Hello!

I am writing today to ask a question in regards to the preparation of bladder instillations (products to be administered intravesically into the bladder) in the outpatient space.

Typically these bladder instillations or bladder “cocktails” involve a combination of injectable heparin, lidocaine+sodium bicarbonate or bupivacaine, steroids and sometimes gentamicin. Typically these are administered in the office setting, however in some instances patients may be taught to administer such therapies at home as well.

My question is this:
Should these bladder instillations be prepared in compliance with USP 797 compounding standards? (If so, is this truly a clean procedure? How then should his be handled in a home setting?)
Does anyone have any experience with this practice (including standard work, training, preparation guidelines, etc.)??

Thank you in advance for any insight or experience!
Emily