Auranofin
Auranofin is an orally administered gold salt used in veterinary medicine primarily for its immunomodulatory properties (a practice known as **chrysotherapy**). * **Clinical Use**: Historically used for immune-mediated conditions like pemphigus foliaceus and idiopathic polyarthritis in dogs and cats. * **Efficacy vs. Toxicity**: It is generally considered less toxic but also less efficacious than injectable gold compounds (e.g., aurothioglucose). * **Modern Context**: Its use has largely been supplanted by newer, safer, and more effective immunosuppressants (e.g., cyclosporine, mycophenolate). * **Compounding Required**: Due to the commercial human capsule size (3 mg), it almost always requires compounding for accurate dosing in small animals.
Mecanismo: The exact mechanism of gold salts is not fully elucidated, but they possess anti-inflammatory, antirheumatic, and immunomodulating effects. * **Macrophage Inhibition**: Auranofin is taken up by macrophages → inhibits **phagocytosis** and suppresses **lysosomal enzyme activity**. * **Mediator Suppression**: Inhibits the release of **histamine** and the production of **prostaglandins**. * **T-Cell Modulation**: Selectively suppresses **helper T-cells (CD4+)** without significantly affecting suppressor T-cell populations, thereby dampening the autoimmune response.
Dosificación por especie
- Rescue drug for feline pemphigus and for idiopathic dermatoses and plasma cell pododermatitis/stomatitis · 0.2-0.3 mg/kg · PO · twice daily · Must be reformulated for accurate dosing.
- Immune-mediated arthropathies and dermatopathies · 0.05-0.2 mg/kg (up to 9 mg/day total dose) · PO · q12h
- Treatment of pemphigus complex (with corticosteroids) · 0.12-0.2 mg/kg · PO · twice daily
Las dosis son una referencia clínica para veterinarios colegiados. Confirme siempre con la ficha técnica vigente y el paciente individual.
Vías de administración
Contraindicaciones
- Systemic Lupus Erythematosus (SLE) - may exacerbate signs
- Pregnancy (known teratogen and maternotoxic)
Efectos adversos
- Immune-mediated thrombocytopenia (dose-dependent)
- Hemolytic anemia
- Leukopenia
- Gastrointestinal disturbances (particularly diarrhea, dose-dependent)
- Renal toxicity (proteinuria)
- Hepatotoxicity (increased liver enzymes)
- Dermatosis
- Corneal ulcers
Interacciones farmacológicas
- Cytotoxic agents (including high dose corticosteroids) · Safety when used with these agents has not been established; use with caution.
- Penicillamine · Increased potential for hematologic or renal toxicity; use with gold salts is not recommended.
- Antimalarial drugs · Increased potential for hematologic or renal toxicity; use with gold salts is not recommended.
Monitorización
- Hepatic function tests (baseline, monthly for 2-3 months, then every other month)
- Renal function tests including urinalysis (baseline, monthly for 2-3 months, then every other month)
- CBC with platelet counts (baseline, monthly for 2-3 months, then every other month). Note: eosinophilia may denote impending reactions.
Sobredosis
Very limited data is available. The minimum lethal oral dose in rats is 30 mg/kg. * **Decontamination**: Gut-emptying protocols should be employed after an acute overdose when applicable. * **Antidotes**: Chelating agents (e.g., penicillamine, dimercaprol) have been used for severe toxicities, but their use is controversial.
La referencia de fármacos de VetSheet está destinada a veterinarios colegiados como apoyo a la decisión clínica, no sustituye el juicio profesional ni la ficha técnica vigente del fabricante.