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What should I discuss with my health care provider before I receive BCG (TheraCys, Tice BCG Vaccine)?

You should not receive this medication if you are allergic to BCG, or if you have:

• tuberculosis;
• a weak immune system from diseases such as AIDS, leukemia, or lymphoma;
• fever, a bladder infection, or blood in your urine;
• if you are using steroids or receiving chemotherapy or radiation treatments; or
• if you have had a bladder biopsy, surgery, or catheter within the past 14 days.

Before you receive BCG, tell your doctor if you are allergic to latex rubber, or if you have:

• any type of bacterial, fungal, or viral infection (including HIV);
• myasthenia gravis;
• a pacemaker or other artificial heart device;
• an artificial joint or other prosthetic;
• a history of aneurysm (dilated blood vessel);
• if you have ever had bypass surgery;
• if you have ever had tuberculosis; or
• if you need to have an organ transplant (kidney, liver, heart, etc).

If you have any of these conditions, you may need a dose adjustment or special tests to safely receive BCG.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Before you receive BCG, tell your doctor if you are pregnant. Use effective birth control, and tell your doctor if you become pregnant during treatment.

It is not known whether BCG passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How is BCG given (TheraCys, Tice BCG Vaccine)?

BCG is a freeze-dried product that is mixed with saline and other diluents (liquids) in an amount equal to approximately 8 ounces. This liquid mixture is injected directly into the bladder using a catheter inserted into the urethra (the tube for passing urine out of your bladder). You will receive this medication in a clinic or hospital setting.

This medication is usually given once every week for 6 weeks, and then given every 3 to 6 months for up to 2 years. Follow your doctor's instructions about your specific dosing schedule.

After BCG is placed into the bladder, you will need hold the medication in your bladder as long as possible up to 2 hours. During that time you may be encouraged to lie down or stay relaxed.

For at least 6 hours after you are treated with BCG, your urine will still contain some of the medication and the bacteria it is made from. To prevent the spread of this bacteria, use a toilet rather than a urinal, and sit on the toilet while urinating.

Before you flush the toilet, disinfect the urine with household bleach in an amount that is approximately equal to how much you have urinated. Pour the bleach into the toilet in which you urinated, let it stand for 15 minutes and then flush.

Your doctor may ask you to drink extra fluids for several hours after your BCG treatment to help flush out your bladder. Follow your doctor's instructions about the type and amount of liquids you should drink.

Call your doctor right away if you have a fever after receiving BCG, especially if the fever lasts for several hours or longer.

Being treated with BCG can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using BCG.

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