Ridaura (auranofin) is a disease-modifying antirheumatic drug (DMARD) used to manage symptoms of active rheumatoid arthritis when other treatments haven't been effective. As a gold-containing medication, it requires careful monitoring for potential adverse reactions that can affect various body systems. Side effects can happen at any time but are often seen within the first six months of starting treatment.
Common Side Effects of Ridaura
Many patients in clinical studies experienced gastrointestinal and skin-related issues. The most frequently reported side effects are:
- Gastrointestinal: Diarrhea or loose stools (in up to 47%), abdominal pain (14%), nausea (10%), constipation, appetite loss, and gas.
- Dermatological: Rash (24%) and itching (17%).
- Mucous Membrane: Mouth sores (stomatitis) (13%), conjunctivitis (pink eye), and a metallic taste in the mouth.
- Other: Hair loss (alopecia).
These reactions often appear early in treatment and may improve with a lower dose. However, any persistent or worsening symptoms should be reported to a healthcare provider.
Serious Side Effects and Gold Toxicity
The gold in Ridaura can be toxic, leading to severe complications that can be life-threatening. It is important to watch for signs of gold toxicity.
Blood Disorders
Ridaura can cause blood disorders that affect blood cell counts. These can occur suddenly and include:
- Thrombocytopenia: A low number of platelets, which can cause easy bruising or bleeding.
- Leukopenia: A low white blood cell count, increasing the risk of infection. Symptoms include fever, chills, and sore throat.
- Aplastic Anemia: A rare but serious condition where the bone marrow doesn't make enough new blood cells.
Kidney Problems
Gold can harm the kidneys and lead to significant issues. Signs of kidney problems include:
- Protein in the urine (proteinuria)
- Blood in the urine (hematuria)
- Swelling in the ankles, feet, or face
- Changes in how often you urinate
- Foamy urine
Pulmonary Complications
In rare instances, Ridaura can cause lung damage, such as interstitial pneumonitis and pulmonary fibrosis. Symptoms to watch for include:
- Shortness of breath
- Dry cough
- Wheezing
- Sudden chest pain
Severe Allergic Reactions
Some patients may have a severe allergic reaction (anaphylaxis). Emergency signs include hives, trouble breathing, or swelling of the face, lips, tongue, or throat.
Comparison of Ridaura and Injectable Gold
Injectable gold was historically the primary gold treatment. Studies have compared the side effects of oral Ridaura and injectable gold.
| Side Effect | Ridaura (Oral) | Injectable Gold |
|---|---|---|
| Diarrhea | Very common (up to 47%) | Less common (about 13%) |
| Rash | Common (up to 26%) | More common (up to 39%) |
| Stomatitis (Mouth Sores) | Common (about 13%) | Common (about 18%) |
| Proteinuria (Protein in Urine) | Less common (0.9%) | More common (5.4%) |
| Thrombocytopenia | Less common (0.9%) | Less common (2.2%) |
Overall, Ridaura is linked to more frequent stomach and bowel issues, while injectable gold is more often associated with skin and kidney problems. Patients switching from injections to Ridaura should be aware of these differences in side effects.
Monitoring and When to Seek Medical Attention
Due to the risk of serious gold toxicity, regular monitoring is necessary throughout Ridaura treatment. Your doctor will order frequent lab tests, including blood counts and tests for kidney and liver function.
Contact your healthcare provider immediately if you experience any signs of potential toxicity:
- Signs of blood disorders: Unusual bruising or bleeding, persistent fever or sore throat, pale skin, or unexplained tiredness.
- Signs of kidney problems: Blood in the urine, foamy urine, swelling in the ankles or feet, or a big change in urination.
- Signs of lung issues: Shortness of breath, dry cough, or wheezing.
- Signs of allergic reaction: Hives, itching, or swelling of the face, tongue, or throat.
- Gastrointestinal distress: Persistent or severe diarrhea, nausea, or vomiting.
- Oral reactions: Mouth sores or a persistent metallic taste.
Conclusion
Ridaura can be effective for rheumatoid arthritis but has potential side effects, from common digestive and skin issues to rare but serious gold toxicity affecting the blood, kidneys, and lungs. Working closely with a healthcare provider and getting regular lab tests are vital for managing these risks. Being aware of adverse reactions can help patients stay safe and get the most benefit from Ridaura. For more detailed prescribing information, you can refer to resources like this one: Drugs.com: Ridaura (auranofin): Side Effects, Uses, Dosage, Interactions.
This content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider for any health concerns or before making decisions related to your treatment.
