Spresica

Mike C · 08-24-2001, 06:10 AM

I just had a dynamic pressure check done on my bladder and my urologist told me about a new method that I can use to better control my bladder pressure and spasticity. It´s called Spresica, which is Oxybutynine-Hydrocloride in a liquified, sterile form placed in an injector. You use it by first emptying your bladder with a cathetor and leaving it in, inject the liquid Oxybutynine directly into your bladder. 1 ml of this solution is equal to 1 mg of Oxybutynine. It comes in 5, 25, and 30mg. My urologist said I was to use 25mg, twice a day, morning and evenings. You no longer have to take Oxybutynine in pill form. Apparently he said it is much more effective in controlling bladder pressure and spasticity when used this way. I have just received my first batch of 40 injectors, so I´ll have to let you know just how effective this really is. There is a website you can check out so that you have a visual image of the injector, but the site is in German. www.vesica-pharma.de What do you think Spinalnurse? Ever hear of this method being used? Totally new to me.

SCI-Nurse · 08-24-2001, 08:29 AM

Yes, this treatment has been used in many centers in the USA. We have used it at my center for at least 8 years, but we have made our own solution out of Ditropan tablets mixed in sterile water, which has been very effective (and I suspect much cheaper than prefilled syringes). As far as I know, it is not yet commercially available in a bladder instillation that is pre-made. It needs to be refrigerated after it is mixed if not used right away.

We tend to use it for those patients where oral Ditropan is not as effective as desired, even at maximum dosage, or those who cannot tolerate Ditropan side effects. It can only be used by those who do intermittent cath...it cannot be used this way for those who must take Ditropan or Detrol and also use indwelling catheters. (KLD)

Mike C · 08-24-2001, 03:35 PM

I take it you mean it is not yet available in the US on a commercial basis. Seems a little weird that such an effective method can and has been used in a "clinical" environment but not "at home". Or can a person chop up some ditropan in sterile water (or have a pharmacy do it)and inject it themselves at home and gain the same effect? Not for nothing Spinalnurse, but is this method FDA approved? Or does it even need FDA approval? Spresica does not need to be refrigerated at all and is also sterile.

[This message was edited by Mike C on August 24, 2001 at 06:49 PM.]

SCI-Nurse · 08-24-2001, 11:14 PM

We provide this for outpatients as well as inpatients at my center, but it is not commercially available pre-mixed, and is not officially FDA approved for this method of administration. Those who use it make their own solution or have it done by a pharmacist. As you know, drug approvals in Europe and the USA are very different. (KLD)

Jordie · 01-05-2008, 06:42 PM

hey I AM HAVING TROUBLE GETTING INTO THE HIGHLITED SITE CAN YOU IMMEDIATELY PLEASE SEND ME MORE INFORMATION ON THIS NEW METHOD I LIVE IN CANADA I DO IT THE OLD WAY BUT I WANT TO CONVINCE OUR GOVERNMENT TO GET THE INJECTORS ON THE MARKET IMMEDIATELY I AM EXTREMELY SERIOUS ABOUT CHANGING THIS FOR MYSELF AND OTHERS JORDIE

Jordie · 01-05-2008, 06:56 PM

Quote:

Originally Posted by SCI-Nurse

Yes, this treatment has been used in many centers in the USA. We have used it at my center for at least 8 years, but we have made our own solution out of Ditropan tablets mixed in sterile water, which has been very effective (and I suspect much cheaper than prefilled syringes). As far as I know, it is not yet commercially available in a bladder instillation that is pre-made. It needs to be refrigerated after it is mixed if not used right away.

We tend to use it for those patients where oral Ditropan is not as effective as desired, even at maximum dosage, or those who cannot tolerate Ditropan side effects. It can only be used by those who do intermittent cath...it cannot be used this way for those who must take Ditropan or Detrol and also use indwelling catheters. (KLD)

HELLO I WANT TO GET THE GOVERNMENTS IN USA AND CANADA TO PUT THE PREFILLED INJECTION ON THE MARKET IMMEDIATELY I DONT AT ALL FEEL THAT WE SHOULD HAVE TO GO WITHOUT SOMETHING THAT IS AVAILABLE TO OTHERS TO MAKE THEIR LIVES EASIER I DESERVE TO BE AS COMFORTABLE AS THEY ARE SO FOR NOW THOUGH CAN YOU AT LEAST HELP ME WITH THE RATIO OF HOW MUCH STERILE WATER I NEED TO USE WHEN I USE 25 MG IN THE AM AND IN THE PM INSTEAD OF WHAT I DO NOW WHICH IS 3 - 5 MG TABLETS DISSOLVED IN 30 MLL OF SALENE I INSTILL (ONCE IT IS DISOLVED) 10 MLL OF THE SOLUTION IN BLADDER 3 TIMES DAILY BUT NOW I WANT TO DO IT ONLY TWICE A DAY BECAUSE I DO NOT WANT TO HAVE TO REFRIGERATE IT WHEN I GO OUT SO IF I ONLY DO IT IN THE AM AND PM THEN OF COURSE I WILL ONLY HAVE TO REFRIGERATE IT AT HOME THE REASON I AM GOING TO 25 IS BECAUSE WHEN I PUT THE CATHETRE IN THE SOLUTION WILL BE EXPELLED OUT OF THE BLADDER BUT I AM GUESSING THAT THE MORE I PUT IN THE MORE THAT WILL BE ABSORBED INTO THE BLADDER TISSUE PLEASE RESPOND ASAP THANKS JORDIE

SCI-Nurse · 01-05-2008, 07:04 PM

Please don't write all in caps. On the internet this is considered to be SHOUTING and is considered rude. It is also very difficult to read.

I am not surprised that a list posted here 7 years ago is no longer good! I suggest you Goggle the drug name for more information about it.

A drug company in Canada or the USA would need to submit research studies showing that this drug is safe and effective for it to be approved in this country. I don't see anyone doing that, and the process is very expensive (so rarely done for a small population such as those who have SCI and do intermittent cath) and takes years.

You don't have to refrigerate the solution if you mix it as needed. Just put the tablets into the syringe (take it apart first) then draw up your solution and shake.

Actually, we are rarely doing this anymore since we now are offering bladder Botox for those who have failed with the drugs or have intolerable side effects due to the usual anticholenergics. Since Botox is already approved for use in the USA and Canada, it is just finding a physician and insurance who will approve it for off-label use like this.

(KLD)

greta · 01-05-2008, 08:39 PM

Can the Botox be used for those with indwelling catheters?

SCI-Nurse · 01-05-2008, 10:59 PM

It can, but for most there is not much point. The reason to use Botox for those using intermittent cath is to decrease bladder pressure and increase capacity. I suppose if you had leakage problems that could not be resolved by the use of anticholenergic drug or could not tolerate them, it could be used, but I know of no studies done for this, and would think it unlikely an insurance would pay for it (as they would definitely consider it experimental).

(KLD)

08-24-2001, 06:10 AM	#1
Mike C Moderator Join Date: Jul 2001 Location: Deutschland Posts: 4,894	Spresica I just had a dynamic pressure check done on my bladder and my urologist told me about a new method that I can use to better control my bladder pressure and spasticity. It´s called Spresica, which is Oxybutynine-Hydrocloride in a liquified, sterile form placed in an injector. You use it by first emptying your bladder with a cathetor and leaving it in, inject the liquid Oxybutynine directly into your bladder. 1 ml of this solution is equal to 1 mg of Oxybutynine. It comes in 5, 25, and 30mg. My urologist said I was to use 25mg, twice a day, morning and evenings. You no longer have to take Oxybutynine in pill form. Apparently he said it is much more effective in controlling bladder pressure and spasticity when used this way. I have just received my first batch of 40 injectors, so I´ll have to let you know just how effective this really is. There is a website you can check out so that you have a visual image of the injector, but the site is in German. www.vesica-pharma.de What do you think Spinalnurse? Ever hear of this method being used? Totally new to me.

08-24-2001, 08:29 AM	#2
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,516	Intravesicular Ditropan Instillation Yes, this treatment has been used in many centers in the USA. We have used it at my center for at least 8 years, but we have made our own solution out of Ditropan tablets mixed in sterile water, which has been very effective (and I suspect much cheaper than prefilled syringes). As far as I know, it is not yet commercially available in a bladder instillation that is pre-made. It needs to be refrigerated after it is mixed if not used right away. We tend to use it for those patients where oral Ditropan is not as effective as desired, even at maximum dosage, or those who cannot tolerate Ditropan side effects. It can only be used by those who do intermittent cath...it cannot be used this way for those who must take Ditropan or Detrol and also use indwelling catheters. (KLD)

08-24-2001, 11:14 PM	#4
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,516	Ditropan instillation We provide this for outpatients as well as inpatients at my center, but it is not commercially available pre-mixed, and is not officially FDA approved for this method of administration. Those who use it make their own solution or have it done by a pharmacist. As you know, drug approvals in Europe and the USA are very different. (KLD)

01-05-2008, 08:39 PM	#8
greta Senior Member Join Date: Jun 2004 Location: Utah Posts: 226	Can the Botox be used for those with indwelling catheters? __________________ T-4 complete since 1973

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08-24-2001, 03:35 PM	#3
Mike C Moderator Join Date: Jul 2001 Location: Deutschland Posts: 4,894	I take it you mean it is not yet available in the US on a commercial basis. Seems a little weird that such an effective method can and has been used in a "clinical" environment but not "at home". Or can a person chop up some ditropan in sterile water (or have a pharmacy do it)and inject it themselves at home and gain the same effect? Not for nothing Spinalnurse, but is this method FDA approved? Or does it even need FDA approval? Spresica does not need to be refrigerated at all and is also sterile. [This message was edited by Mike C on August 24, 2001 at 06:49 PM.]

01-05-2008, 06:42 PM	#5
Jordie Junior Member Join Date: Jan 2008 Location: WINDSOR ONT CANADA Posts: 4	hey I AM HAVING TROUBLE GETTING INTO THE HIGHLITED SITE CAN YOU IMMEDIATELY PLEASE SEND ME MORE INFORMATION ON THIS NEW METHOD I LIVE IN CANADA I DO IT THE OLD WAY BUT I WANT TO CONVINCE OUR GOVERNMENT TO GET THE INJECTORS ON THE MARKET IMMEDIATELY I AM EXTREMELY SERIOUS ABOUT CHANGING THIS FOR MYSELF AND OTHERS JORDIE

01-05-2008, 07:04 PM	#7
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,516	Please don't write all in caps. On the internet this is considered to be SHOUTING and is considered rude. It is also very difficult to read. I am not surprised that a list posted here 7 years ago is no longer good! I suggest you Goggle the drug name for more information about it. A drug company in Canada or the USA would need to submit research studies showing that this drug is safe and effective for it to be approved in this country. I don't see anyone doing that, and the process is very expensive (so rarely done for a small population such as those who have SCI and do intermittent cath) and takes years. You don't have to refrigerate the solution if you mix it as needed. Just put the tablets into the syringe (take it apart first) then draw up your solution and shake. Actually, we are rarely doing this anymore since we now are offering bladder Botox for those who have failed with the drugs or have intolerable side effects due to the usual anticholenergics. Since Botox is already approved for use in the USA and Canada, it is just finding a physician and insurance who will approve it for off-label use like this. (KLD)

01-05-2008, 10:59 PM	#9
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,516	It can, but for most there is not much point. The reason to use Botox for those using intermittent cath is to decrease bladder pressure and increase capacity. I suppose if you had leakage problems that could not be resolved by the use of anticholenergic drug or could not tolerate them, it could be used, but I know of no studies done for this, and would think it unlikely an insurance would pay for it (as they would definitely consider it experimental). (KLD)