Auranofin
Auranofin is a gold-containing oral capsule used to treat active rheumatoid arthritis in adults who haven't responded well to other anti-inflammatory medicines.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 2 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
Auranofin (Ridaura) is an oral gold medicine for active rheumatoid arthritis that anti-inflammatories such as ibuprofen have not controlled. It is thought to calm the inflamed joint lining, and it is an older standby, on the market since about 1985 and available as a generic, now rarely prescribed because methotrexate and newer drugs usually come first. Loose stools or diarrhea are very common and often the first thing people notice, with stomach upset, itching and hair loss also possible. Its boxed warning is gold toxicity, so blood and urine tests are reviewed before every prescription, and bruising, bleeding, rash, mouth sores or persistent diarrhea mean calling your prescriber right away.
Clinical pearls
- Relief usually takes three to six months, and it cannot undo joint damage already done, so early, active disease benefits most.
- Gold lingers in the body for a long time, so reactions can surface after months; report foamy urine or new breathlessness.
- If you take phenytoin for seizures, tell that prescriber, because auranofin may raise phenytoin levels.
- Coming from gold injections, expect fewer side effects but possibly a weaker effect, as trials found when the two were compared.
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert ▾
Auranofin contains gold, and gold can be toxic. Before each prescription is filled, your doctor is required to review your latest lab results to check for early warning signs of gold toxicity. These warning signs include a drop in red blood cells (anemia), low white blood cell or platelet counts, protein or blood in the urine, skin rash, itching, mouth sores, or persistent diarrhea. Auranofin is only appropriate for carefully selected patients with active rheumatoid arthritis, and your prescriber should be trained and experienced in gold therapy. Report any new or unusual symptoms to your doctor right away — don't wait for your next appointment.
Patient information guide A plain-language walkthrough of Auranofin, written from its FDA label.
What Auranofin is used for
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Auranofin capsules are approved to treat active rheumatoid arthritis in adults. Here's who qualifies:
- Ridaura (auranofin) capsules are indicated for adults with active classical or definite rheumatoid arthritis who haven't had enough benefit from — or cannot tolerate — a full course of one or more NSAIDs.
- Auranofin capsules carry the same indication: active rheumatoid arthritis in adults with an inadequate response or intolerance to NSAIDs.
- Both products are meant to be added to a full treatment program that includes non-drug therapies — not used alone.
- Neither product can reverse bone or cartilage damage that has already occurred; the greatest benefit is in patients with active joint inflammation (synovitis), especially early in the disease.
How Auranofin works
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Auranofin contains gold, and gold has long been known to reduce inflammation in rheumatoid arthritis — though researchers still don't fully understand exactly how. In the body, auranofin is quickly broken down and the gold is absorbed into the bloodstream, where it binds to proteins and red blood cells. It appears to reduce synovitis (inflammation of the joint lining) and lower certain blood markers of disease activity, such as ESR (erythrocyte sedimentation rate, a measure of inflammation). There's no strong evidence that it causes full remission of rheumatoid arthritis, but it can meaningfully reduce symptoms and slow disease activity in many patients.
Auranofin dosage
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Auranofin capsules are taken by mouth. Both Ridaura and Auranofin capsules are typically taken once or twice a day, as directed by your prescriber. If your response after six months isn't adequate, your doctor may consider a higher frequency — but there's an upper limit, and doses above that haven't been studied for safety.
- Don't start at a higher-than-recommended dose — this increases the risk of diarrhea.
- If you're switching from injectable gold, Ridaura or Auranofin capsules are started at the standard daily dose once the injections are stopped.
- Always follow your prescriber's instructions exactly, and don't adjust your dose on your own.
Dosing details from the FDA-approved label
From the Auranofin prescribing information (“Dosage and Administration”). Doses are set by your prescriber for your product, condition, kidney function and age — never change a dose on your own.
- Usual adult dosage
- 6 mg daily, given either as 3 mg twice daily or 6 mg once daily
- If response is inadequate after six months, an increase to 9 mg (3 mg three times daily) may be tolerated
- Maximum: Safety at dosages exceeding 9 mg daily has not been studied
- Initiation at dosages exceeding 6 mg daily is not recommended because of increased incidence of diarrhea; discontinue if response remains inadequate after a three-month trial of 9 mg daily
- Transferring from injectable gold
- Discontinue the injectable agent and start oral therapy with 6 mg daily
- Patients should be informed of the adverse reaction profile, in particular gastrointestinal reactions; data beyond six months are not available
Read the label’s full dosing text
DOSAGE AND ADMINISTRATION Usual Adult Dosage: The usual adult dosage of Auranofin Capsules (auranofin) is 6 mg daily, given either as 3 mg twice daily or 6 mg once daily. Initiation of therapy at dosages exceeding 6 mg daily is not recommended because it is associated with an increased incidence of diarrhea. If response is inadequate after six months, an increase to 9 mg (3 mg three times daily) may be tolerated. If response remains inadequate after a three-month trial of 9 mg daily, Auranofin therapy should be discontinued. Safety at dosages exceeding 9 mg daily has not been studied. Transferring from Injectable Gold: In controlled clinical studies, patients on injectable gold have been transferred to Auranofin Capsules (auranofin) by discontinuing the injectable agent and starting oral therapy with Auranofin Capsules, 6 mg daily. When patients are transferred to Auranofin Capsules, they should be informed of its adverse reaction profile, in particular the gastrointestinal reactions. (See PRECAUTIONS— Information for Patients .) At six months, control of disease activity of patients transferred to Auranofin Capsules and those maintained on the injectable agent was not different. Data beyond six months are not available.
Read the full Dosage and Administration section on DailyMed →
Auranofin side effects
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Gastrointestinal side effects are the most common, especially in the first six months. Here's what to expect:
Common side effects
- Loose stools or diarrhea (very common)
- Stomach pain or nausea
- Skin rash or itching
- Mouth sores (stomatitis)
- Hair loss
- Loss of appetite
- Protein in the urine
- Elevated liver enzymes
- Diarrhea or loose stools — affects close to half of patients
- Nausea or vomiting
- Skin rash or itching — affects roughly 1 in 4 patients
- Loss of appetite or indigestion
When to get medical help
- Call your doctor right away if you notice unusual bruising, tiny red spots on the skin, or bleeding — these could be signs of a dangerous drop in platelets (thrombocytopenia).
- Get medical help immediately if you develop mouth sores, a rash, or persistent diarrhea — these can be signs of gold toxicity.
- Tell your doctor if you notice swelling, foamy urine, or blood in the urine — this may signal kidney problems.
- Seek help promptly if you have shortness of breath or difficulty breathing, which could indicate a rare lung reaction (interstitial pneumonitis).
- Report any signs of severe infection or unusual fatigue — auranofin can lower white blood cell counts.
- If you develop yellowing of the skin or eyes (jaundice), contact your doctor immediately.
Serious reactions — including dangerous drops in blood cell counts (thrombocytopenia, leukopenia, aplastic anemia), significant kidney problems (protein or blood in the urine), or lung inflammation — are less common but require immediate medical attention. Call your doctor right away if you notice unusual bruising, bleeding, shortness of breath, or changes in your urine.
Auranofin warnings and precautions
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- Blood cell problems: Auranofin can cause dangerously low platelet counts (thrombocytopenia), which can lead to bleeding. This can happen rapidly and at any point during treatment — not just early on. Monthly blood monitoring is required.
- Kidney problems: Protein or blood in the urine can develop and signal kidney damage. If this occurs, auranofin must be stopped immediately.
- Gold toxicity: Because gold stays in your body for weeks to months, toxicity can develop at any time. Warning signs include rash, itching, mouth sores, persistent diarrhea, and changes in blood counts or urine.
- Rare but serious: Cases of aplastic anemia (bone marrow failure), interstitial pneumonitis (lung inflammation), and peripheral neuropathy (nerve damage) have been reported.
- Lab monitoring is essential: Your doctor must review your blood work and urine before each prescription refill.
Auranofin interactions
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Auranofin has limited documented drug interactions, but at least one has been reported:
- Phenytoin (Dilantin): One case report suggested that taking auranofin alongside phenytoin — a medication used to prevent seizures — may raise phenytoin blood levels. Higher phenytoin levels can increase the risk of phenytoin toxicity. Tell your doctor if you take phenytoin.
Interactions listed in the FDA-approved label
From the Auranofin prescribing information (“Drug Interactions”): what the manufacturer studied or reported to the FDA.
- Phenytoin: In a single patient report, there is a suggestion that concurrent administration with Auranofin Capsules may have increased phenytoin blood levels.
Read the label’s full interactions text
Drug Interactions: In a single patient-report, there is the suggestion that concurrent administration of Auranofin Capsules and phenytoin may have increased phenytoin blood levels.
Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.
Before taking Auranofin
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- Previous serious gold reactions: Do not take auranofin if you have ever had anaphylaxis (a severe allergic reaction), necrotizing enterocolitis, pulmonary fibrosis, exfoliative dermatitis (widespread skin peeling), or bone marrow failure related to gold therapy.
- Kidney or liver disease: Tell your doctor if you have any history of kidney or liver problems, as auranofin can affect both organs.
- Pregnancy and breastfeeding: Discuss the risks and benefits with your doctor before taking auranofin if you are pregnant, planning to become pregnant, or breastfeeding.
- Other medications: Tell your doctor about all medications you take — especially phenytoin — before starting auranofin.
- Commitment to monitoring: You must be willing and able to have regular blood and urine tests throughout treatment, as these are essential for catching early signs of toxicity.
Auranofin overdose
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Taking too much auranofin can be very serious. One reported case of a person taking nearly five times the usual daily dose for ten days resulted in brain and nerve damage (encephalopathy and peripheral neuropathy), though the person eventually recovered after stopping the medication. If you or someone else takes too much, seek emergency medical help immediately — treatment may include steps to clear the drug from the stomach, and supportive care.
What Auranofin does in the body
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Auranofin works by modifying the activity of rheumatoid arthritis — reducing joint inflammation (synovitis) and related symptoms, and lowering blood markers of inflammation such as ESR (erythrocyte sedimentation rate). It is not a pain reliever in the traditional sense and does not produce immediate relief. It does not appear to induce full remission of rheumatoid arthritis, and it cannot reverse bone or joint damage that has already occurred.
How your body processes Auranofin
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After you swallow auranofin, the body absorbs roughly 25% of the gold it contains; the rest passes through in the stool. The gold is rapidly broken down — intact auranofin is never detected in the blood — and the absorbed gold binds to blood proteins and red blood cells. Gold has a very long half-life: it takes about 26 days for blood levels to fall by half, and the body can hold onto gold for up to several months. About 60% of what's absorbed leaves the body through urine and the rest through feces. It takes roughly three months of daily dosing to reach steady, stable gold levels in the blood.
How to store Auranofin
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Store between 15° and 30°C (59° and 86°F). Dispense in a tight, light-resistant container.
Written from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
Supplements & herbs that interact with Auranofin
37 supplements and herbal products have documented interactions with Auranofin in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.
- Major · 1
- Moderate · 26
- Minor · 10
Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.
Auranofin: pharmacist answers to common questions
Quick, plain-English answers to the questions patients ask most about Auranofin — the kind of thing our pharmacy team would talk through with you at the counter.
How long before I notice auranofin actually helping my arthritis?
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Why does my doctor keep ordering blood tests and urine tests while I'm on this?
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What side effects are most likely, and which ones should I call my doctor about right away?
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Can auranofin interact with my other medications?
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I was on gold injections before — is switching to the capsule the same thing?
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Is it safe to take auranofin if I'm pregnant or trying to become pregnant?
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Is Auranofin available over the counter?
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When was Auranofin first available?
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Who makes Auranofin?
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Answers drafted from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
More about Auranofin on HelloPharmacist
Auranofin forms and strengths (how it comes)
Auranofin is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Need a version that does not list lactose, a gluten source, a dye or gelatin? Inactive ingredients differ by manufacturer: see Auranofin inactive ingredients by manufacturer.
Capsule
How this form is used
- Ridaura capsules are used to manage active rheumatoid arthritis in adults who have not responded adequately to, or cannot tolerate, full doses of one or more NSAIDs.
- Auranofin capsules are used to manage active rheumatoid arthritis in adults who have not responded adequately to, or cannot tolerate, full doses of one or more NSAIDs.
- Ridaura capsules may also be used in patients transferring from injectable gold therapy.
- Auranofin capsules may also be used in patients transferring from injectable gold therapy.
- Ridaura is taken by mouth once or twice daily as directed by your prescriber; do not exceed the prescribed dose.
- Auranofin capsules are taken by mouth once or twice daily as directed by your prescriber; do not exceed the prescribed dose.
- Ridaura therapy should be part of a comprehensive treatment plan that includes non-drug therapies.
- Patients transferring to Ridaura or Auranofin capsules from injectable gold should be counseled about the different side effect profile, especially gastrointestinal reactions.
Auranofin on the U.S. market: products, makers and brands
How Auranofin appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
2 companies list 2 Auranofin product records with the FDA, mostly as capsule; the earliest marketing or approval year on record is 1985. Brand names on the directory include Ridaura; the rest are generics.
Also listed with the FDA, not a patient dose form: Powder (1) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.
Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
How widely Auranofin is used (Medicaid data)
A general measure of how commonly Auranofin is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Auranofin is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Auranofin prescribed? Of the 1,601 medications we measure, Auranofin ranks #1,528 by Medicaid prescriptions — more than 5% of them.
Utilization by Auranofin product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
auranofin 3 MG Oral Capsule
Summed across the 1 of 3 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 197386
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Auranofin, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 1 of 3 listed Auranofin NDCs with Medicaid activity.
Compare Auranofin products
A representative set of FDA-listed product records for Auranofin — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Capsule | ||||
| 3 mg | Oral | Coral Way Pharma, LLC | NDA AUTHORIZED GENERIC | View NDC → |
| 3 mg | Oral | Sebela Pharmaceuticals Inc. | NDA | View NDC → |
Showing 2 of 2 products — FDA National Drug Code Directory. See every product, package size and price: browse all 2 Auranofin NDCs →
Auranofin side effects reported to the FDA (FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Auranofin — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Auranofin in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
Auranofin FDA approval history
How Auranofin went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
Auranofin recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
The FDA’s enforcement reports list no Auranofin recalls since July 2021.
✅No Auranofin recalls on record since July 2021Source: FDA enforcement (recall) reports, via openFDA; our copy was last updated Sep 24, 2026.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.
RxCUI 1227 2 dose forms · 2 strengths
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Dose form (SCDF) Oral Capsule RxCUI 370629In current FDA listingsClinical drug / strength (SCD) 3 MGRxCUI 197386 -
Dose form (SCDF) Oral Tablet RxCUI 370967No current FDA listingClinical drug / strength (SCD) 3 MGRxCUI 141995
Look up RxCUI 1227 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
Auranofin supply and shortage status
Whether Auranofin is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
💵 What Auranofin costs pharmacies (NADAC benchmark)
The national average invoice price pharmacies pay for the drug itself, from CMS's NADAC survey (data as of Sep 30, 2026). This is a supply-cost benchmark — not a retail price and not what you'd pay at the counter.
| Form | Strength | Pharmacy acquisition benchmark | |
|---|---|---|---|
| Capsule · Oral | 3 mg | $24.85 per capsule | NDC details & price history |
Source: CMS National Average Drug Acquisition Cost (NADAC), a survey of retail pharmacy invoice prices. Benchmarks shown are the range across package sizes of a representative product for each form and strength — other manufacturers' products may differ.
Auranofin brand names
Auranofin is sold under one brand name in the FDA directory — Ridaura. A brand and its generic contain the same active ingredient; the brand name belongs to one company's product.
Who makes Auranofin: manufacturers and labelers
2 companies list Auranofin products with the FDA. By number of product records, the largest are Coral Way Pharma, LLC, Sebela Pharmaceuticals Inc.. Labelers include manufacturers and repackagers; the product in your bottle depends on which one your pharmacy stocks.
Auranofin drug class (RxNorm)
Auranofin belongs to the Gold preparations class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
Sources for this Auranofin page
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How this page is built
HelloPharmacist combines public FDA and NLM records and does not author the underlying clinical facts. The plain-language sections are written with AI from the FDA-approved label text and reviewed by our pharmacy team before publication. Coral Way Pharma, LLC is the representative DailyMed label linked for verification and dates. This is general education, not medical advice: always talk to your doctor or pharmacist about your own medicines. How we build and review drug pages →