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 to tissues
Metabolism/Excretion: Metabolized to dimethyl sulfone and dimethyl sulfide.
Half-Life: Unknown.
Time/Action Profile⬆⬇
ROUTE
ONSET
PEAK
DURATION
Topical, Intravesicular
unknown
4 hr
unknown
Contraind./Precautions⬆⬇
Contraindicated in:
OB: Pregnancy.
Use Cautiously in:
Diabetes;
Liver disease;
Lactation: Use during breastfeeding only if potential maternal benefit justifies potential risk to infant.
Intravesical(Adults ): Instill 50 mL into bladder and retain for 15 min; repeat every 2 wk until symptoms are relieved, then ↑ intervals between treatments orinstill 50 mL into bladder and retain for 15–20 min every 1 to 2 weeks for 4 to 8 treatments.
Extravasation
(Adults ): Within 10 min of extravasation, apply to a region covering twice the affected area every 8 hours for 7 days.
Availability⬆⬇
Intravesical (or topical) solution: 50%
Assessment⬆⬇
Assess for symptoms of interstitial cystitis (suprapubic pain, urinary frequency, nocturia hematuria) before and periodically during therapy.
Complete ophthalmologic examination, including slit lamp examinations, prior to treatment and every 6 mo thereafter in patients receiving long-term therapy.
Lab Test Considerations:
Assess CBC, hepatic function, renal function every 6 mo.
Implementation⬆⬇
Intravesical: Instill 50 mL of 50% solution into the bladder. Instruct patient to retain solution for 15–60 min.
Topical For extravasation of antineoplastics, stop infusion immediately and disconnect, but leave the cannula in place. Gently aspirate as much extravasated fluid as possible through the cannula. Do not flush the line. Remove the cannula and elevate the extremity. Apply Rimso-50 using a saturated gauze pad to an area twice the size of the extravasation. May repeat every 8 hr for 7 days.
Patient/Family Teaching⬆⬇
Explain the purpose and side effects of dimethyl sulfoxide. Advise patient to notify health care professional if symptoms worsen or if changes in symptoms occur. Advise patient to read Patient Information before starting and periodically during therapy in case of changes.
Inform patient that this drug may cause a garlic taste that can last for a few hours and a garlic odor to the breath/body that may persist up to 72 hr after drug administration.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
Rep: May cause fetal harm. Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
Evaluation/Desired Outcomes⬆⬇
Decrease in symptoms of interstitial cystitis.
Prevention of extravasation injury from antineoplastic agents (unlabeled use).