Auranofin

What is auranofin?

Auranofin is a gold salt that is given orally to treat certain skin conditions and immune-mediated conditions in cats and dogs. It has been used to treat pemphigus foliaceous and idiopathic polyarthritis in cats and dogs. It has been used to treat eosinophilic granuloma complex, stomatitis, and plasma cell pododermatitis in cats.

Auranofin is being studied for its potential anticancer effects for osteosarcoma. This medication is not well studied in veterinary medicine and should only be used when conventional therapies are not well-tolerated and/or no longer effective.

It is used off label (extra label) in veterinary medicine. Many drugs are commonly prescribed for off-label use in veterinary medicine. “Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions very carefully, as their directions may be significantly different from those on the label.

How do I give my pet auranofin?

• Auranofin comes in capsule form. Capsules may be compounded into a liquid suspension.
• Capsules are given orally (by mouth).
• This medication is best taken with food.
• Measure compounded liquids carefully.
• Give this medication to your pet for the entire time prescribed by your veterinarian, even if it appears that your pet is feeling better.

This medication may take several doses for effects to be seen.

What if I miss giving my pet the medication?

If you miss a dose, give it as soon as you remember, and then continue with the regular dosing schedule. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not give the pet two doses at once.

Are there any potential side effects from auranofin?

Auranofin may cause the following side effects:

• Diarrhea
• Vomiting

Serious adverse reactions may occur. If any of the following signs develop, stop giving auranofin and contact your veterinarian immediately:

• An allergic reaction such as irregular breathing, rash, fever, puffiness and swelling around the face
• Signs of low platelets, low red blood cells, and/or low white blood cells (e.g., lethargy, pale gum color, weakness, unusual bruising or bleeding)
• Changes in bloodwork (complete blood count, kidney values, liver values)

Drug sensitivities can develop over time with repeated exposure. Your pet may have no reaction after the first few doses, but may develop a sensitivity later. It is important to watch for signs of an allergic reaction over the entire course of treatment.

Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This long-acting medication should stop working within several weeks, though effects can be longer in animals with kidney and/or liver disease.

Are there any risk factors for this medication?

DO NOT USE auranofin in:

• Pets who are allergic to any component
• Pets who have systemic lupus erythematous
• Pets who have bone marrow suppression
• Pets receiving bone marrow-suppressing drugs (e.g., azathioprine, cyclophosphamide)

USE WITH CAUTION in:

• Pets who are pregnant or nursing

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with auranofin:

• Antimalarial drugs
• Immunosuppressive drugs (e.g., corticosteroids azathioprine, leflunomide)
• Myelosuppressive drugs (e.g., cyclosporine, chlorambucil, cyclophosphamide)
• Theophylline, aminophylline
• Penicillamine

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any new treatment.

Is any monitoring needed with this medication?

• Baseline complete blood count (CBC), kidney and liver function blood tests, and urinalysis are required.
• Follow your veterinarian’s directions for lab work monitoring during treatment.
• At home, monitor for any abnormal changes. If any occur, discontinue the medication and contact your veterinarian.

How do I store auranofin?

• Store the medication in a tight, light-resistant container at room temperature of 59°F–86°F (15°C–30°C).
• Keep medication out of reach of children and pets.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet’s weight and symptoms.