Clinical events of intramuscular gold

• Rash

Often non-specific erythematous dry & itchy. Stop drug if severe, consider using 1% hydrocortisone and/or antihistamines. Consider other causes. If mild re-introduce when settled.

• Mouth ulcers/Stomatitis

Stop if severe, reduce dose if mild/moderate. Consider carbenoxalone or difflam mouth washes. Consider other causes.

• Malaise, increased stiffness

Continue drug, reduce dose if necessary, usually settles as treatment continues.

Reduce dose, add fibre to diet. Stop if unacceptable

• Nitroid reaction - hypotension, flushing, nausea

Stop drug. Re-introduce drug at lower dose if not severe

• Dyspnoea

Stop drug. Pulmonary complications rare, but potentially serious, seek advice.

• visual disturbance

Stop drug. Can be deposits of drug in lens, seek advice.

• Alopecia

Stop drug if severe.