Ridaura

Selected form

Auranofin

Method of action: Nonsteroidal Anti-Inflammatory

Treatment option: Arthritis,Osteoarthritis, Rheumatoid Arthritis, Synovitis

Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Ridaura

Quick Facts

Property	Description
Active ingredient	Auranofin (a Gold (I) complex)
Form	Capsule (solid oral preparation)
Pharmacological class	Disease-Modifying Antirheumatic Drug (DMARD)
Common use	Long-term control of chronic inflammatory conditions
Origin	Synthetic compound

Ridaura (Auranofin): What Type of Medicine is It?

Ridaura is a prescription medication whose active substance is Auranofin, classified as a Disease-Modifying Antirheumatic Drug (DMARD). This classification signifies its specific purpose: to target the underlying disease processes of chronic inflammation, rather than only providing relief for symptoms. As an immunomodulatory agent, it is designed to gradually regulate the aberrant activity of immune cells that drive tissue damage. Auranofin is a chemically unique gold coordination complex with antiarthritic properties and is characterized as the only gold compound formulated for oral administration, a key feature distinguishing it from older, injectable gold therapies.

Composition, Origin, and Delivery Form

The core component of Ridaura, Auranofin, is a complex synthetic compound chemically defined as a Gold (I) complex. It is a single-ingredient product supplied for oral administration in the form of a capsule. The medication is used for the management of rheumatoid arthritis, providing a non-injectable systemic treatment option for long-term therapy. The capsule formulation allows for systemic distribution, where the drug is absorbed through the digestive system to exert its effects throughout the body.

General Purpose: Long-Term Disease Activity Control

The fundamental therapeutic purpose of Auranofin is to achieve long-term disease activity control in chronic inflammatory conditions. By modulating the immune response and suppressing the function of specific inflammatory cells, the drug aims to manage the pathology that leads to progressive tissue damage. This sustained intervention works to limit the progression of the disease and is typically used in a scenario where patients require a foundational treatment to slow the underlying condition, rather than immediate, acute symptomatic relief.

Regulatory References

FDA Prescribing Information for Ridaura (Auranofin)

What side effects are possible with Ridaura?

Adverse Reactions and Safety Profile

Ridaura (auranofin) is a gold compound with the potential to cause gold toxicity, which necessitates regular monitoring. The adverse reactions are primarily categorized by the body system affected, with the most common reactions occurring in the gastrointestinal system and on the skin.

Common Adverse Reactions (Reported Incidence):

System-Organ Class	Specific Reaction	Approximate Incidence
Gastrointestinal	Loose stools or diarrhea	47%
Dermatologic	Rash	24%
Dermatologic	Pruritus (Itching)	17%
Gastrointestinal	Abdominal pain	14%
Mucous Membrane	Stomatitis (Mouth sores)	13%

Other less common reactions include nausea, vomiting, conjunctivitis (pink eye), loss of appetite (anorexia), and proteinuria (protein in the urine).

Serious Adverse Reactions and Contraindications

Serious adverse reactions, while rare, have been reported across multiple organ systems and can be potentially life-threatening. These include severe hematologic disorders such as aplastic anemia, leukopenia, and thrombocytopenia; severe gastrointestinal issues like ulcerative enterocolitis; and serious pulmonary reactions such as interstitial pneumonitis and pulmonary fibrosis. Generalized exfoliative dermatitis and nephrotic syndrome are also documented serious reactions. The highest incidence of these more serious events is typically observed during the first six months of therapy.

Treatment is contraindicated in patients with a history of any gold-induced toxicity, including anaphylactic reactions, exfoliative dermatitis, necrotizing enterocolitis, pulmonary fibrosis, or severe blood disorders. Due to documented risks, use in pregnancy is contraindicated, and the drug is not recommended for use during lactation.

Safety Monitoring

Due to the risk of gold toxicity, frequent laboratory monitoring is essential, particularly for the formed elements of the blood (hemoglobin, white blood cell count, platelet count) and for protein and blood in the urine. Specific signs indicative of potential gold toxicity include a precipitous decline in platelet counts, significant proteinuria, persistent diarrhea, rash, pruritus, or stomatitis.

Overdose and Emergency Response

The official regulatory profile for Ridaura addresses potential overdosage by identifying specific danger signs of systemic gold toxicity that require immediate attention. These manifestations include severe hematologic and renal abnormalities, such as leukopenia (low white blood cell count), a precipitous decline in platelets (thrombocytopenia), proteinuria, and hematuria. Clinical signs of excessive exposure cited in official labeling also involve the mucous membranes and skin, presenting as stomatitis, pruritus, and rash, alongside persistent diarrhea.

In cases of acute overdosage, it is officially mandated to seek medical help right away and contact a Poison Control center. Certain severe acute outcomes, such as collapse, a seizure, or trouble breathing, require immediate emergency services. Regulatory guidance is specific: if a precipitous decline in platelets is detected, the medication must be immediately withdrawn.

For acute overdosage procedures, regulatory sources recommend immediate induction of emesis or gastric lavage, followed by appropriate supportive therapy. While chelating agents such as BAL may be considered for management, the official documents note that there is no specific clinical experience with their use for Ridaura overdosage.

Therapeutic Uses of Ridaura

What Ridaura Treats: Main Uses and Benefits

Ridaura, a Disease-Modifying Antirheumatic Drug (DMARD), is commonly used to help manage chronic inflammatory conditions in adults. The drug is considered relevant for easing symptoms related to systemic imbalance in patients with active classical or definite rheumatoid arthritis in conditions where functional stability becomes affected. This intervention is applied when appropriate in situations where a patient requires sustained support beyond initial relief.

Managing Joint Discomfort and Functional Symptoms

The therapeutic benefit provided is its role in managing active disease, which contributes to easing the overall symptom load. It is used in situations involving certain distressing symptoms to address groups of symptoms that may become intense or disruptive. Specifically, the medication may assist with reducing physical signs of active disease, such as joint swelling, tenderness, and noticeable morning stiffness. This supportive relief helps maintain a sense of stability when symptoms are more noticeable and assists with maintaining functional stability.

A key benefit for patients is the drug’s potential to limit or slow the progressive damage to joint structures. The therapeutic benefit is considered relevant in contexts involving heightened systemic burden, especially where preventing structural deterioration is the main therapeutic goal.

Quick Fact: Symptomatic Support

Feature	Description
Primary Indication	Active classical or definite rheumatoid arthritis
Symptom Focus	Joint swelling, tenderness, and morning stiffness
Main Benefit	Long-term disease control and structural support
Clinical Context	Used in situations involving episodic or fluctuating manifestations

Regulatory References

DailyMed, a service of the NIH

Eligibility and Restrictions for Use

Eligibility Scope

Category	Official Regulatory Status
Populations for whom use is allowed	Adults with active classical or definite rheumatoid arthritis [Source 1.1, 1.2].
Populations for whom use is not recommended	Nursing mothers (gold may be excreted into breast milk) [Source 1.2]. Children under 16 years of age (safety and effectiveness have not been established) [Source 1.1, 1.2].
Populations for whom use is contraindicated	Patients with a history of serious gold-induced toxicity (e.g., necrotizing enterocolitis, pulmonary fibrosis, severe hematologic disorders, or hypersensitivity) [Source 1.2, 1.6]. Patients with progressive renal disease, severe hepatological disorders, or severe blood/bone marrow disorders [Source 1.2, 1.6].

Age- and Condition-Based Rules

Pediatric Use: The drug is not approved for use by anyone younger than 18 years old in some jurisdictions, or is restricted to those over 16 in others, as safety and efficacy data are insufficient for children [Source 1.1, 3.3].
Pregnancy Status: Ridaura should not be given to pregnant women due to evidence of embryotoxicity and teratogenicity in animal studies [Source 1.2, 1.7]. Women of childbearing potential must avoid pregnancy during treatment and for a specified time (e.g., at least six months) after discontinuation [Source 1.7].
Conditional Use: Use requires caution in older adults with decreased renal function. Additionally, treatment must be avoided in patients with porphyria or certain rare hereditary sugar intolerances [Source 1.1].

What should I know about interactions with other medicines?

Ridaura Interactions with Other Medicines and Products

The official regulatory documentation for Ridaura (Auranofin) establishes specific constraints on co-administration with other medicinal products, primarily based on formal prohibitions and combinations for which clinical safety has not been established.

Formal Restrictions and Contraindications

The following table summarizes the key interaction classifications based on government prescribing information, which includes substances that must not be combined and those whose concurrent use is not recommended due to unestablished safety profiles.

Classification	Interacting Substance(s)	Official Constraint
Contraindicated	Dimercaprol (chelating agent)	Combination is explicitly prohibited.
Safety Not Established	Injectable Gold (e.g., Gold Sodium Thiomalate)	Not recommended for co-administration.
Safety Not Established	Penicillamine, Hydroxychloroquine	Not recommended for co-administration.
Safety Not Established	Immunosuppressive Agents (e.g., Methotrexate, Azathioprine)	Not recommended for co-administration.
Safety Not Established	High Doses of Corticosteroids	Not recommended for co-administration.

Exposure Modification

While explicit enzyme- or transporter-based mechanisms are not documented in the labeling, there is a regulatory note regarding altered plasma levels when Ridaura is co-administered with a specific antiepileptic drug:

Phenytoin: A single patient report is documented in the prescribing information indicating an association with increased phenytoin blood levels when used concurrently with Ridaura.

Official regulatory sources do not explicitly document clinically significant interactions with food, alcohol, or herbal products.

Mechanism of Action

Inhibiting Thioredoxin Reductase and Shifting Redox Balance

The fundamental mechanism of Auranofin involves the covalent inhibition of the intracellular enzyme Thioredoxin Reductase (TrxR1). This action disrupts the cell's ability to maintain its reducing environment, leading to a controlled increase in intracellular oxidative stress. This biochemical shift serves as a molecular signal that initiates the drug's downstream effects on inflammatory pathways.

Suppressing Pro-inflammatory Gene Signaling

The resulting change in cellular redox status functionally suppresses the activation of key inflammatory transcription factors, notably NF-kappaB. By impeding NF-kappaB's ability to drive gene expression, the drug sharply reduces the synthesis and release of powerful pro-inflammatory cytokines, such as Interleukin-6 (IL-6), which are crucial mediators in the sustained signaling of the inflammatory cascade.

Functional Modulation of Immune and Synovial Cells

These molecular actions collectively modulate the sustained, abnormal activity of immune cells (T-lymphocytes, macrophages) and synovial fibroblasts. The mechanism is characterized by the slow, cumulative process of accumulating the compound and gradually suppressing chronic cellular pathology, which ultimately results in a sustained modulation of the underlying biological pathology, consistent with a gradual onset of effect.

Dosage and Administration Information

Ridaura (Auranofin) is administered exclusively through the oral route, with the medication typically supplied as a 3 mg capsule. The regimen is generally integrated into a comprehensive management program, often involving non-pharmacological therapies.

The standard adult regimen begins with a daily dose of 6 mg, which often serves as the maintenance dose. This total daily dose may be administered either as a single 6 mg dose or divided into two 3 mg doses throughout the day. In certain instances, the dose is taken with breakfast and the evening meal.

A feature of Ridaura's use is the required duration for assessing its effect. The onset of therapeutic response is gradual, usually taking between three and six months to manifest.

If a patient shows an inadequate response after six months on the standard dose, the daily dose may be increased to a maximum of 9 mg as a temporary trial. This highest dose is administered as three 3 mg doses daily and is subject to a limited three-month trial period. If the response remains insufficient following this trial, the treatment is typically discontinued. Adjustments to the dosing schedule are determined based on monitoring clinical response and tolerability.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Ridaura

Evidence for Use in Active Rheumatoid Arthritis

The clinical evaluation of Ridaura (Auranofin) was evaluated in adults with active classical or definite rheumatoid arthritis (RA). The foundation of the evidence relies on Randomized Controlled Trials (RCTs), where Auranofin was studied for its role in conditions characterized by fluctuating or episodic manifestations compared to an inactive substance (placebo). These trials were conducted during periods of increased symptom activity and typically monitored outcomes over defined time intervals, such as six months.

The research examined key outcomes linked to inflammatory or irritative states, including counts of tender or swollen joints, and the length of time patients experienced morning stiffness. Studies monitored changes in these physical signs as well as certain laboratory parameters linked to inflammatory states, such as the Erythrocyte Sedimentation Rate (ESR). Findings describe patterns observed in the studies regarding short-term changes in these symptomatic measures over the observed trial duration.

Comparative Study Landscape

Research was also studied for comparative purposes, assessing Auranofin against two main groups: an inactive substance (placebo) and other active treatments for RA. The objective of these comparisons was observed in research exploring short-term symptom changes, where studies monitored differences in the measurable outcomes linked to inflammatory or irritative states. When compared to injectable gold, some trials reported how symptoms evolved under each therapy. The evidence describes variability and inconsistency in the observed magnitude of change across the different forms of gold therapy.

Long-Term Research and Structural Effects

While the primary RCTs often focused on short-term relief, research examined follow-up periods extending up to one or two years and sometimes longer. These longer-term studies explored the maintenance of the initial symptomatic changes.

Research examined whether these observation periods coincided with changes in structural measures (radiological progression). However, evidence is limited, and certainty remains low or data are still emerging when comparing findings on structural changes to those on short-term symptoms.

Frequently Asked Questions (FAQ)

Common questions about Ridaura (FAQ)

Q: Does Ridaura interact with common pain relievers like ibuprofen?

A: Official regulatory documents do not list specific interactions between Ridaura and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. According to the product information, the drug is often reserved for patients who have not responded adequately to or tolerated an adequate trial of NSAIDs. Consult your healthcare provider for guidance tailored to your health plan.

Q: What types of food or drinks should be avoided when on Ridaura?

A: Regulatory documentation does not explicitly list any specific food or drinks that must be avoided while taking Ridaura. It is important to follow any specific guidance provided as part of your overall treatment plan.

Q: Is it okay to drink alcohol while taking Ridaura?

A: Official regulatory documentation does not explicitly report clinically significant interactions between Ridaura and alcohol. Questions about individual alcohol consumption should be addressed with your healthcare provider.

Q: What does Ridaura do to the immune system?

A: Official information describes Ridaura as having immunomodulating effects. This means it is intended to modify disease activity by suppressing certain inflammatory responses and regulating the function of immune cells and inflamed joint tissue.

Q: What research shows about Ridaura compared to placebo?

A: Clinical trials observed that Ridaura modifies disease activity when compared to an inactive substance (placebo). This was shown by observed improvements in measures of disease activity, such as reductions in joint swelling, tenderness, and morning stiffness.

Q: Does Ridaura stop the progression of the disease or just manage symptoms?

A: Ridaura is classified as a Disease-Modifying Anti-Rheumatic Drug (DMARD) because it addresses the underlying inflammatory process, not just the symptoms. However, gold compounds are not substantially evidenced to induce disease remission, and the medication cannot reverse structural damage to joints caused by previous disease activity. Official classification suggests it is intended to modify the disease course.

Q: Does Ridaura have a boxed warning?

A: Yes, Ridaura has a Boxed Warning in the United States. This is a serious warning that highlights the potential for severe and fatal toxicities associated with gold-containing compounds (chrysotherapy). The warning emphasizes the necessity of close patient monitoring during treatment.

Q: Is Ridaura considered a strong medication?

A: Ridaura is a gold compound classified as a Disease-Modifying Anti-Rheumatic Drug (DMARD). This class of medicine is typically used when initial non-steroidal anti-inflammatory treatments have not been sufficient.

Q: Does Ridaura contain actual gold?

A: Yes, the active ingredient in Ridaura is called auranofin. This substance is a gold-containing chemical compound and contains approximately 29% gold by weight.

Q: Do I need a special diet while taking Ridaura?

A: Official regulatory documentation does not explicitly require a special diet while taking Ridaura. Follow any dietary recommendations that are part of your comprehensive medical care plan.

Q: Is Ridaura a type of biologic drug?

A: No, Ridaura is a chemically synthesized gold compound, which is a gold salt. It is classified as a Disease-Modifying Anti-Rheumatic Drug (DMARD), but it is not considered a biologic agent.

Q: Why do some people call Ridaura 'gold therapy'?

A: Ridaura is often called 'gold therapy' because its active ingredient, auranofin, is a compound containing gold. The use of gold compounds to manage conditions like rheumatoid arthritis is known as chrysotherapy.

Q: Can I take Ridaura if I have kidney problems?

A: Official information states that Ridaura is contraindicated (should not be used) in patients with progressive renal disease (worsening kidney issues). This is due to the risks associated with gold compounds.

Q: Can Ridaura cause skin rashes or discoloration?

A: Skin rash and itching (pruritus) are reported as common side effects of Ridaura. The label notes that a type of rash called gold dermatitis may develop and can sometimes be made worse by exposure to sunlight.

Q: Is Ridaura safe for long-term use?

A: Official regulatory documents state that continuing therapy beyond six months is generally unwarranted in patients who show insufficient improvement, due to the potential for serious adverse reactions that may be associated with extended use.

Q: Is Ridaura the same as the injections some people get for arthritis?

A: No, Ridaura is an oral gold compound taken as a capsule. It is different from injectable gold compounds, which are administered differently and have distinct properties.

Q: Can Ridaura make me feel tired or fatigued?

A: Fatigue or unusual weakness may be a symptom of anemia, which is a reduction in red blood cell levels. Anemia is a potentially serious hematological side effect that is reported with the drug.

Q: Is Ridaura a controlled substance?

A: No, Ridaura (auranofin) is not classified as a controlled substance under the US Controlled Substances Act.

Q: Can Ridaura be used by teenagers?

A: Ridaura is indicated only for the management of adults with active classical or definite rheumatoid arthritis. Official product information does not include an indication for use in children or adolescents.

Q: What is the evidence supporting the use of Ridaura?

A: Clinical evidence supports its use in adults with active rheumatoid arthritis when initial non-steroidal anti-inflammatory treatments have not been sufficient.

Q: Do regulatory bodies still recognize Ridaura as an approved treatment?

A: Yes, Ridaura (auranofin) is recognized by regulatory bodies as an approved prescription drug for its indicated use.

Q: What age groups is Ridaura approved for?

A: Ridaura is indicated for use in adults with active classical or definite rheumatoid arthritis.

Q: Is Ridaura known to cause hair loss?

A: Yes, Alopecia (hair loss) is listed in official documents as an adverse effect. It was reported with an approximate incidence of 1% to 3% in clinical trials.

Q: How quickly does Ridaura leave the body once I stop taking it?

A: The gold from auranofin is known to be slowly excreted from the body. Official regulatory documents report the gold having a mean terminal body half-life of approximately 80 days.

Q: Is Ridaura an anti-inflammatory drug?

A: Ridaura is described as having anti-inflammatory and antiarthritic properties. Its mechanism of action includes reducing the synthesis and release of pro-inflammatory cytokines, which are substances involved in inflammation.

Q: Can I take Ridaura if I have liver disease?

A: Ridaura is contraindicated (should not be used) in patients with severe hepatological disorders (severe liver problems).

Q: Do people gain weight while on Ridaura?

A: Loss of appetite (anorexia) and weight loss are listed in official documents as potential side effects. Weight gain is not listed among the commonly reported side effects.

Q: Is Ridaura a brand name or a generic drug?

A: Ridaura is the brand name for the generic drug auranofin.

Q: Are there any reported interactions between Ridaura and vaccines?

A: Ridaura may decrease the effects of certain live vaccines due to its immunosuppressive effects. This information is provided in the drug labeling for consideration as part of your overall treatment plan.

Q: Do official sources describe Ridaura's effect as disease-modifying?

A: Yes, Ridaura is officially categorized as a Disease-Modifying Anti-Rheumatic Drug (DMARD). This classification indicates the drug is intended to modify the course of the disease.

Q: Are there different strengths of Ridaura capsules available?

A: According to official documentation on dosage forms and strengths, Ridaura is supplied exclusively as a 3 mg capsule.

Q: Can Ridaura affect my vision?

A: Conjunctivitis, commonly known as pink eye, is listed as a potential side effect. Official documents are silent on other forms of wider vision impairment.

Q: What if I experience unusual bruising while taking Ridaura?

A: Unusual bruising or bleeding is a serious sign that should be reported promptly. This symptom may be indicative of a serious hematological reaction, such as thrombocytopenia (low platelet count).

Q: Can Ridaura be crushed or opened for easier swallowing?

A: Ridaura is supplied as an oral capsule, and the regulatory information does not contain instructions or support for altering its form, such as crushing or opening it.

How should Ridaura be stored and disposed of?

Storage Conditions

Ridaura (auranofin) capsules must be stored at controlled room temperature, typically between 15 C and 30 C (59 F and 86 F). The medication must be protected from light and excess moisture; therefore, it should not be stored in a bathroom or near a sink.

The capsules must remain in the original container, which should be kept tightly closed to maintain product stability. Per regulatory requirements, the medication must be kept securely out of the sight and reach of children.

Disposal Instructions

Expired or unused Ridaura should be disposed of through a drug take-back program when available. If a take-back program is not accessible, the capsules should be mixed with an undesirable substance (such as dirt or used coffee grounds), sealed in a container, and then placed in the household trash. It is explicitly advised not to flush Ridaura down the toilet or pour it down a drain.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.