Immucyst: Is It a Type of BCG Vaccine and What Are Its Side Effects?

Immucyst

Immucyst is a form of intravesical therapy that contains the active ingredient Bacillus Calmette-Guérin (BCG), which is derived from the tuberculosis vaccine.
It is used primarily for the treatment of superficial bladder cancer.

The side effects of Immucyst can include:
1.
Urinary symptoms such as increased frequency, urgency, and dysuria (painful urination).
2.
Hematuria (blood in urine).
3.
Flu-like symptoms, including fever, chills, and malaise.
4.
Localized bladder irritation or inflammation.
These side effects typically occur within a few days to a week after the instillation of the treatment.
However, some effects may persist longer or appear later, depending on the individual response to the therapy.

Ms. Li, 40~49 year old female. Ask Date: 2003/12/24

Dr. Gu Zhenting reply Pharmacology

1.
ImmunCyst is a freeze-dried preparation made from a live attenuated strain of Mycobacterium bovis.

2.
Recommended management for adverse reactions to ImmunCyst:
(1) Irritative bladder symptoms lasting <48 hours – symptomatic treatment.

(2) Irritative bladder symptoms lasting >48 hours – symptomatic treatment: Delay the next ImmunCyst treatment until symptoms are completely resolved.
If symptoms do not fully resolve within one week, administer isoniazid (INH) 300 mg daily until complete relief is achieved.

(3) Concurrent bacterial urinary tract infection – delay the next ImmunCyst treatment until the antimicrobial course is completed and urine culture shows negative results.

(4) Other genitourinary adverse reactions: symptomatic granulomatous prostatitis, epididymitis, ureteral obstruction, or renal abscess – discontinue ImmunCyst.
Administer isoniazid (INH) 300 mg daily and rifampin 600 mg daily for 3-6 months.

(5) Fever <38.5°C lasting <48 hours – use acetaminophen for symptomatic treatment.

(6) Skin rash, joint pain, or migratory arthritis – antihistamines or non-steroidal anti-inflammatory drugs; if ineffective, discontinue ImmunCyst and administer isoniazid (INH) 300 mg daily for 3 months.

(7) Systemic BCG reaction without signs of septic shock – discontinue ImmunCyst.
Seek infectious disease consultation.
Administer triple anti-tuberculosis therapy for 6 months.

(8) Systemic BCG reaction with signs of septic shock – same as above.
Consider short-term high-dose systemic corticosteroid therapy.

Reply Date: 2003/12/24

More Info

Immucyst is indeed related to the BCG (Bacillus Calmette-Guérin) vaccine, but it is not the same as the traditional BCG vaccine used for tuberculosis. Instead, Immucyst is a formulation of BCG that is specifically used for the treatment of superficial bladder cancer. The BCG vaccine itself is a live attenuated strain of Mycobacterium bovis, which is closely related to the bacteria that cause tuberculosis. When used in the bladder, BCG stimulates the immune system to attack cancer cells, thereby helping to prevent recurrence of bladder cancer.

The administration of Immucyst typically involves intravesical therapy, where the solution is instilled directly into the bladder through a catheter. This method allows for localized treatment with minimal systemic exposure, which is beneficial in reducing potential side effects compared to systemic chemotherapy.

As for side effects, they can vary from person to person, but some common side effects associated with Immucyst treatment include:
1. Bladder Irritation: This may manifest as increased frequency of urination, urgency, and discomfort or pain during urination. These symptoms can occur shortly after the treatment and may last for a few days to weeks.

2. Hematuria: Blood in the urine is another potential side effect, which can occur after treatment. This is usually temporary but should be monitored.

3. Flu-like Symptoms: Some patients may experience systemic symptoms such as fever, chills, fatigue, and malaise, which can occur within a few days after treatment.

4. Allergic Reactions: Although rare, some individuals may experience allergic reactions to the BCG solution, which could include rash, itching, or more severe reactions.

5. Infection: There is a small risk of developing a urinary tract infection (UTI) following the procedure, which may require treatment with antibiotics.

The onset of these side effects can vary. Bladder irritation and hematuria may occur shortly after the instillation, often within the first 24 to 48 hours. Flu-like symptoms may develop within a few days following treatment. It is essential for patients to communicate with their healthcare provider about any side effects they experience, as management strategies can be implemented to alleviate discomfort.

In summary, while Immucyst is derived from the BCG vaccine, its application is specifically tailored for bladder cancer treatment. The side effects, primarily related to bladder irritation and systemic responses, are generally manageable and should be discussed with a healthcare provider to ensure proper care and monitoring throughout the treatment process. If you have further concerns or specific symptoms, it is advisable to consult with your oncologist or urologist for personalized guidance and support.

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