Bacillus of Calmette and Guerin vaccine, live (Intravesical)

Bacillus of Calmette and Guerin vaccine is used to help prevent tuberculosis in individuals who may be exposed to this serious illness.

Overview

Bacillus Calmette-Guerin is an injection which helps to prevent tuberculosis, which is a disease that can prove life threating. It is spread to others from an infected individual and is highly contagious. People who contract tuberculosis become severely ill and develop a number of symptoms including a hallmark cough which gets progressively worse as the disease progresses. There have been many deaths in the past from this disease, but medicines such as Bacillus Calmette-Guerin have helped to lessen the occurrence of this lethal disease and it is rare in the United States today. This drug is also used after a person is treated for bladder cancer or transurethral resection of bladder tumor (TURBT), and is intended for use for non-invasive or stage 1 bladder cancer as a preventative measure. The intravesical use of the vaccine affects the cells inside of the bladder without affecting other parts of the body. It is administered through a catheter once a week for six weeks.

You can only obtain this live vaccine from a doctor by prescription and is administered by a health care provider or health care facility by IV. Although the vaccine is highly effective, it is not 100% effective. Caution should be used to avoid others who may have tuberculosis and take measures to reduce the risk of exposure. This live vaccine will be administered to adults and children who have been exposed to tuberculosis. This vaccine is freeze-dried and must be reconstituted in order to administer it. Each individual will have a specially tailored treatment plan based on their individual needs. It is important to monitor your health and look for any side effects not only immediately following the injection but throughout the course of treatment.

There is a rare chance of developing a life-threatening condition such as anaphylactic shock when injected with the vaccine. The onset of this condition would immediately follow the injection and would need to be treated right away. Health care professionals who administer vaccines are trained to handle anaphylaxis events. In addition to this condition, there are instances of rashes and other signs of intolerance. Monitor children closely for the symptoms of an allergic reaction or an intolerance. If any of the rare side effects present themselves, you should proceed to the emergency room and notify your doctor or health care professional right away.

If you are pregnant or are nursing, you should discuss treatment with the BCG vaccine. It can pose risks to pregnant individuals and babies who are still breastfeeding. Caution should be used when taking this vaccine during pregnancy. Your dose may need to be altered to accommodate your pregnancy. Certain medications should be avoided when taking this vaccine, because they could create a life-threatening reaction. If you change any medications or quit taking any medications while you are taking the BCG vaccine, you should alert your doctor right away because they may need to alter your dose to compensate for the change.

Condition treated

  • Tuberculosis

Type of medicine

  • Tuberculosis vaccine

Side Effects

This drug is known to have a variety of side effects in some individuals who are taking it to prevent tuberculosis. If you experience any of these side effects, you should alert your doctor or local health care provider immediately because you may require immediate attention. In some cases, the BCG vaccine can pose a risk to your life, especially immediately following the injections.

Common side effects:

Accumulation of pus

If you begin to notice an accumulation of puss anywhere on your body, you should alert your doctor or health care provider immediately because you may develop a life-threatening condition which requires immediate attention.

Peeling and scaling of skin

This is a common side effect, but it should be carefully monitored and reported to your doctor because if the condition persists action may need to be taken to alleviate this side effect. If the condition accompanies a rash or severe pain you should go to the nearest emergency room and contact your doctor.

Injection site sores

Although this is a common side effect, your doctor will want to monitor this condition in case it develops into anything serious. Blistering immediately following the injection is normal.

Swelling of the lymph glands

Any swelling of the lymph glands should be reported to your doctor and monitored closely during the duration of your treatment with the Bacillus of Calmette and Guerin vaccine.

Rare side effects:

Cough

If you develop a cough as a result of your treatment, you should contact your doctor or go to the nearest emergency facility right away. This may also indicate the appearance of tuberculosis which can be highly contagious to others if not treated immediately.

Fever

Developing a fever as a result of this treatment is very rare. If you do, however, develop a fever, you should contact your doctor immediately or go to the emergency room to monitor your condition. This may signal an intolerance to the treatment which can pose an immediate danger to your health.

Bone pain

If you begin to experience bone pain, you may not be tolerating the vaccine well. This can also be a sign of another more serious health risk. If pain in the bones is present, you should alert your doctor immediately so they can monitor the situation closely.

Skin rash

A skin rash can signal an allergic reaction or an intolerance to the Bacillus of Calmette and Guerin vaccine. If the rash is painful or appears suddenly, you should go to the emergency room and contact your doctor immediately.

Dosage

The dosing for Bacillus of Calmette and Guerin vaccine live intravesical route is different for each individual and depends on a variety of factors. You must carefully your doctor's directions to get the optimal benefit from this medication. Do not change your dose or any of the instructions without your doctor's advice or consent.

The dose is very dependant on the strength of the vaccine. Your individual treatment also relies on the amount of vaccine and number of doses you take daily, as well as the time between the dose. The length of time you take the vaccine is determined by your doctor before you begin treatment. It is important to keep all of your appointments and carefully monitor your situation while you are taking the vaccine. Issues can develop quickly which could become a serious threat to your health and could create a life-threatening situation.

Interactions

There are 222 known drugs that interact with BCG:

Of those 222, there are 192 major drug interaction, 27 moderate drug interactions, and 3 minor drug interactions.

The most common medications that interact with BCG include Levaquin and Symbicort. Levaquin poses a major interaction risk, while Symbicort poses a moderate interaction risk.

Warnings

Upon receiving the BCG vaccine, you may notice blistering at the vaccination site which is normal. In some rare cases, individuals have developed a serious reaction to the vaccine called anaphylactic shock which is life-threatening and needs to be treated immediately. Some individuals will have scarring at the injection site or a rash that lasts for several weeks. In most cases, the rash disappears without scarring.

If you are pregnant or nursing, you should discuss this treatment thoroughly with your doctor so they can adjust the dose to the appropriate safe levels to avoid complication with your pregnancy or related to breastfeeding your baby. If you notice any changes in your pregnancy or your child, you should contact your doctor and pediatrician immediately and proceed to the nearest emergency room for immediate treatment.

Avoid adding medications or herbal supplements while taking this vaccine. If you medication regimen changes, or you stop taking any medication, you should contact your doctor because an adjustment to your dose may be required. If you develop a cough or a general feeling of being unwell, you should contact your doctor or proceed to the emergency room. This may be a symptom of tuberculosis and can also signal another serious health condition which requires immediate medical treatment. When taking the vaccine, it is important to discard any unused portion after six hours. The vaccine is unstable once it is reconstituted.

Pain at or near the injection site is normal as well as blistering immediately following the injection. If the pain at the injection site lasts, or the blistering around the area continues to get worse, you should alert your doctor. Always keep your appointments during treatment. Close monitoring for complication and developments is critical during your treatment. The BGC vaccine does not work 100% of the time, so if tuberculosis does develop in a patient, it is crucial to detect it immediately and begin the proper course of treatment to avoid a life-threatening situation and other health complications. Before beginning treatment, you should discuss the risks associated with this vaccine to determine if it is the proper course of treatment for your situation.

Storage

The BCG vaccine is freeze-dried and should be kept cool. It can be refrigerated between +2 to +8 degrees Celsius. Once the vaccine is reconstituted it should be used within six hours. Once reconstituted, the vaccine should be continuously kept cold because it is highly unstable. After six hours the vaccine should be discarded appropriately. This vaccine should also be stored away from ultraviolet and fluorescent lighting because it is particularly sensitive to this type of light.

Summary

Bacillus of Calmette and Guerin vaccine is a live vaccine used to help prevent contracting tuberculosis, which is a serious and possibly life-threatening condition which is easily transmitted. This vaccine is administered under the close supervision of a doctor and each individual who takes the vaccines will have a dose which is tailored to their specific needs. This vaccine is also used for toddlers and children who have been exposed to tuberculosis. It has also been used via an intravesical route to successfully preventative the return of bladder cancer in patients who either have a non-invasive stage 0 cancer, or a stage 1 cancer. It is administered once per week for six weeks and is injected directly into the bladder through a catheter.

If you have any health conditions, you should alert your doctor and thoroughly discuss the medications you are currently taking because they could pose a significant interaction risk with this medication. This vaccine is also used to treat pediatric patients who have been exposed to tuberculosis. Discuss the risk to children when using this vaccine and make sure you provide close supervision while this treatment is administered. Use caution when handling and administering this live vaccine, and follow all of the CDC's guidelines for handling this live vaccine, as well as administering it.