Gold toxicity, involving dermatologic (dermatitis and lesions of mucous membranes, pruritus, skin reaction), GI (diarrhea, stomatitis, and enterocolitis), hematologic (depressed hemoglobin, eosinophilia >5%, leukocytes, granulocytes, or platelets), pulmonary (interstitial fibrosis), renal (from mild proteinuria to nephrotic syndrome), and hepatic (development of cholestatic jaundice) systems, is possible. Avoid use in prior inflammatory bowel disease, urticaria or eczema, history of blood dyscrasias (anemia, agranulocytosis), hemorrhagic diathesis, or drug-induced granulocytopenia, hepatic impairment, renal impairment, and in systemic lupus erythematosus. Rare hypersensitivity reactions, including anaphylactic shock, syncope, bradycardia, thickening of the tongue, difficulty in swallowing and breathing, and angioedema reported. Also, vasomotor (nitritoid) reaction characterized by acute flushing and tachycardia might occur. Use caution in heart failure, hypertension, or cerebrovascular disease. Concurrent use with ACEIs may increase risk of nitritoid reactions. In general, corticosteroids and NSAIDs may be discontinued after initiation of therapy. Must not be injected I.V.