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Gold (Myochrisine) & ACE Inhibitor Interaction
This information was provided by Dr. Alice Klinkhoff, director of the Gold Clinic, Vancouver, Canada.
Dr. Klinkhoff and the staff at the Vancouver gold clinic have recently observed Nitritoid reactions in a number of patients attending the clinic routinely for Gold treatment. All patients who experienced these reactions have concurrently been taking ACE inhibitors.
Nitritoid reactions are characterized by hypotension, vasodilation, flushing, nausea or fainting and any combination of the above. We are fully aware of an interaction between the Gold and ACE inhibitors: an interference with the breakdown of bradykinin which can potentially result in prolonged hypotension. For this reason the Vancouver protocol has been to reduce the Gold dosage for those clients on ACE inhibitors (as these reactions typically occur at doses greater than Gold 25 mg/week), and require clients to hold their ACE Inhibitors for 18 hours prior t to their Gold injection and for 4 hours following their Gold. However, in frail patients or those with underlying cardiovascular disease, these reactions can be serious: they recently had one client who developed hypotension, leading to cardiac arrest.
Therefore, in in order to optimize the safety of gold administration, Dr. Klinkoff recommends you consider switching to a non-ACE antihypertensive.