Dosage
iAluRil treatment begins with a course of instillations given once a week for the first month.
The recommended dosage is then*:
one instillation every two weeks for the second month. In the following months, one instillation a month should be given until symptoms resolve to the satisfaction of both the clinician and patient.

From clinical trials, data has shown that further instillations can then be given at varying intervals dependent on the condition being treated:7
Painful Bladder Syndrome/ Interstitial Cystitis: at weeks 6 and 8.
Prevention of Urinary Tract Infections: monthly for 5 months.
Chemical induced cystitis (Including BCG): weekly for another 4 weeks.
Radiation induced cystitis: at weeks 6, 8 and 12.

Once the symptoms have improved, the interval between instillations can be increased slowly until you are happy that the regular doses are enough to keep symptoms under control. If the symptoms reoccur, the initial course of instillations can be repeated in order to settle the symptoms down again.

Clinical efficacy Protocols

 Condition Number of instillations Administration regimen Referred clinical work
Recurrent Urinary Tract Infection (rUTI) 9 Weekly for 4 weeks, then
monthly for 5 months		 Damiano et al 20111,
Cicione et al. 20142
Painful Bladder Syndrome/ Interstitial Cystitis (PBS / IC) 6 Weekly for 4 weeks,
then at weeks 6 and 8*		 iAluRil Prefill
patient leaflet
 Chemical induced Cystitis (including BCG) 8 Weekly for 8 weeks Imperatore et al. 20183,
Creta et al. 20124
 Radiation induced cystitis 7 Weekly for 4 weeks,
then at weeks 6, 8 and 12		 Gacci et al. 20165,
Giannessi et al. 20146

 

Method of administration
iAluRil is administered intravesically as a 50 ml bladder instillation via catheter (with Luer-Lock adapter) or using the ialuadapter®. Self-administration of iAluRil is permitted following appropriate training. Self help videos and nurse-led tutorials for both male and female patients are available on the patient website, in order to facilitate this training.

Administration via the catheter

  1. After the patient has urinated spontaneously, empty the bladder of all traces of urine by inserting a suitable sterile catheter through the external urethral meatus and wait for all the urine in the bladder to be evacuated (use of an 8 Ch catheter is recommended during this stage).
  2. Screw the plunger rod supplied with the prefilled syringe, until it is perfectly in place.
  3. Mount the Luer-Lock adapter on the top of the prefilled syringe and apply onto it the sterile catheter previously placed in the bladder.
  4. Instill  all the solution contained in the syringe into the bladder through the catheter.
  5. Keep iAluRil  in the bladder for as long as possible (minimum time recommended is 30 minutes).

Administration via the iAluadapter®

  1. The patient urinates spontaneously.
  2. Screw the plunger rod supplied with the prefilled syringe, until it is perfectly in place.
  3. Fasten the iAluadapter® to the top of the prefilled syringe.
  4. Instill all the solution contained in the syringe into the bladder through the iAluadapter®.
  5. Keep iAluRil in the bladder for as long as possible (minimum time recommended is 30 minutes).

The iAluadapter® is an innovative device for catheter-free administration of iAluRil.®
Catheter-free GAG therapy
• Minimally invasive and practically pain free
• Enables simultaneous treatment of the urethral and bladder mucosa
• Low risk of infection
• Included in iAluRil® packs at no extra cost

Only licensed for use with iAluRil®

*One instillation of iAluRil should be given weekly for the first month, followed by one instillation every two weeks for the second month. In the following months, one instillation a month should be given until symptoms resolve to the satisfaction of both the clinician and patient.
1. Damiano R et al. Prevention of Recurrent Urinary Tract Infections by Intravesical Administration of Hyaluronic Acid and Chondroitin Sulfate: a Placebo-Controlled Randomised Trial. Eur Urol 2011; 59(4): 645-651. 2. Cicione A et al. Intravesical treatment with highly-concentrated hyaluronic acid and chondroitin sulphate in patients with recurrent urinary tract infections: Results from a multicentre study. Can Urol Assoc J. 2014; 8(9-10): E721-7. 3. Imperatore V et al, Intravesical administration of combined hyaluronic acid and chondroitin sulfate can improve symptoms in patients with refractory bacillus Calmette-Guerin-induced chemical cystitis: Preliminary experience with one-year follow-up. Arch Ital Urol Androl. 2018 Mar 31; 90(1): 11-14. 4. Creta M et al. Intravesical instillation of hyaluronic acid and chondroitin sulfate for bacillus calmette-guerin induced chemical cystitis. Poster presentation P164, 85th SIU (Italian Society of Urology) 2012; October 21-24. 5. Gacci M et al. Bladder Instillation Therapy With Hyaluronic Acid and Chondroitin Sulfate Improves Symptoms of Post radiation Cystitis: Prospective Pilot Study. Clin Genitourin Cancer. Oct;14(5):444-449 (2016). 6. Giannessi C et al. Nocturia related to post bladder pain can be improved by hyaluronic acid chondroitin sulphate. Eur Urol Suppl. 2014; 13; e592. 7. 1010244349 v 3.0 January 2019 iAluRil Clinical efficacy protocol
Prescribing Information
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard.
Adverse events should also be reported to Aspire Pharma Ltd on 01730 231148
Revision reference – iAluRil_13_21.10.2020