lidocaine + heparin + sodium bicarbonate + triamcinolone acetonide + gentamicin

This intravesical bladder instillation is a multimodal therapeutic cocktail developed for the management of interstitial cystitis (IC), bladder pain syndrome (BPS), and chronic pelvic pain (CPP). The formulation consists of lidocaine, heparin, sodium bicarbonate, triamcinolone acetonide (Kenalog), and gentamicin. Lidocaine acts as a local anesthetic by blocking voltage-gated sodium channels to provide immediate pain relief. Heparin is intended to replenish the bladder's protective glycosaminoglycan (GAG) layer, which is often deficient in IC/BPS patients. Sodium bicarbonate is included to alkalize the solution, which enhances the penetration of lidocaine into the bladder wall. Triamcinolone acetonide is a potent corticosteroid that reduces local inflammation, while gentamicin provides antimicrobial coverage. This specific combination is currently being studied in a Phase 3 clinical trial led by Jocelyn Fitzgerald at the University of Pittsburgh as part of a bundled care approach.

Other names

Bladder InstillationIntravesical cocktailFitzgerald bladder instillation cocktailLidocaine-Heparin-Bicarbonate-Triamcinolone-Gentamicin cocktail