What adjustments may be made to dosing of Bacillus Calmette-Guérin (BCG) immunotherapy to increase tolerability?

Updated: Nov 12, 2019
  • Author: Gary David Steinberg, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Patients often have difficulty completing long-term therapy because of irritative adverse effects in the bladder. In such cases, the intervals between instillations should be lengthened; in addition, dose modification may also be necessary. Generally, a full ampule is administered, but some patients respond just as well to half or even one third of a dose and seem to have fewer adverse effects. The dose selection depends on the degree of reaction in the patient. Patients treated with the Tokyo172 substrain need only a 25% dose because of the potency of this product. The intent of the treatment is to elicit an immune response without overwhelming the immune system.

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