Lisinopril and Gold Sodium Thiomalate: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Lisinopril
Gold Sodium Thiomalate
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Here's what this means for you. If you get gold shots (gold sodium thiomalate) for your arthritis while also taking lisinopril for blood pressure, there's a small chance you could have what's called a nitritoid reaction around the time of the injection. That can look like sudden facial flushing, feeling sick to your stomach, throwing up, and feeling lightheaded or dizzy from a drop in blood pressure.
The good news is this is uncommon, and your care team knows to watch for it. They can monitor you closely after your injections and manage this if it happens. Let them know if you feel flushed, sick, or dizzy after a shot.
Effect: Concomitant injectable gold sodium thiomalate (sodium aurothiomalate) and an ACE inhibitor such as lisinopril have been associated with nitritoid reactions (facial flushing, nausea, vomiting, hypotension), typically peri-injection.
- Mechanism: Unknown; not a clearly defined PK interaction. Neither agent is metabolically activated in a way that alters the other.
- Onset: Unspecified; reactions occur around dosing.
- Evidence: Probable, based on rare case reports.
- Severity: Moderate.
- Management: Use caution when combined; monitor vital signs and for vasomotor symptoms during and after gold injections.
What happens
Nitritoid reactions (facial flushing, nausea, vomiting, and hypotension)
Interaction Deep Dive
In uncommon cases, taking injectable gold sodium thiomalate together with an ACE inhibitor like fosinopril or lisinopril has led to nitritoid reactions, which can present with facial flushing, nausea, vomiting, and low blood pressure12.
Why it happens (mechanism)
Unknown
How to manage this interaction
What your care team may do:
- Keep giving your gold injections and blood pressure medicine as prescribed, but watch you more closely, especially right after each shot.
- Check your blood pressure and look for flushing, nausea, or vomiting around injection time.
- If reactions occur, your team may adjust your treatment or consider an alternative.
What you should do: Take both medications as directed and don't stop either on your own. Tell your pharmacist or prescriber if you notice facial flushing, nausea, vomiting, or feeling dizzy or faint after a gold injection.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Lisinopril and Gold Sodium Thiomalate together?
Combining gold sodium thiomalate injections with lisinopril can rarely trigger a nitritoid reaction (flushing, nausea, vomiting, and low blood pressure), so your team should watch you around injection time. Keep taking both as prescribed and report any of these symptoms. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lisinopril and Gold Sodium Thiomalate interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Lisinopril and Gold Sodium Thiomalate interaction managed?
What your care team may do: Keep giving your gold injections and blood pressure medicine as prescribed, but watch you more closely, especially right after each shot. Check your blood pressure and look for flushing, nausea, or vomiting around injection time. If reactions occur, your team may adjust your treatment or consider an alternative. What you should do: Take both medications as directed and… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Lisinopril or Gold Sodium Thiomalate need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (2)
Keep reading about Lisinopril
Keep reading about Gold Sodium Thiomalate
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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