In order for this medicine to work, it must be taken regularly as ordered by your doctor. Continue receiving the injections or taking auranofin even if you think the medicine is not working. You may not notice the effects of this medicine until after three to six months of regular use.

For patients taking auranofin:

• Do not take more of this medicine than ordered by your doctor. Taking too much auranofin may increase the chance of serious unwanted effects.

If you have any questions about this, check with your doctor.

Dosing

The dose of these medicines will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

For auranofin
• For oral dosage form (capsules):
  • For arthritis:
    • Adults 6 milligrams (mg) once a day or 3 mg twice a day. After six months, your doctor may increase the dose to 3 mg three times a day.
    • Children Dose must be determined by your doctor.

For aurothioglucose
• For injection dosage form:
  • For arthritis:
    • Adults and teenagers 10 milligrams (mg) for the first dose, then 25 mg once a week for the next two weeks, then 25 or 50 mg once a week. The medicine is injected into a muscle. After several months, the injections may be given less often (25 or 50 mg every two weeks for a while, then every three or four weeks).
    • Children 6 to 12 years of age 2.5 mg for the first dose, then 6.25 mg once a week for the next two weeks, then 12.5 mg once a week. The medicine is injected into a muscle. After several months, the injections may be given less often (6.25 or 12.5 mg every three or four weeks).
    • Children younger than 6 years of age Dose must be determined by your doctor.

For gold sodium thiomalate
• For injection dosage form:
  • For arthritis:
    • Adults and teenagers 10 milligrams (mg) for the first dose, then 25 mg a week later, then 25 or 50 mg once a week. The medicine is injected into a muscle. After several months, the injections may be given less often (25 or 50 mg every two weeks for a while, then every three or four weeks).
    • Children 10 mg for the first dose, then 1 mg per kilogram (about 0.45 mg per pound) of body weight, but not more than a total of 50 mg, once a week. The medicine is injected into a muscle. After several months, the same dose may be given less often (every two weeks for a while, then every three or four weeks).

Missed dose

For patients taking auranofin: If you miss a dose of this medicine, and your dosing schedule is

• One dose a day Take the missed dose as soon as possible. However, if you do not remember until the next day, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
• More than one dose a day Take the missed dose as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For gold compounds, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to gold or other metals, if you have received a gold compound before and developed serious side effects from it, or if any medicine you have taken has caused an allergy or a reaction that affected your blood. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy Studies on birth defects with gold compounds have not been done in humans. However, studies in animals have shown that gold compounds may cause birth defects.

Breast-feeding Aurothioglucose and gold sodium thiomalate pass into the breast milk and may cause unwanted effects in nursing babies. It is not known whether auranofin passes into the breast milk.

Children Auranofin has been tested only in adult patients and there is no specific information about its use in children. However, aurothioglucose and gold sodium thiomalate have been tested in children and have not been shown to cause different side effects or problems than they do in adults.

Older adults These medicines have been tested and have not been shown to cause different side effects or problems in older people than they do in younger adults.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking a gold compound, it is important that your health care professional know if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine, especially:

• Penicillamine (e.g., Cuprimine) The chance of side effects may be increased.

• Blood or blood vessel disease or
• Colitis or
• Kidney disease (or history of) or
• Lupus erythematosus or
• Sjögren's syndrome or
• Skin disease The chance of unwanted effects may be increased