Bacillus Calmette and Guerin (BCG, strain Tice)
Consumer Medicine Information
What is in this leaflet
This information has been provided to help understand how this product works and to answer some common questions about OncoTICE. If you need more information please ask your doctor.
All medicines have risks and benefits. Your doctor has weighed the risks of you being given OncoTICE against the benefits they expect it will have for you.
If you have any concerns about being given this medicine, ask your doctor.
Keep this leaflet. You may need to read it again.
What OncoTICE is used for
OncoTICE belongs to the group of medicines called immunostimulants. These medicines stimulate certain parts of the immune system.
OncoTICE is used for the treatment of superficial bladder cancer by stimulating the body's natural ability to fight disease. It is also used to prevent the disease from recurring after bladder surgery.
Before you are given OncoTICE
Do not take OncoTICE if:
- you have a urinary tract infection. If you have cystitis (inflammation of the bladder), you will receive a course of antibiotics before treatment with OncoTICE starts. The treatment with antibiotics needs to be finished before treatment with OncoTICE is commenced.
- you have blood in your urine
- you have active tuberculosis.
Your doctor will probably do a skin reaction test (Mantoux) to assist in making this diagnosis.
- you are being treated with anti-tuberculosis drugs.
- you suffer from an impaired immune system (reduced immunity against infectious diseases), irrespective of the cause.
- you are HIV-positive
- you are pregnant or are breast feeding your baby
Take special care with OncoTICE in the following situations:
- Before the first intravesical instillation of OncoTICE, your doctor will probably perform a skin reaction test (Mantoux) to investigate if you have an active tuberculosis infection.
- When the bladder wall or ureter is damaged during catheterisation, treatment will need to be postponed until the lesion is healed.
- It is important that infection with the HIV virus is excluded. It may be necessary that a blood sample is taken to test for HIV. Your doctor may also ask if there are any risk factors, such as unsafe sex, use of dirty needles if you are a drug user and blood transfusions.
- To protect your partner from transmission of the BCG bacteria, it is advisable to refrain from sexual intercourse during the week following treatment with OncoTICE. The use of a condom may protect your partner provided it is used correctly and does not tear.
OncoTICE should not be administered to children.
Taking other medicines
Tell your doctor if you are taking any other medication.
The following medicines/therapies can reduce the effects of OncoTICE:
- Treatment for tuberculosis
- Medicines that suppress the immune system (immune suppressants) such as anticancer drugs
- Medicines that suppress the production of bone marrow cells (bone marrow suppressants)
- Radiation therapy
If you are using any of these medicines or undergoing one of these therapies, your doctor will postpone treatment with OncoTICE.
How OncoTICE is given
OncoTICE will be introduced into the bladder by a doctor or nurse.
The contents of one vial will be dissolved in 50mL of saline solution. A sterile tube will be inserted into the bladder through the normal urine passage and the bladder will be emptied of urine. The OncoTICE solution will be instilled into the bladder via the tube.
It is important you move around while OncoTICE is in the bladder. The solution must remain in the bladder for two hours and you should not empty your bladder during this period. After two hours the bladder should be emptied in a sitting position. For six hours after treatment the bladder should continue to be emptied in a sitting position. Two cups of household bleach should be added to the toilet containing the urine and left to stand for 15 minutes before flushing.
For cancer of the bladder, 7 to 14 days should elapse before BCG is administered following biopsy or traumatic catheterisation. The treatment schedule comprises a weekly instillation for the first 6 weeks, followed by a monthly treatment for a period of 12 months.
If you have had bladder surgery, your doctor will start using OncoTICE between 10 and 15 days later. It will generally be given once a week for 6 weeks, then an instillation in the 8th and 12th week followed by monthly instillations from month 4 through to month 12.
Your doctor will decide on the duration and frequency of treatment for you.
If you are given too much (overdose)
In the unlikely event that more than one vial is administered, you will be monitored for signs of BCG infection, and if indicated, you may be treated with anti-tuberculosis medication.
While you are using OncoTICE
Refrain from drinking any fluid in the four hours prior to receiving this product and during the two hours the OncoTICE remains in the bladder.
OncoTICE is generally well tolerated.
If you do experience unusual symptoms or feel unwell after receiving this medication please inform your doctor.
After treatment with OncoTICE you may suffer from one or more of the common (in more than 10% patients) side effects:
- Bladder inflammation
- Painful urination, urinary frequency, and blood in the urine. In general these symptoms disappear within two days.
- Flu-like symptoms such as fever, fatigue and a feeling of discomfort. These symptoms usually occur as soon as 4 hours after treatment and last for 24 to 48 hours.
The following side effects occur less frequently (1% -10% of patients):
- Painful joints
- Muscular pain
- Nausea and vomiting
- Abdominal pain
- Lung inflammation
- Loss of urine
- Urinary tract infection
- Urge to urinate
- Abnormal urine lab test
- Feverish shivers
Uncommon side effects (0.1% – 1% of patients):
- Skin rash
- Hepatitis associated with jaundice (yellow colouration of the skin or eyes)
- Abnormal liver function test
- Pus in the urine
- Decreased amount of red blood cells or platelets possibly associated with symptoms such as fatigue and/or bruises
- Decrease of white blood cells
- Difficult urination
- Bladder constriction and blocked urine flow
- Tuberculous infections
Rare side effects (0.01% – 0.1% of patients):
- Inflammation of the epididymis
The following side effects occur very rarely (less than 0.01% patients):
- Hair loss
- Increased perspiration
- Dizziness (sensation of spinning)
- Increased muscle tension
- Abnormal sensation such as prickling, burning, pins and needles or itching
- Loss of appetite
- Indigestion and gas
- Weight loss
- Low blood pressure
- Shortness of breath
- Sore throat
- Runny nose
- Swelling of lymph glands
- Insufficient function of the kidney
- Granuloma (nodule in an organ)
- Inflammation of the glands
- Inflammation of the testicles
- Reiter's syndrome (inflammation of the eyes, joints and genitourinary system)
- Lupus vulgaris (tuberculosis of the skin)
- Inflammation of the prostate
- Elevation of Prostatic specific antigen (PSA) (prostate laboratory test)
- Burning, itching and soreness in the female genital area
- Back pain
- Chest pain
- Fluid retention in the limbs
Other observed side effects are
- Allergic reactions
- BCG infection in the blood (sepsis)
- Abnormal arterial dilation for bacterial infection (infective aneurysm)
In case your symptoms are severe or last longer than 48 hours, you are advised to contact your doctor. If you notice any side effects not mentioned in this leaflet, please inform your doctor or pharmacist.
After using OncoTICE
Store OncoTICE at 2°C to 8°C, protect from light and use before the expiry date on the product label. The product in solution can be stored for a maximum of 2 hours under these conditions.
OncoTICE is a freeze dried preparation containing two hundred million – eight hundred million Colony Forming Units of Calmette and Guerin (BCG strain Tice) in sealed glass vials. In addition to the active ingredient, BCG, OncoTICE contains the following additives: lactose, asparagine, citric acid monohydrate, potassium phosphate (dibasic), magnesium sulphate, ferric ammonium citrate, glycerol, zinc formate and ammonium hydroxide.
Merck Sharp & Dohme (Australia) Pty Limited
Level 1, Building A
26 Talavera Road
Macquarie Park NSW 2113
Vials: AUST R 59912
This leaflet was revised 23 November 2016.
Published by MIMS April 2017