Dimethyl Sulfoxide
Mechanism :
The exact mechanism is unknown but shows anti-inflammatory and analgesic properties. It may inhibit free radical formation.
Indication :
- Intravesical administration(50%): in interstitial cystitis.
- Topical administration which is not FDA approved(99%): prevent soft tissue damage by iv chemotherapeutic agents.
Contraindications :
It should be used with caution in the following conditions.
• Urinary tract malignancy, especially bladder cancer because this drug causes vasodilation.
• Cataract.
The safety profile is not established in the pediatric age group.
Its safety if used in pregnancy is not established and has been shown to cause teratogenic effects in preclinical studies. Hence, should be used with caution. There isn't enough data to know if the drug is excreted in breastmilk and should be used with caution in lactating mothers.
Dosing :
Intravesical administration: Directly instill into the bladder using a catheter or syringe dimethyl sulfoxide DMSO 50% aqueous irrigation solution(RIMSO-50). Allow 15 minutes to pass before voiding the bladder. Use it in conjunction with an analgesic to prevent pain due to bladder spasms.
Topical: Use 99% DMSO on an area twice the size of the affected area with a local cooling pack.
Adverse Effect :
Garlic odor and breath, allergic reaction, transient chemical cystitis, abnormal body odor, pain
Interaction :
• Sulindac: Concurrent use reduces plasma concentration of dimethyl sulfoxide and has reportedly caused peripheral neuropathy.
• Verteporfin: Concommitant use reduces verteporfin efficacy