bacillus calmette-guerin at a glance
Medicine class
Live attenuated bacterial immunotherapy
Usual role
Treating carcinoma in situ and reducing recurrence of selected high-risk non-muscle-invasive bladder cancers
Administration
Instilled into the bladder through a urinary catheter by an experienced healthcare professional
Important precaution
Treatment is postponed for urinary infection, visible blood in the urine or unhealed urinary-tract injury
What is bacillus calmette-guerin used for?
Licensed intravesical uses include:
Treatment of primary or concurrent carcinoma in situ of the bladder.
Prevention of recurrence after transurethral resection in selected high-grade, relapsing or high-risk non-muscle-invasive urothelial bladder cancer.
BCG-medac is additionally licensed for aggressive urothelial carcinoma variants, such as micropapillary or nested variants.
How does bacillus calmette-guerin work?
BCG attaches to the bladder lining and triggers a local inflammatory immune response involving immune cells and signalling molecules that attack abnormal cells.
How to take bacillus calmette-guerin
BCG is prepared and administered in hospital by trained staff. The bladder is emptied, a catheter is inserted carefully and the suspension is instilled directly into the bladder.
Follow the treatment unit's instructions about limiting drinks beforehand; food can usually be eaten normally.
Retain the suspension and change position or remain mobile as instructed.
When told to empty your bladder, urinate sitting down. Follow instructions for toilet disinfection, handwashing and genital hygiene.
Drink more water afterwards if your clinical team says this is appropriate.
bacillus calmette-guerin side effects
Common or expected effects
- Bladder inflammation, discomfort or pain when urinating
- Needing to urinate more frequently or urgently
- Mild blood or debris in the urine
- Temporary fever, chills, muscle aches or other flu-like symptoms
- Fatigue
- Nausea
Get urgent medical advice
- Persistent or high fever, worsening illness or organ symptoms suggesting systemic BCG infection or sepsis
- Cough, breathlessness or chest symptoms
- Jaundice or liver inflammation
- Severe allergic reaction, including breathing difficulty or facial swelling
- Inability to pass urine or severe, persistent bladder pain
- Painful joints with red eyes and urinary symptoms, which may indicate reactive arthritis
bacillus calmette-guerin in pregnancy
Intravesical BCG is contraindicated during pregnancy. Tell the specialist team if you are pregnant, may be pregnant or are planning pregnancy; effective contraception may be advised.
bacillus calmette-guerin while breastfeeding
Both selected products are contraindicated during breastfeeding. Discuss feeding alternatives and future breastfeeding with the oncology or urology team.
bacillus calmette-guerin interactions
Tell the specialist team about all prescribed, over-the-counter and hospital treatments before each instillation.
Antituberculosis medicines
They act against BCG organisms and are contraindicated during treatment unless specialists are managing a suspected BCG complication.
Antibiotics, particularly fluoroquinolones, doxycycline or gentamicin
They may reduce BCG activity, so instillation is generally postponed until antibiotic treatment has finished and infection has resolved.
Common questions about bacillus calmette-guerin
Answers are fully visible for fast scanning and source review.
Is bladder-cancer BCG the same as the BCG tuberculosis vaccine?
It uses related live, weakened organisms, but intravesical products are formulated for bladder cancer and must not be used as TB vaccines.
Can BCG be given during a urinary tract infection?
No. Treatment is postponed until the infection has resolved and relevant antibiotic treatment has finished.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.