Adverse effects are generally mild and transient. They appear to be directly related to cumulative CFU count of BCG administered in various instillations. Common side effects are: Frequency, urgency of micturition and dysuria - these symptoms usually occur from 2nd
Cystitis and typical granulomatous inflammatory reactions which occur in the mucosa of urinary bladder may be an essential component of anti tumour activity of the drug. The symptoms usually disappear within 2 days and do not require treatment. Cystitis may be more prolonged during maintenance treatment and if severe, Isoniazid 300 mg daily can be given with analgesics until symptoms disappear.
Malaise and low-medium grade fever and/or a flu like syndrome. These symptoms usually occur in 4 hours after instillation and disappear within 24-48 hours.
RARE ADVERSE EFFECTS:
Fever more than 39°C. The fever resolves within 24-48 hours with antipyretics and fluids.
Systemic BCG infections due to traumatic catheterization, perforation of bladder or early BCG instillation after extensive TURBT which may be manifested by pneumonitis, hepatitis or cytopenia. Patients with such symptoms should be treated with tuberculostatic drugs as per treatment schedules used. Triple drug therapy with or without cycloserine for some weeks should be used.
Arthritis, Arthralgia, Haematuria, Orchitis, Transient urethral obstruction, Epididymitis or bladder contraction may occur.