Also known as Auranofina, Auranofine, Auranofinum, Auroafen, Ridaura, Triethylphosphine gold

An orally available, lipophilic, organogold compound, used to treat rheumatoid arthritis, with anti-inflammatory and potential antineoplastic activities. Auranofin interacts with selenocysteine residue within the redox-active domain of mitochondrial thioredoxin reductase (TrxR), thereby blocking the activity of TrxR. As a result, this agent induces mitochondrial oxidative stress leading to the induction of apoptosis. Furthermore, this agent strongly inhibits the JAK1/STAT3 signal transduction pathway, thereby suppressing expression of immune factors involved in inflammation. TrxR, overexpressed in many cancer cell types, inhibits apoptosis, promotes cell growth and survival and plays a role in resistance to chemotherapy; TrxR catalyzes the reduction of oxidized thioredoxin (Trx) and plays a central role in regulating cellular redox homeostasis.

Originator: NCI Thesaurus | Source: The website of the National Cancer Institute (http://www.cancer.gov)

Can I take Auranofin while breastfeeding?

Excretion of gold into milk after auranofen has not been studied. Case reports with other gold salts indicate that gold appears in milk in small quantities and at least a little of it is absorbed because it is detectable in the infant’s urine. No convincing cases of toxicity have been reported. Opinions of authors of review articles vary from recommending avoidance to allowing use.[1][2][3][4][5] Monitoring for possible adverse effects in the breastfed infant would seem prudent.

Drug levels

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Possible effects on lactation

Relevant published information was not found as of the revision date.

Alternate drugs to consider

Etanercept, Gold Sodium Thiomalate, Hydroxychloroquine, Infliximab, Methotrexate, Penicillamine, Sulfasalazine

References

1. Ostensen M. Treatment with immunosuppressive and disease modifying drugs during pregnancy and lactation. Am J Reprod Immunol. 1992;28:148-52. PMID: 1285866

2. Rayburn WF. Connective tissue disorders and pregnancy. Recommendations for prescribing. J Reprod Med. 1998;43:341-9. PMID: 9583066

3. Janssen NM and Genta MS. The effects of immunosuppressive and anti-inflammatory medications on fertility, pregnancy and lactation. Arch Intern Med. 2000;160:610-9. PMID: 10724046

4. Ramsey-Goldman R, Schilling E. Optimum use of disease-modifying and immunosuppressive antirheumatic agents during pregnancy and lactation. Clin Immunother. 1996;5:40-58.

5. Brooks PM, Needs CJ. Antirheumatic drugs in pregnancy and lactation. Baillieres Clin Rheumatol. 1990;4:157-71. PMID: 2282661

6. Bell RA, Dale IM. Gold secretion in maternal milk. Arthritis Rheum. 1976;19:1374. Letter. PMID: 826260

7. Sorensen SS. [Pharmacodynamic examination of patients treated with gold preparations] Nord Med. 1970;84:1508. Letter. PMID: 5494985

8. Bennett PN, Humphries SJ, Osborne JP et al. Use of sodium aurothiomalate during lactation. Br J Clin Pharmacol. 1990;29:777-9. PMID: 2116162

9. Blau SP. Metabolism of gold during lactation. Arthritis Rheum. 1973;16:777-8. Letter. PMID: 4757877

Last Revision Date

20150310

Disclaimer:Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

Source: LactMed – National Library of Medicine (NLM)