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Although rare, blood dyscrasias including granulocytopenia, agranulocytosis, thrombocytopenia with or without purpura, leukopenia, eosinophilia, panmyelopathy, hemorrhagic diathesis, and hypoplastic and aplastic anemia, have been reported. These reactions may occur separately or in combination.

/SIGNS AND SYMPTOMS/ Dermatitis is the most common reaction. Pruritus should be considered a warning signal of an impending cutaneous reaction. Erythema and occasionally the more severe reactions such as popular, vesicular, and exfoliative dermatitis leading to alopecia and shedding of the nails may occur. Chrysiasis (gray-to-blue pigmentation) has been reported, especially in photo-exposed areas. Gold dermatitis may be aggravated by exposure to sunlight, or an actinic rash may develop.

/SIGNS AND SYMPTOMS/ Less common but more severe effects that may occur shortly after injection or at any time in gold therapy include: anaphylactic shock, syncope, bradycardia, thickening of the tongue, difficulty in swallowing and breathing, and angioneurotic edema. If they are observed, treatment with Solganal suspension should be discontinued.

Aurothioglucose

Group 3: Not classifiable as to its carcinogenicity to humans

Volume 13: (1977) Some Miscellaneous Pharmaceutical Substances

1987

1987

Drug-Induced Liver Injury Severity and Toxicity (DILIst)

aurothioglucose

DILI Positive

Intramuscular

DOI:10.1016/j.drudis.2019.09.022

/LABORATORY ANIMALS: Chronic Exposure or Carcinogenicity/ Renal adenomas developed in rats receiving an injectable gold product similar to Solganal suspension at doses of 2 mg/kg weekly for 46 weeks followed by 6 mg/kg daily for 47 weeks. These doses were higher and administered more frequently than the recommended human doses. The adenomas were similar histologically to those produced by chronic administration of other gold compounds and heavy metals such as lead or nickel. Renal tubular cell neoplasia consisting of renal adenoma and adenocarcinoma were noted in dose-response relationship in another study in rats using daily intramuscular doses of 3 mg/kg and 6 mg/kg for up to 2-years. These doses were higher and administered more frequently than the recommended human doses. In this same study, sarcomas at the injection site occurred in some rats but their numbers were not sufficient to demonstrate a dose-response relationship.

/LABORATORY ANIMALS: Developmental or Reproductive Toxicity/ Myochrysine /aurothioglucose/ has been shown to be teratogenic during the organogenetic period of in rats and rabbits Hydrocephaly and microphthalmia were malformation observed in rats when myochrysine was administered subcutaneously at a dose of 25 mg/kg/day from day 6 through day 15 of gestation. In rabbits, limb malformations and gastroschisis were the malformations observed when myochrysine was administered subcutaneously at doses 20 to 45 mg/kg/day from day 6 through day 18 of gestation.

In the event of toxic reactions gold therapy should be discontinued immediately. In the presents of mild reactions, it may be sufficient to discontinue the administration of Solganal /aurothioglucose/ suspension for a short period and then to resume treatment with smaller doses.

Dermatitis and pruritus may respond to soothing lotions, other appropriate antipruritic treatment or topical glucocorticoids.

If dermatitis or stomatitis becomes severe or spreads, systemic glucocorticoid treatment may be indicated. For renal hematologic, and most other adverse reactions, glucocorticoids may be required in larger doses and for longer time than dermatologic reactions. Often this treatment may be required for many months because of the slow elimination of gold from the body.

If severe adverse reactions do not improve with steroid treatment in patients who receive large doses of gold, a chelating agent, such as dimercaprol (BAL), may be used. In one case it was reported that penicillamine was beneficial in the treatment of gold-induced thrombocytopenia. Adjunctive use of an anabolic steroid with other drugs (i.e., BAL, penicillamine, and corticosteroids) may contribute to recovery of bone marrow deficiency.

For more Antidote and Emergency Treatment (Complete) data for AUROTHIOGLUCOSE (7 total), please visit the HSDB record page.