dimethyl sulfoxide

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

REMS

Interstitial cystitis (intravesical instillation)

Unlabeled Use:

Amyloidosis.
Topical Prevention of extravasation injury from antineoplastic agents.

Action ⬆ ⬇

Stimulates bladder afferent pathways, causing release of nitrogen oxide from afferent neurons which controls lower urinary tract function. Also has anti-inflammatory, anti-ischemic analgesic, and vasodilatory properties.

Therapeutic effects:

Improved symptoms of interstitial cystitis.
Prevention of tissue necrosis from extravasation injuries.

Pharmacokinetics ⬆ ⬇

Absorption: Easily penetrates the skin.

Distribution: Widely distributed in body fluids and tissues.

Metabolism/Excretion: Metabolized to dimethyl sulfone and dimethyl sulfide.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
PO, Topical, Intravesicular	unknown	4 hr	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

OB: Pregnancy and lactation.

Use Cautiously in:

Diabetes;
Liver disease.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: dry skin, pruritus

GI: diarrhea, nausea, vomiting

GU: bladder discomfort

Hemat: eosinophilia

Neuro: dizziness, headache, sedation

Misc: garlic-like breath/body odor

Interactions ⬆ ⬇

Natural-Drug Products:

May ↓ effectiveness of sulindac.

Natural-Natural Products:

None known.

Route/Dosage ⬆ ⬇

(Adults ): Interstitial cystitis: Instill 50 mL of aqueous 50% dimethyl sulfoxide solution into the bladder up to every 2 wk; Extravasation injury: 77–90% DMSO applied topically every 3–8 hrs.
PO (Adults ): Amyloidosis: 7–15 grams daily.

Availability ⬆ ⬇

Liquid: ^OTC
Cream: ^OTC
Gel: ^OTC

Assessment ⬆ ⬇

Assess for symptoms of interstitial cystitis (suprapubic pain, urinary frequency, nocturia hematuria) prior to and periodically during therapy.

Implementation ⬆ ⬇

Intravesical: Instill 50 mL of 50% solution into the bladder. Instruct patient to retain solution of 15–60 min.

Patient/Family Teaching ⬆ ⬇

Instruct patient as to what to expect during therapy. Advise patient to notify health care professional if symptoms worsen or if changes in symptoms occur.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇