monitoring for safety
Last reviewed 06/2018
Gold therapy is potentially toxic and therefore the drug must be carefully monitored.
FBC, U&Es, urine dipstick Every 2 weeks until stable; then before each injection
Before each injection:
- FBC (watch Hb, MCV, Differential WCC & platelets for trends as well as absolute levels) - give injection only if previous result is available and satisfactory
- urinalysis for proteinuria or haematuria
ESR is monitored monthly.
Stop drug, inform specialist if:
- rash or mouth ulcers
- WBC < 3.5 x10^9/l
- platelets < 150 x 10^9/l
- haematuria or proteinura on two or more occasions - inform specialist, order MSU and 24-hour urinary protein
If suspicious symptoms or signs:
- urgent FBC if there are symptoms of infection(leucopenia)
- urgent platelets if bruising, bleeding(thrombocytopenia)
Ideally results should be recorded in a patient-held booklet
- Doctor magazine(December 2002). Disease-modifying anti-rheumatic drugs
- MeReC Bulletin 2007;17(5):1-8.