Gold (myochrysine) is a Disease Modifying Anti-Rheumatic Drug (DMARD) that is used to treat Rheumatoid Arthritis and Psoriatic Arthritis.
Gold tends to be an older therapy and it is not commonly prescribed any more. It may be given to patients who have not responded to other medications, or to patients who cannot take other medications.
Gold is administered as an intramuscular injection once a week, usually into a muscle in the buttocks or thigh. Injections are usually given by a doctor or nurse.
When starting gold, a small “test dose” of 10mg is usually given in the first week to make sure patients are not sensitive to it. A second injection is given a week later, building up to 25mg. If there were no issues with the first two injections, then a dose of 50mg is usually given every week. In patients who respond well to gold, it may be possible to reduce the frequency to every two to four weeks.
Gold does not work right away. It can take 3 months for patients to start feeling the effects of gold, and up to 12 months to start feeling the maximum effects.
Important Tests and Risks
Patients who take Gold need to get regular blood and urine tests to continually monitor for side effects. It is important to make sure the medicine is having no harmful effects on the kidneys, liver, or to blood counts. Tests are usually done every week. For some patients who are responding well and have not experienced any problems after a long time, the testing frequency may be reduced.
Severe reactions called nitritoid reactions can occur when Gold is given to patients who are taking ACE-inhibitors, a type of medicine used to treat hypertension. These reactions can include severe lowering of blood pressure, flushing, nausea, and fainting.
Because gold therapy is not often used and tends to be an older therapy, we have created a handy information pamphlet to help primary care physicians understand the side effects of gold and how to handle them: Gold Information for Administering Health Care Practitioners (PDF).