Bacillus Calmette-Guerin (BCG) Bladder Instillation

What is this medication?

BACILLUS CALMETTE-GEURIN (buh SIL us cal MET gey RAHN), or BCG, prevents and treats bladder cancer. It works by helping your immune system slow or stop the spread of cancer cells.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Theracys, TICE BCG

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Blood in your urine
• HIV or AIDs
• Immune system conditions
• Infection, such as tuberculosis (TB) or other bacterial, fungal, or viral infections
• Leukemia or lymphoma
• Bladder biopsy or surgery in the last 14 days
• Small bladder
• An unusual or allergic reaction to Bacillus Calmette-Guerin (BCG), other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breastfeeding

How should I use this medication?

This medication is infused into the bladder. It is given by your care team in a hospital or clinic setting.

This medication contains live bacteria. Wash your hands before and after urinating. Disinfect your urine for 15 minutes with an equal volume of household bleach for 6 hours after treatment. Flush the toilet several times after you use it. Wash your hands, inner thighs, and genital area with soap and water each time after going to the bathroom. If urine gets on your clothing, wash it right away. Wash it separately from other clothing.

It is important to keep this medication in your bladder for 2 hours after your procedure. If you need to go to the bathroom before this, talk to your care team. Follow special bathroom precautions for 6 hours after your treatment. Avoid public restrooms. Do not go to the bathroom outside. Sit on the toilet while you urinate. This limits urine splash. After you urinate, add 2 cups of bleach to the toilet. Close the lid. Wait 15 minutes before flushing. Wash your hands, inner thighs, and genital area with soap and water. If urine gets on your clothing, wash it right away. Do not wash with other clothes. If you are wearing an incontinence pad, pour bleach on the pad and let it soak in. Then place it in a plastic bag and place it in the trash.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

Keep appointments for follow-up doses. It is important not to miss your dose. Call your care team if you are unable to keep an appointment.

What may interact with this medication?

• Antibiotics
• Medications that lower your chance of fighting infection

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Your condition will be monitored carefully while you are receiving this medication. Tell your care team if your symptoms do not start to get better or if they get worse.

This medication may make you feel generally unwell. This is not uncommon as chemotherapy can affect healthy cells as well as cancer cells. Report any side effects.

This medication may increase your risk of getting an infection. Call your care team for advice if you get a fever, chills, sore throat, or other symptoms of a cold or flu. Do not treat yourself. Try to avoid being around people who are sick.

Talk to your care team about this medication if you may be pregnant. Its use during pregnancy has not been well studied. There are benefits and risks to taking medications during pregnancy. Your care team can help you find the option that works for you.

Use a condom during sex while receiving this medication.

Talk to your care team about this medication if you are breastfeeding. Its use during breastfeeding has not been well studied.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Flu-like symptoms—fever, chills, muscle pain, cough, headache, fatigue
• Red or dark brown urine
• Urinary tract infection (UTI)—burning when passing urine, passing frequent small amounts of urine, bloody or cloudy urine, pain in the lower back or sides

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

• Bladder irritation
• General discomfort and fatigue
• Headache
• Nausea

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

This medication is given in a hospital or clinic. It will not be stored at home.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.