Penicillamine , antimalarials, immnospressants, cyclotoxics, phenylbutazone, levamisole,

high dose steroids, warfarin, colonidine, propoxyphene,

other DMARDs, aminoglycosides, amphotericin B penicillins, phenytoin, sulphonamides NSAIDs,

acyclovir, alcohol, metal agonists, nephrotics, haemotoxics,

Rheumatoid arthiritis inadequately controlled by NSAIDs

Diarrhea, nausea, Abdominal pain, Ulcerative colitis,

Rashes, pruritis, Stomatitis, alopecia,

Conjuctivitis, Taste disturbances

Blood dyscrasiasis, Nephrotoxic syndrome,

Pulmonary fibrosis,

Photosentivity Lens and corneal deposits

Bone marrow depression

Proteinuria, haematuria GI upset,

Exfolitaive dermatisis. Chloestatic jaundice,

Goid bronchitis, pneumonitis,

Peripheral neuropathy, changes in liver function

Exfoliative dermatitis, SLE, necrotising enterocolitis, pulmonary fibrosis,

severe renal/hepatic dysfunction.

Pregnancy and lactation.

Special precautions:

Haemotological disorders,diabetes.CCF,H/o allergies.

Contains 29% Gold

Indications:

Rheumatoid arthiritis inadequately controlled by NSAIDs

Dosage:

Adults - 6 mg/day as 3 mg twice daily or 6 mg once daily.

EVIDENCE BASED MEDICINE (MIMS -April 2003)

Pain of Osteoarthiritis

Comparative effectiveness of various interventions

Beneficial

1. Systemic simple analgesics (eg paracetamol for short term pain relief, and improvement in function)

2. Systemic NSAIDs (short term pain relief and improvement in function)

3. Topical agents (short term pain relief)

Likely to be beneficial

1. Education, dietary advice,empowerment and support ( improved knowledge of disease and pain relief)

2. Physical support (pain relief and improvement in function)

KEY POINTS

1. There is no good evidence that NSAIDs were superior to simple analgesics such as paracetamol or to suggest that any one of the many available NSAIDs had greater efficacy in relieving pain of osteoarthritis.

2. One systematic review of randomised controlled trials has found that topical agents provide pain relief in patients with osteoarthritis and offer a non-toxic alternative to systemic drug treatment. However there is no evidence to indicate whether the prescribed agents were superior to less expensive, non-prescribtion drugs over the counter (OTC) alternatives, or to other local treatments such as hot or cold packs.

Refer gold compounds

Refer gold compounds

Take with meal or a light snack
 

Refer gold compounds