Warnings Prescribing physicians should understand severe and fatal toxicities of chrysotherapy Thorough patient discussion explaining adverse reactions is essential; encourage patients to report any adverse reactions Monitor for signs of gold toxicity (ie, decreased hemoglobin, leukopenia <4,000/cu.mm, granulocytes <1,500/cu.mm, platelets <150,000/cu.mm, proteinuria, hematuria, pruritus, rash, stomatitis, persistent diarrhea) and establish baseline measurements before prescribing Should be reserved for use in certain patients with active rheumatoid arthritisContraindications Pts who have had previous gold-induced disorders (anaphylaxis, necrotizing enterocolitis, pulmonary fibrosis, dermatitis, bone marrow suppression, or other hematologic disorder) Cautions Not to be used as the sole agent in treatment of RA No evidence that gold compounds induce remission of RA Gold toxicity Hemoglobin (decreased) Leukopenia (WBC <4000/cu.mm) [4 x10^9/L] Granulocytes (<1500/cu.mm) [1.5 x10^9/L] Platelets (<150 x 10^3/cu.mm) [150 x10^9/L] Proteinuria, hematuria, pruritus, rash, stomatitis, chronic diarrhea Pregnancy Category: C Lactation: enters breast milk/not recommendedPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Unknown Gold compound, has anti-inflammatory, antiarthritic, and immunomodulating effects Pharmacokinetics Peak plasma time: 2 hr Peak plasma concentration: 0.025 mcg/mL Onset of effects: 3-6 months Half-life: 21-31 days Protein bound: 60% Excretion: 50% urine; feces BRAND FORM. UNIT PRICE PILL IMAGE Ridaura oral- 3 mg capsuleCopyright © 2010 First DataBank, Inc.Print Patient Educationauranofin oral AURANOFIN - ORAL (aw-RAN-o-fin) COMMON BRAND NAME(S): Ridaura WARNING: This medication can cause serious (sometimes fatal) side effects, including diarrhea that doesn't go away, blood cell problems (such as anemia, low white blood cells/platelets), kidney problems, rash, itching, or mouth sores/irritation (stomatitis). Low white blood cells can increase your risk of infection. See Side Effects section for more details. Tell your doctor right away if you develop any of these side effects.Your doctor will be closely monitoring certain lab tests (such as white blood cells, platelets) before you start taking this medication and while you are taking it. It is important that you keep all medical/lab appointments. USES: This medication is used as part of a complete treatment program including non-drug therapies (such as rest, physical therapy) to treat active rheumatoid arthritis. It is used to treat patients with severe rheumatoid arthritis who have not responded to or cannot take other medications. Auranofin is a gold compound.Auranofin is not a true pain reliever (such as like aspirin) but it is thought to decrease pain that occurs with arthritis by decreasing inflammation. It is known as a disease-modifying antirheumatic drug (DMARD). It decreases morning stiffness and pain/swelling in joints and can increase grip strength. HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start taking auranofin and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with or without food as directed by your doctor, usually once or twice a day. Dosage is based on your medical condition and response to therapy. To decrease side effects such as upset stomach, your doctor may start you at a low dose (once a day) and slowly increase to twice a day. Do not increase your dose or take this medication more often without your doctor's approval. Your condition will not improve any faster, and the risk of serious side effects may be increased. The usual maximum adult dose is 9 milligrams each day.Almost half of all patients have diarrhea or more frequent/loose stools while taking this medication. If this lasts or becomes a problem, your doctor may lower the dose or have you temporarily stop the medication. Do not stop or change the dose of your medicine without talking with your doctor.Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time(s) each day.If you have been receiving gold injections, you can usually start taking gold by mouth as soon as you stop the injections. If you are changing over from penicillamine, you will usually need to wait 1 month after stopping the penicillamine before starting auranofin. Ask your doctor for more details.It may take 3 to 4 months of therapy before you see the full benefits of this medication.Inform your doctor if your condition lasts or gets worse. SIDE EFFECTS: See also How to Use section.Stomach/abdominal cramping may occur, usually within the first several hours after taking this medication. Nausea, loss of appetite, heartburn, and headache may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: eye redness/pain, hair loss, numbness/tingling of arms/legs, signs of low blood count (such as fast/pounding heartbeat, pale skin, unusual tiredness), easy bleeding/bruising, black/bloody stools, cough that doesn't go away, mucus/pus/blood in watery diarrhea, difficult/painful breathing, dizziness, signs of infection (such as sore throat that doesn't go away, fever), severe stomach/abdominal pain, change in the amount/color of urine, vomit that looks like coffee grounds, yellowing eyes/skin.This medication may cause mouth/lip/throat sores (stomatitis). Tell your doctor if you notice a metallic taste in your mouth. This could be the first sign of stomatitis. Rinsing your mouth with a mild salt solution may provide some relief. Discuss with your doctor.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: itching/swelling (especially of the face/tongue/throat), rash, severe dizziness, trouble breathing.Auranofin can commonly cause a rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe reaction. Get medical help right away if you develop any rash.This is not a complete list of possible side effects. If