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Gold Sodium Thiomalate and Penicillamine

Determining the interaction of Gold Sodium Thiomalate and Penicillamine and the possibility of their joint administration.

Check result:
Gold Sodium Thiomalate <> Penicillamine
Relevance: 20.09.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Ask your doctor before using gold sodium thiomalate together with penicillAMINE. Using these medications together can increase the side effects of either medication. This can cause fever, chills, sore throat, unusual bruising or bleeding, coughing, wheezing, unexplained shortness of breath, muscle weakness, or double vision. If your doctor prescribes these medications together, you may need a dose adjustment or special tests to safely take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

GENERALLY AVOID: The concomitant use of penicillamine and gold salts may potentiate the risk of serious hematologic, dermatologic and renal adverse reactions due to overlapping toxicity profiles of these drugs. With respect to sequential use, prior development of toxicity with gold salts may be associated with increased risk of toxicity, though not necessarily of the same type, during subsequent therapy with penicillamine. Some studies have reported a higher frequency of penicillamine adverse reactions in patients who had previously experienced major toxic reactions with gold compounds, particularly proteinuria and bone marrow depression. One group of investigators found that to be true when penicillamine was prescribed less than 6 months after an adverse reaction to gold, and a shorter time interval between treatments was associated with more similar toxic effects to both drugs. Based on these findings, they suggested that the mechanism might involve mobilization of gold stores from various tissues via chelation with penicillamine. Another investigator suggested a genetic predisposition, while others have not found a predictable pattern of penicillamine toxicity based on previous gold use or intolerance or interval between treatments.

MANAGEMENT: Penicillamine and gold therapy should not be administered concurrently. Penicillamine may be prescribed following discontinuation of gold therapy, although some have suggested waiting a period of at least six months between treatments. Patients should be monitored closely and advised to notify their physician if they experience signs and symptoms of penicillamine toxicity such as fever, chills, sore throat, unusual bruising or bleeding, hematuria, coughing, wheezing, unexplained shortness of breath, muscle weakness, or double vision.

References
  • Goldberg IJ, Lawton K, Redding JR, Francois PE, Phull J "Influence of previous gold toxicity on subsequent development of penicillamine toxicity." Br Med J (Clin Res Ed) 285 (1982): 1659
  • Calin A "Adverse reactionsto D-penicillamine after gold toxicity." Br Med J 281 (1980): 454
  • Halla JT, Cassady J, Hardin JG "Sequential gold and penicillamine therapy in rheumatoid arthritis." Am J Med 72 (1982): 423-6
  • Netter P, Bannwarth B, Pere P, Nicolas A "Clinical pharmacokinetics of D-penicillamine." Clin Pharmacokinet 13 (1987): 317-33
  • Kean WF, Lock CJ, Howard-Lock HE, Buchanan WW "Prior gold therapy does not influence the adverse effects of D-penicillamine in rheumatoid arthritis." Arthritis Rheum 25 (1982): 917-22
  • Billingsley LM, Stevens MB "The relationship between D-penicillamine--induced proteinuria and prior gold nephropathy." Johns Hopkins Med J 148 (1981): 64-7
  • Kean WF, Dwosh IL, Anastassiades TP, Ford PM, Kelly HG "The toxicity pattern of D-penicillamine therapy. A guide to its use in rheumatoid arthritis." Arthritis Rheum 23 (1980): 158-64
  • Webley M, Coomes EN "An assessment of penicillamine therapy in rheumatoid arthritis and the influence of previous gold therapy." J Rheumatol 6 (1979): 20-4
  • Haagsma CJ "Clinically important drug interactions with disease-modifying antirheumatic drugs." Drugs Aging 13 (1998): 281-9
  • Day RO, Graham GG, Champion GD, Lee E "Anti-rheumatic drug interactions." Clin Rheum Dis 10 (1984): 251-75
  • Dodd MJ, Griffiths, Thompson M "Adverse reactions to D-penicillamine after gold toxicity." Br Med J 280 (1980): 1498-9
  • Smith PJ, Swinburn WR, Swinson DR, Stewart IM "Influence of previous gold toxicity on subsequent development of penicillamine toxicity." Br Med J 285 (1982): 595
  • Davis P, Barraclough D "Interaction of D-penicillamine with gold salts: in vivo studies on gold chelation and in vitro studies on protein binding." Arthritis Rheum 20 (1977): 1413-8
  • "Product Information. Cuprimine (penicillamine)." Merck & Co, Inc, West Point, PA.
Gold Sodium Thiomalate

Generic Name: gold sodium thiomalate

Brand name:

Synonyms: n.a.

Penicillamine

Generic Name: penicillamine

Brand name: Cuprimine, Depen, D-Penamine, Depen Titratabs

Synonyms: PenicillAMINE

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle