Onco BCG Bacillus Calmette-Guerin Strain 40mg Injection

Q1: What is BCG intravesical therapy used for?

BCG is used to treat non-muscle invasive bladder cancer (NMIBC), including carcinoma in situ (CIS), and to prevent recurrence of high-risk papillary bladder tumors after transurethral resection (TURBT).

Q2: How does BCG work against bladder cancer?

BCG is a live attenuated bacterial strain that stimulates a local immune response inside the bladder. It activates macrophages and T-lymphocytes that attack residual cancer cells, creating an anti-tumor immune environment.

Q3: How is BCG administered?

It is instilled directly into the bladder through a urethral catheter by a trained urologist. The standard induction course is once weekly for 6 consecutive weeks, followed by a maintenance schedule every 3–6 months.

Q4: What is the BCG induction and maintenance schedule?

Induction consists of 6 weekly instillations. Maintenance therapy (SWOG schedule) involves 3 weekly instillations at 3 months, 6 months, and then every 6 months for up to 3 years, depending on tolerability and response.

Q5: How long must I retain BCG in the bladder?

You are asked to retain the BCG instillation for approximately 2 hours, rotating position periodically to distribute it throughout the bladder. Do not urinate until the 2 hours are complete.

Q6: What are the common side effects of BCG therapy?

Common side effects include bladder irritation, painful urination (dysuria), urinary frequency, blood in urine (hematuria), and flu-like symptoms (fever, chills, fatigue) lasting 24–48 hours after instillation.

Q7: What serious side effects require emergency care?

Seek immediate medical attention for: persistent fever above 38.5°C (101.3°F) lasting more than 48 hours, severe systemic infection (BCG sepsis), severe joint pain, granulomatous infections, or pulmonary symptoms. BCG sepsis is rare but life-threatening.

Q8: Can BCG be given to patients with a weakened immune system?

No. BCG is contraindicated in immunocompromised patients (e.g., HIV/AIDS, organ transplant recipients on immunosuppressants, patients on high-dose corticosteroids) because the live bacteria can cause systemic BCG infection.

Q9: Can I receive BCG if I have an active urinary tract infection?

No. BCG must not be given when there is an active urinary tract infection or gross hematuria (heavy blood in urine). Your urologist will test your urine before each instillation and delay treatment if an infection is present.

Q10: How should I manage side effects after BCG treatment?

Drink plenty of fluids after instillation to flush the bladder. Bleach your urine for 6 hours post-instillation (add bleach to toilet before urinating, leave for 15 minutes). Take paracetamol for fever/discomfort as needed.

Q11: Who should avoid BCG intravesical therapy?

BCG is contraindicated in patients with active TB, immunocompromised states, current urinary tract infection, traumatic catheterisation, gross hematuria, or confirmed muscle-invasive disease. Pregnancy is also a contraindication.

Q12: Is BCG available without a prescription?

No. BCG intravesical therapy is a hospital-administered specialist treatment available only under urologist prescription and supervision. It is not available over the counter.