Version May 2024
Note: Dosage of an irrigating solution depends on the capacity or surface area of the structure being irrigated:
Continuous or intermittent bladder irrigation: The rate of administration will approximate the rate of urine flow; usually 500 to 1,500 mL/24 hours.
Periodic indwelling catheter irrigation: ~50 mL of 0.25% acetic acid irrigation is required. May be repeated as often as desired.
There are no dosage adjustments provided in the manufacturer’s labeling.
There are no dosage adjustments provided in the manufacturer’s labeling.
Refer to adult dosing.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.
Endocrine & metabolic: Acidosis
Genitourinary: Hematuria
Local: Application site pain
Irrigation during transurethral surgical procedures; injection by usual parenteral routes.
Concerns related to adverse effects:
• Bladder irritation: Use of irrigation in patients with mucosal lesions of urinary bladder may cause irritation. Open lesions of the bladder mucosa may result in systemic acidosis from absorption.
Other warnings/precautions:
• Administration: Not for internal intake or IV infusion; topical use or irrigation use only.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Solution, Irrigation:
Generic: 0.25% (250 mL [DSC], 500 mL, 1000 mL)
Solution, Irrigation [preservative free]:
Generic: 0.25% (250 mL, 1000 mL)
Yes
Solution (Acetic Acid Irrigation)
0.25% (per mL): $0.01
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
For irrigation only. Not for internal intake or IV infusion. Inspect for particulate or discoloration prior to administration. Administer immediately after opening container; discard any unused portion. Do not heat over 150°F (66°C).
Continuous/intermittent irrigation: Administer by gravity drip via a disposable administration set connected to an indwelling urethral catheter designed for continuous or intermittent 2-way flow. Adjust drip rate to maintain urinary pH of 4.5 to 5; may use nitrazine or other pH paper to monitor pH (recommended 4 times/day).
Irrigation of indwelling catheter: May use bulb or piston syringe for injection and aspiration as often as needed.
Continuous or intermittent bladder irrigation: Constant or intermittent bladder rinse to help prevent growth and proliferation of susceptible urinary pathogens in the management of patients who require prolonged placement of an indwelling urethral catheter.
Periodic indwelling catheter irrigation: To help maintain patency by reducing the formation of calcium encrustations.
Acetic acid for irrigation may be confused with glacial acetic acid
Glacial acetic acid (≥99%): Severe burns and permanent scarring have occurred after glacial acetic acid was accidently applied topically on patient's skin or mucous membranes. Care should be taken to ensure that diluted acetic acid solutions are used in patient care only and that there aren't mix-ups between these products and glacial acetic acid (ISMP 2013).
None known.
There are no known significant interactions.
Animal reproduction studies have not been conducted. Systemic absorption following bladder irrigation is not likely unless open lesions are present.
Use with caution in breast-feeding women.
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