®
Publish public
Coordinator
Medicines Information pharmacist
Signature:
I Mweemba
Applies to: NHS Grampian Version 2
Authorised for issue by
Document no:
NHSG/SCPa/SoAu/MGPG348
Medicines Guidelines and Policies Group
Signature:
C Hind
Effective date:
August 2010
Review Date: August 2012
Supersedes: Version 1

PATIENT NAME
 HOSPITAL
UNIT NUMBER
CHI NUMBER TELEPHONE NO
ADDRESS CONSULTANT
(print name)
DATE OF BIRTH

Insert patient sticker here

SIGNATURE
WARD
DATE
THERAPEUTIC INDICATION FOR THIS PATIENT:
(to be completed by consultant)
DOSAGE/PREPARATION/ROUTE/FREQUENCY OF ADMINISTRATION:
(to be completed by consultant)
SAFE PRACTICE IS THAT THE CLINICIAN WHO ORDERS THE TEST MUST ACT ON THE RESULT
CARE WHICH IS THE RESPONSIBILITY OF
THE HOSPITAL CONSULTANT
1. Baseline: Full blood count (FBC); urinalysis; urea, creatinine and electrolytes (U&E); liver function tests(LFTs).
2. Copy of results to be sent to GP.
3. Exclude pregnancy before starting therapy, give advice on contraception, and advise to contact their physician immediately should pregnancy occur.
4. Initiation of therapy (an initial test dose of
10mg should be given in the first week) and recommendations for dose increments.
5. Decision on final dose required for patient
6. Monitoring clinical response to treatment.
7. Annual chest X-ray.
8. Advise patients to immediately report any sore throat, fever, infection, inexplicable bruising or bleeding, mouth ulcers, metallic taste, rash or any breathlessness or dry cough.
CARE WHICH IS THE RESPONSIBILITY OF THE
GENERAL PRACTITIONER
1. Prescribing of medication under guidance of consultant.
2. Check before prescribing medication that the monitoring is up to date and that results are within the normal range.
3. The GP should be aware that the drug can cause blood disorders, skin reactions.
 Patients should be asked about the presence of sore throat, rash, abnormal bruising or bleeding, oral ulceration before each injection.
When the patient has an intercurrent illness a FBC,
U&E and LFTs should be done and any abnormal results including those noted above should be reported to the consultant .
4. The General Practitioner has primary responsibility for monitoring therapy according to the schedule below
 FBC and urinalysis with each injection. (Ideally, these should be available before the injection is given although in most cases it is acceptable simply to ensure that the preceding FBC is satisfactory).
When writing laboratory request forms always include details of the patient’s medication
NOTE: in addition to absolute values for haematological indices a rapid fall or a consistent downward trend in any value should prompt caution and extra vigilance.
If something unexpected occurs contact consultant.
Notify the consultant if the drug is stopped.
UNCONTROLLED WHEN PRINTED Review Date August 2012 (sooner if recommendations change)
SCP and Prescribing Information for GPs for SODIUM AUROTHIOMALATE - Version 2, August 2010
NHSG/SCPa/SoAu//MGPG348
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®
Abnormal Monitoring Result
 WBC <4.0 x 10 9 /L
 Neutrophils <2.1 x 10 9 /L
 Platelets <150 x 10 9 /L
 Abnormal bruising or sore throat
 Rash or oral ulceration
 Proteinuria 2
or greater
Action To Be Taken
Withhold until discussed with consultant
Withhold until discussed with consultant
Withhold until discussed with consultant
Withhold until FBC result available
Withhold until discussed with consultant
Check MSSU: if infection, treat accordingly. If sterile and proteinuria persists, withhold until discussed with consultant
For specific product information please consult the current summary of product characteristics
( http://emc.medicines.org.uk/) and the BNF ( http://www.bnf.org/bnf/)
Other information
 If a total dose of 1g has been administered and no response has occurred, treatment should be stopped.
 If no response is seen at six months or loss of effect occurs, it is occasionally suggested that 100mg be given weekly for six weeks. Discuss with consultant.
 There are a number of drug interactions that must be considered. When a new drug is prescribed please refer to Summary of Product Characteristics , BNF or contact Medicines Information.
 Sodium aurothiomalate injection should be administered only by deep intramuscular injection followed by gentle massage of the area.
 The patient should remain under medical observation for allergic reactions for 30 minutes after drug administration.
Pregnancy
Discuss with consultant. Contra-indicated in pregnancy. Manufacturer advises patients should avoid pregnancy. Advise to contact their physician immediately should pregnancy occur.
Breast-feeding
Discuss with Aberdeen Maternity Hospital. Significant amounts excreted in breast milk, infants should not be breast-fed.
Responsibilities of GPs undertaking monitoring
A GP agreeing to monitor sodium aurothiomalate should:
 Ensure that the relevant monitoring requirements are undertaken at the correct frequency.
 Ensure that the test results are checked for any abnormality as soon as the results are available.
 Ensure abnormal results are acted upon.
 Only continue to prescribe sodium aurothiomalate if it is being satisfactorily monitored.
 Contact the consultant in the event of a drug reaction or monitoring abnormality or anything you are unhappy about.
 Be alert for any of the known adverse reactions.
** The patient should be encouraged to ensure blood tests are taken at the correct intervals. **
UNCONTROLLED WHEN PRINTED Review Date August 2012 (sooner if recommendations change)
SCP and Prescribing Information for GPs for SODIUM AUROTHIOMALATE - Version 2, August 2010
NHSG/SCPa/SoAu//MGPG348
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