BCG (Intravesical)

• Tell all of your health care providers that you take this medicine. This includes your doctors, nurses, pharmacists, and dentists.
• If you have a latex allergy, talk with your doctor.
• Take extra care with your urine for the first 6 hours after getting BCG. Use the same toilet each time you use the bathroom at home. Sit down to urinate so your urine does not splash or spray.
• Before flushing, add an equal amount of bleach to the urine. Wait 15 minutes, then flush. Do this for the first 6 hours after BCG is given.
• It is fine to be around close contacts like household members, friends, and caregivers. However, do not allow anyone to come into contact with your urine.
• You may need a TB (tuberculosis) test before starting this medicine.
• This medicine may affect certain lab tests. Be sure your doctor and lab workers know you use BCG.
• Use birth control that you can trust to prevent pregnancy while taking this medicine.
• Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using BCG while you are pregnant.

Use this medicine as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• It is given through a catheter into the bladder.
• You will need to try to keep BCG in your bladder for up to 2 hours, but no longer than 2 hours. This medicine will come out when you pass urine.
• Drink plenty of liquids that do not have caffeine for several hours after getting this medicine unless told to drink less liquids by your doctor. This helps to get rid of the drug from your bladder.

What do I do if I miss a dose?

• Call your doctor to find out what to do.

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
• Signs of lung or breathing problems like shortness of breath or other trouble breathing, cough, or fever.
• Worse pain or burning when passing urine or if these effects will not go away.
• Not able to pass urine or change in how much urine is passed.
• Blood in the urine.
• High fever over 103.1 degrees F or 39.5 degrees C for more than 12 hours.
• Mild fever over 101.3 degrees F or 38.5 degrees C for more than 48 hours.
• Very bad dizziness or passing out.
• Chest pain.
• Joint pain.
• Eye pain.
• Eye irritation.
• Eye redness.
• Cough.
• Throwing up.
• Feeling very tired or weak.

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Refer to adult dosing.

TheraCys: Reconstitute with 3 mL of sterile preservative free saline and shake gently to create a fine, even suspension (avoid foaming). Do not use if flocculation or clumping (that is not dispersed with gentle shaking) occurs after reconstitution. Withdraw contents (~3 mL) and further dilute with sterile preservative free saline to a final volume of 50 mL.

TICE BCG: Reconstitute with 1 mL sterile preservative free saline using a 3 mL syringe. Add to vial and swirl gently to form a homogenous suspension (forceful agitation may cause clumping). Dispense into a catheter tip syringe containing 49 mL of sterile preservative free saline. Mix by gently rotating the syringe.

Antibiotics: May diminish the therapeutic effect of BCG (Intravesical). Exceptions: Acetic Acid (Otic); Acetic Acid (Topical); Aluminum Acetate; Azithromycin (Ophthalmic); Aztreonam (Oral Inhalation); Bacitracin (Ophthalmic); Bacitracin (Topical); Chlortetracycline; Ciprofloxacin (Ophthalmic); Clindamycin (Topical); Dapsone (Topical); Erythromycin (Ophthalmic); Erythromycin (Topical); Fidaxomicin; Framycetin; Fusidic Acid (Ophthalmic); Fusidic Acid (Topical); Gatifloxacin; Gentamicin (Ophthalmic); Gentamicin (Topical); MetroNIDAZOLE (Topical); Mupirocin; Nitrofurazone; Sulfacetamide (Ophthalmic); Tobramycin (Ophthalmic). Avoid combination

Hexaminolevulinate: BCG (Intravesical) may diminish the diagnostic effect of Hexaminolevulinate. Avoid combination

Immunosuppressants: May diminish the therapeutic effect of BCG (Intravesical). Avoid combination

Myelosuppressive Agents: May diminish the therapeutic effect of BCG (Intravesical). Avoid combination

Use of BCG (intravesical) may result in tuberculin sensitivity. Determine the tuberculin reactivity of patients receiving BCG by PPD skin testing PRIOR to treatment initiation.

PPD test prior to treatment

Intravesical treatment: Monitor for signs/symptoms of toxicity/infection following every treatment. Signs that antituberculous therapy may be needed: Flu-like symptoms ≥72 hours, fever ≥101.3°F, systemic symptoms which worsen with each treatment, persistently abnormal liver function tests, prostatitis, epididymitis or orchitis of >2 to 3 day duration