DMSO is a clear odorless liquid, inexpensively produced as a by-product of the paper industry. It is widely available in the USA as a
solvent but its medical use is currently restricted by the FDA to the
palliative treatment of
interstitial cystitis and to certain experimental applications. Cutaneous manifestations of scleroderma appear to resolve (albeit equivocally) following topical applications of high concentrations of
DMSO. A limited number of small clinical trials indicate that intravenous
DMSO may be of benefit in the treatment of
amyloidosis, possibly by mobilizing
amyloid deposits out of tissues into urine. Dermal application of
DMSO seems to provide rapid, temporary, relief of
pain in patients with
arthritis and connective tissue
injuries. However, claims for antiinflammatory effects or acceleration of healing are currently unwarranted. There is no evidence that
DMSO can alter progression of degenerative
joint disease, and, for this reason,
DMSO may be considered for
palliative treatment only and not to the exclusion of standard
antiinflammatory agents. The safety of
DMSO in combination with other drugs has not been established; neurotoxic interactions with
sulindac have been reported. In experimental animals, intravenous
DMSO is as effective as
mannitol and
dexamethasone in reversing
cerebral edema and
intracranial hypertension. An initial clinical trial in 11 patients tends to support this latter application.
DMSO enhances diffusion of other chemicals through the skin, and, for this reason, mixtures of
idoxuridine and
DMSO are used for topical treatment of
herpes zoster in the UK. Adverse reactions to
DMSO are common, but are usually minor and related to the concentration of
DMSO in the medication
solution. Consequently, the most frequent side effects, such as
skin rash and
pruritus after dermal application,
intravascular hemolysis after
intravenous infusion and gastrointestinal discomfort after
oral administration, can be avoided in large part by employing more dilute solutions. Most clinical trials of
DMSO have not incorporated the components of experimental design necessary for objective, statistical evaluation of efficacy. Randomized comparisons between
DMSO, placebo and known active treatments were rarely completed. Final approval of topical
DMSO for treatment of
rheumatic diseases in particular will require a multi-center, randomized comparison between high and low concentrations of
DMSO and an orally-active, nonsteroidal
antiinflammatory agent.(ABSTRACT TRUNCATED AT 400 WORDS)