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dimethyl sulfoxide (generic name)

a genitourinary tract agent - treats Interstitial cystitis, Surgical skin flap ischemia, Diabetic ulcers, Extravasation, Reflex sympathetic dys...
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Alternate Title

Dimethyl sulfoxide

Category

Herbs & Supplements

Synonyms

C2H6OS, dimethyl sulfoxide, dimethyl sulphoxide, dimethylis sulfoxidum, methyl sulphoxide, NSC-763, SQ-9453, Rimso-50®, sulphinybismethane.

Background

Dimethyl sulfoxide (C2H6OS), or DMSO, is a sulfur-containing organic compound. DMSO occurs naturally in vegetables, fruits, grains, and animal products. DMSO was first synthesized in 1866 as a byproduct of paper manufacturing. Therapeutic interest began in 1963. DMSO was reported to penetrate through the skin and produce analgesia, decrease pain, and promote tissue healing. DMSO is available for both non-medicinal and medicinal uses. The major clinical use of DMSO is to relieve symptoms of interstitial cystitis.

Potential toxic effects to the lens of the eye have been reported in animals but no effects have been noted in humans. Topical application has been associated with redness and inflammation of skin, and a garlic-like taste and odor on the breath have been reported.

DMSO has been used to treat amyloidosis, diabetic ulcers, extravasation, erosive gastritis, and ischemia prevention in surgical flaps, but well designed clinical trials are lacking. Because of the limited scientific evidence, whether DMSO provides effective treatment of patients with closed head trauma, herpes zoster, tendopathies, and complex regional pain syndrome will require more research.

Evidence

DISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Interstitial cystitis (chronic bladder infection): Intravesical DMSO is U.S. Food and Drug Administration (FDA)-approved for interstitial cystitis when given by a qualified healthcare professional. DMSO may work when other treatments have failed.
Grade: B

Amyloidosis: DMSO may change the course of amyloidosis if treatment is started early. However, there is not much scientific support for this claim.
Grade: C

Anesthesia (for kidney and gallbladder stone removal): Extracorporeal shock wave lithotripsy (ESWL) is sometimes used to break down kidney or gallbladder stones so that they can be passed in the urine. Treatment with DMSO may help reduce the pain of ESWL. Also, the diuretic, anti-inflammatory, muscle relaxant, and hydroxyl radical scavenger effects may also be beneficial for patients undergoing ESWL. However, more research is needed in this area.
Grade: C

Diabetic ulcers: Currently, there is not enough scientific evidence available to recommend for or against the use of topical DMSO for diabetic ulcers.
Grade: C

Extravasation (drug accidentally going outside of a vein): DMSO applied to the skin may prevent tissue death after extravasation of anticancer agents. It can be applied alone or with steroids. Further research is needed to confirm these results.
Grade: C

Gastritis: When used with acid-blocking drugs (like ranitidine), DMSO may help treat gastritis. More research is needed before this treatment can be recommended.
Grade: C

Herpes zoster (shingles): DMSO may help treat herpes zoster. This treatment may work even better when used with the drug idoxuridine. Further research is necessary before a recommendation can be made.
Grade: C

Inflammatory bladder disease: DMSO may relieve the symptoms of inflammatory bladder disease. Further research is needed to confirm these results.
Grade: C

Intracranial pressure: DMSO may help treat high pressure in the skull (increased intracranial pressure), but most research is vague and results are conflicting. The risks may be greater than potential benefits.
Grade: C

Pressure ulcers (prevention): Based on early research, massage therapy with a DMSO cream does not appear to effectively prevent pressure ulcers (also called bedsores). More research with DMSO alone is needed.
Grade: C

Reflex sympathetic dystrophy: Little research has been done to see if DMSO helps reflex sympathetic dystrophy. More studies in this area are needed before a decision can be made.
Grade: C

Rheumatoid arthritis: Applying DMSO to the skin may help rheumatoid arthritis. More study is needed before a conclusion can be drawn.
Grade: C

Surgical skin flap ischemia: One trial suggests that DSMO improves lack of blood flow (ischemia) in surgical flaps. More research is needed to confirm these results.
Grade: C

Tendopathies: A randomized, controlled, double-blind trial evaluating DMSO for acute tendopathies found a positive effect. Conclusions cannot be made without further trials.
Grade: C

Scleroderma: DMSO does not seem to help treat scleroderma and is therefore not recommended.
Grade: D

Tradition

WARNING: DISCLAIMER: The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.
Acute herpes infection, Alzheimer's disease, burns, cancer, closed head trauma, colitis, complex regional pain syndrome, fibromyalgia, gallstones, high cholesterol, muscle pain, pancreatitis, schizophrenia, systemic lupus erythematosus (SLE), tuberculosis.

Dosing

Adults (18 years and older)

Administering DMSO in the bladder (intravesically) is U.S. Food and Drug Administration (FDA)-approved for interstitial cystitis when given by a qualified healthcare professional.

There is no proven effective dose for DMSO for other conditions. DMSO has been taken by mouth in doses between 7 and 15 grams per day. Various solutions ranging from 10-100% DMSO have been applied on the skin. DMSO creams and gels have also been used.

Children (younger than 18 years)

There is not enough scientific information available to recommend the safe use of DMSO in children.

Safety

DISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Allergies

Individuals with a known allergy or hypersensitivity to DMSO should avoid its use.

Side Effects and Warnings

Skin reactions are the most common side effects with topical (applied to the skin) administration and are usually reversible after discontinuing the drug. Erythema (reddening of the skin), pruritus (itching), burning, drying, scaling, blistering, dermatitis, and wheals have been reported. Cases of headache, dizziness, sedation, and agitation have also been reported. Encephalopathy, stroke, and heart attack have been reported after DMSO was used in stem cell transplantations.

Cautious use is advised in patients with urinary tract malignancies and with hepatic (liver) and renal (kidney) dysfunction. One clinical trial reported increased urgency, dysuria (difficult or painful urination), hematuria (blood in the urine), and red urine discoloration.

Cases of nausea, vomiting, constipation, halitosis (bad breath), garlic taste, and diarrhea have been reported. Other adverse effects that have been reported include anorexia, influenza-like symptoms, facial flushing from intravenous administration, and low blood pressure resulting from topical use. Negative effects on blood cell counts like eosinophilia and hemolysis have been reported to result from intravenous (into the vein) administration. Based on one case report, seizure occurred following a dimethylsulfoxide-preserved stem cell infusion.

Pregnancy and Breastfeeding

Not recommended due to lack of sufficient available data.

Interactions

Interactions with Drugs

Using DMSO with sulindac (Clinoril®) may cause peripheral neuropathy. Animal studies have reported that the action of sulindac may be decreased by DMSO. Although human data is lacking, this drug combination should be avoided.

Interactions with Herbs and Supplements

Insufficient available information.

Attribution

This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Tracee Rae Abrams, PharmD (University of Rhode Island); Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Heather Boon, B.Sc.Phm, PhD (University of Toronto); Thomas Brendler, BA (PlantaPhile, Berlin); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Catherine DeFranco Kirkwood, MPH, CCCJS-MAC (MD Anderson Cancer Center); Joerg Gruenwald, PhD (Phytopharm Consulting); Dana A. Hackman, BS (Northeastern University); David Keifer, MD (University of Arizona); Benjamin Kligler, MD, MPH (Continuum Center for Health and Healing); Hope J. Lafferty, AM (Memorial Sloan-Kettering Cancer Center); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collabroation); Jen Woods, BS (Northeastern University).

Bibliography

DISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

Barker SB, Matthews PN, Philip PF, et al. Prospective study of intravesical dimethyl sulphoxide in the treatment of chronic inflammatory bladder disease. Br J Urol 1987;59(2):142-144.

Bauwens D, Hantson P, Laterre PF, et al. Recurrent seizure and sustained encephalopathy associated with dimethylsulfoxide-preserved stem cell infusion. Leuk Lymphoma 2005 Nov;46(11):1671-4.

Bertelli G, Gozza A, Forno GB, et al. Topical dimethylsulfoxide for the prevention of soft tissue injury after extravasation of vesicant cytotoxic drugs: a prospective clinical study. J Clin Oncol 1995;13(11):2851-2855.

Chen-Plotkin AS, Vossel KA, Samuels MA, et al. Encephalopathy, stroke, and myocardial infarction with DMSO use in stem cell transplantation. Neurology 2007 Mar 13;68(11):859-61.

Dawson TE, Jamison J. Intravesical treatments for painful bladder syndrome/ interstitial cystitis. Cochrane Database Syst Rev 2007 Oct 17;(4):CD006113.

Demir E, Kilciler M, Bedir S, et al. Comparing two local anesthesia techniques for extracorporeal shock wave lithotripsy. Urology 2007 Apr;69(4):625-8.

Duimel-Peeters IG, J G Halfens R, Ambergen AW, et al. The effectiveness of massage with and without dimethyl sulfoxide in preventing pressure ulcers: a randomized, double-blind cross-over trial in patients prone to pressure ulcers. Int J Nurs Stud 2007 Nov;44(8):1285-95.

Karaca M, Bilgin UY, Akar M, et al. Dimethly sulphoxide lowers ICP after closed head trauma. Eur J Clin Pharmacol 1991;40(1):113-114.

Kingery WS. A critical review of controlled clinical trials for peripheral neuropathic pain and complex regional pain syndromes. Pain 1997;73(2):123-139.

Kneer W, Kuhnau S, Bias P, et al. [Dimethylsulfoxide (DMSO) gel in treatment of acute tendopathies. A multicenter, placebo-controlled, randomized study]. Fortschr Med 1994;112(10):142-146.

Olver IN, Aisner J, Hament A, et al. A prospective study of topical dimethyl sulfoxide for treating anthracycline extravasation. J Clin Oncol 1988;6(11):1732-1735.

Ozkaya-Bayazit E, Kavak A, Gungor H, et al. Intermittent use of topical dimethyl sulfoxide in macular and papular amyloidosis. Int J Dermatol 1998;37(12):949-954.

Rademaker-Lakhai JM, van den BD, Pluim D, et al. A Phase I and pharmacological study with imidazolium-trans-DMSO-imidazole-tetrachlororuthenate, a novel ruthenium anticancer agent. Clin Cancer Res 2004;10(11):3717-3727.

Takeda T, Kozakai N, Ikeuchi K. Localized amyloidosis of the bladder treated effectively by occlusive dressing technique therapy using Dimethyl sulfoxide (DMSO): two case reports] ippon Hinyokika Gakkai Zasshi 2005 Nov;96(7):705-8.

Zuurmond WW, Langendijk PN, Bezemer PD, et al. Treatment of acute reflex sympathetic dystrophy with DMSO 50% in a fatty cream. Acta Anaesthesiol Scand 1996;40(3):364-367.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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