Instilla Gel

Adult dosage

1. Catheter insertion: Inject 6 mL or 11 mL of this medication. Clean the glans and urethra, then slowly inject into the urethra, applying pressure to the glans until local anesthetic and disinfectant effects manifest. 2. Cystoscopy: Use 11 mL of this medication, adding an additional 6 mL or 11 mL as needed. Apply to the entire urethra, including the external sphincter. 3. Urethral stricture (urethrotomy): Use 11 mL of this medication, and if necessary, add 6 mL or 11 mL with a clamp. The urethral anesthetic effect appears within 5 to 10 minutes. 4. Disinfection: Apply or inject 6 mL or 11 mL evenly onto the mucous membrane. 5. Other: Slowly inject 6 mL or 11 mL to the application site, applying evenly to the catheter or procedural tools to be inserted. Local anesthetic and disinfectant effects appear in 5 to 10 minutes.

This medication should not be used by individuals allergic to amide-type anesthetics, chlorhexidine, or alkyl paraben. It should not be applied to damaged skin or around the eyes. Care should be taken when used directly on the nervous system, such as the brain, spinal cord, or ears, as it may cause hearing loss or neurological disorders. It is not safe for patients with porphyria, uncontrolled epilepsy, severe cardiac conduction abnormalities, and children under 2 years old. Patients with mucosal injury or sepsis, epilepsy, cardiac conduction abnormalities, liver dysfunction, severe shock, asthma or a history of allergies, and women who are pregnant or breastfeeding should use this medication cautiously. Shock symptoms may arise during the use of this medication, so if there are signs of decreased blood pressure, pale face, irregular pulse, difficulty breathing, nausea, cold sweat, dizziness, or skin flushing, use should be stopped immediately, and healthcare professionals should be notified. Severe neurological symptoms, such as tremors or seizures, may occur, requiring immediate cessation of administration and appropriate treatment. Various neurological symptoms such as drowsiness, anxiety, dizziness, vomiting, loss of consciousness, and hallucinations may also arise, necessitating careful observation. Cardiovascular side effects can include hypotension, arrhythmias, and cardiac arrest, so immediate action should be taken if any abnormal signs are detected. Symptoms of rapid or difficult breathing may also occur. Frequent use can lead to gastrointestinal discomfort such as nausea or vomiting. If any hypersensitivity reactions such as skin rash, urticaria, or swelling occur, usage should be stopped immediately, as severe anaphylactic shock can occur in rare cases. Overuse may cause damage to the urethra, and in rare cases, allergic dermatitis or light sensitivity reactions may occur at the contact site. This medication can rarely cause severe shock or serious symptoms as a local anesthetic, so emergency measures should always be prepared prior to use. Check for a history of allergy to chlorhexidine or hypersensitivity to medications. To minimize adverse reactions, closely monitor the patient's condition, use only the minimum required amount, and limit the amount used for topical anesthesia in the airways. When used in the mouth and pharynx, it can impair swallowing function and increase the risk of aspiration, so caution should be taken especially in children. Care should be taken as numbness of the tongue or oral mucosa may lead to injury from chewing or biting. When intubating, care must be taken to prevent the drug from entering the intubation tube, and during rectal administration, overuse should be avoided. Using on damaged mucosal areas can increase drug absorption, so caution should be observed. Although the amount absorbed through the skin is small, it poses a risk of affecting tissues, necessitating caution. Athletes should be aware that the components of this medication can cause a positive reaction in drug tests. High blood concentrations may impair the ability to operate vehicles or machinery, requiring careful attention. This medication may exacerbate side effects when used with antiarrhythmic agents, and using it with pethidine can increase toxicity, so care should be taken during co-administration. It is advisable not to use chlorhexidine with anionic substances such as soap. Women who are pregnant should only use this medication when necessary, as its safety during pregnancy has not been established, and it is advisable to avoid it during the first three months of pregnancy. Breastfeeding women should avoid nursing for about 12 hours after administration. Overdose may present with neurotoxic symptoms, necessitating prompt treatment with appropriate medication and oxygen. In the case of significant oral overdose, the drug should be removed via gastric lavage. Care must be taken to avoid contact with the eyes, and if the medication does come into contact with the eyes, they should be rinsed thoroughly with clean water immediately. This medication should be stored in a cool, dry place below 25 degrees Celsius, ensuring moisture does not accumulate during storage.

Serious side effects

• Shock
• hypotension
• facial pallor
• irregular pulse
• respiratory depression
• cold sweat
• discomfort
• neurological tremors
• seizures
• severe neurological symptoms

Mild side effects

Drowsiness, anxiety, agitation, neglect, dizziness, nausea, vomiting, nervousness, loss of consciousness, discomfort, fatigue, disorientation, visual disturbances, speech difficulties, tinnitus, restlessness, yawning, tremors, worry, eye twitching, pathological hyperactivity, headache, slow reactions, agitation, gastrointestinal discomfort such as nausea and vomiting, flushing, rash, urticaria, and swelling due to chlorhexidine contact dermatitis, photosensitivity.

This medication is sensitive to air and moisture, so it should be stored in a tightly sealed container. The storage temperature should be maintained between 1 and 25 degrees Celsius, and it is advisable to avoid places with high humidity.

Appearance

A colorless, transparent gel in a pre-filled syringe that is colorless to almost colorless and transparent.

Package unit

10 syringes/box [(6 milliliters/syringe)], 10 syringes/box [(11 milliliters/syringe)]