Auranofin

Drug Levels and Effects:




Summary of Use during Lactation:


Excretion of gold into milk after auranofen has not been studied. Case reports with other gold salts indicate that gold appears in milk in small quantities and at least a little of it is absorbed because it is detectable in the infant's urine. No convincing cases of toxicity have been reported. Opinions of authors of review articles vary from recommending avoidance to allowing use.[1][2][3][4][5] Monitoring for possible adverse effects in the breastfed infant would seem prudent.


Drug Levels:


Maternal Levels.

Relevant published information was not found as of the revision date.

Infant Levels.

Relevant published information was not found as of the revision date.


Effects in Breastfed Infants:


Four infants reportedly have been breastfed during maternal gold therapy (including goldsodiumthiomalate and gold aurothioglucose).[6][7][8][9] Transient facial edema occurred in an 18-month-old infant, 3 months after the mother's treatment stopped.[6] The reaction was possibly due to gold in the mother's milk ingested by the infant.


Possible Effects on Lactation:


Relevant published information was not found as of the revision date.


Alternate Drugs to Consider:


(Rheumatoid Arthritis) Etanercept,GoldSodiumThiomalate,Hydroxychloroquine,Infliximab,Methotrexate,Penicillamine,Sulfasalazine


References:


1. Ostensen M. Treatment with immunosuppressive and disease modifying drugs during pregnancy and lactation. Am J Reprod Immunol. 1992;28:148-52. PMID:1285866
2. Rayburn WF. Connective tissue disorders and pregnancy. Recommendations for prescribing. J Reprod Med. 1998;43:341-9. PMID:9583066
3. Janssen NM and Genta MS. The effects of immunosuppressive and anti-inflammatory medications on fertility, pregnancy and lactation. Arch Intern Med. 2000;160:610-9. PMID:10724046
4. Ramsey-Goldman R, Schilling E. Optimum use of disease-modifying and immunosuppressive antirheumatic agents during pregnancy and lactation. Clin Immunother. 1996;5:40-58.
5. Brooks PM, Needs CJ. Antirheumatic drugs in pregnancy and lactation. Baillieres Clin Rheumatol. 1990;4:157-71. PMID:2282661
6. Bell RA, Dale IM. Gold secretion in maternal milk. Arthritis Rheum. 1976;19:1374. Letter. PMID:826260
7. Sorensen SS. [Pharmacodynamic examination of patients treated with gold preparations] Nord Med. 1970;84:1508. Letter. PMID:5494985
8. Bennett PN, Humphries SJ, Osborne JP et al. Use ofsodiumaurothiomalate during lactation. Br J Clin Pharmacol. 1990;29:777-9. PMID:2116162
9. Blau SP. Metabolism of gold during lactation. Arthritis Rheum. 1973;16:777-8. Letter. PMID:4757877



Substance Identification:




Substance Name:

Auranofin

CAS Registry Number:

34031-32-8

Drug Class:


  • Antirheumatic Agents


  • Administrative Information:




    LactMed Record Number:


    18


    Last Revision Date:


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