Live attenuated mycobacterial immunotherapy
Bacillus Calmette-Guérin (intravesical)
Brand names: BCG-medac, ImmuCyst, OncoTICE
Adult dose
Dose: Intravesical instillation per protocol — induction 6 weekly, maintenance 3-weekly courses for up to 3 years
Route: Intravesical
Frequency: Weekly induction / 3-weekly maintenance
Clinical pearls
- NICE NG2 / EAU bladder cancer: standard adjuvant therapy for high-risk non-muscle invasive bladder cancer (NMIBC) post-TURBT
- BAUS / EAU
- Specialist urology with isolation precautions for sharps
- BCGosis is medical emergency — anti-TB therapy
Contraindications
- Active TB
- Severe immunosuppression
- Active UTI
- Recent traumatic catheterisation / haematuria
- Pregnancy/breastfeeding
- Hypersensitivity
Side effects
- Cystitis (very common)
- Haematuria
- Fever / flu-like symptoms
- Disseminated BCG (BCGosis — sepsis-like)
- Granulomatous prostatitis / orchitis
- Hypersensitivity
Interactions
- Immunosuppressives (avoid)
- Antibiotics with anti-mycobacterial activity (reduce efficacy)
Monitoring
- Cystoscopy / cytology surveillance
- Urinary symptoms
- Systemic symptoms (BCGosis)
Reference: BNF; NICE NG2; EAU NMIBC; BAUS; SmPC; https://bnf.nice.org.uk/drugs/bacillus-calmette-gurin-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators