Dimethylsulfoxide

Health Care Professional Information

Clinical Summary

Dimethylsulfoxide (DMSO) is a widely used chemical solvent because of its high polarity. It is used in the laboratories as a cryopreservative. DMSO is readily absorbed by the skin and has been studied as a vehicle for topical drugs. DMSO is thought to have analgesic and anti-inflammatory properties and has been used topically to relieve pain and to treat arthritis.
Small scale studies conducted in the early 1980s suggested that DMSO may help to relieve peripheral neuropathy (1) and post-thoracotomy pain (2). But a systematic review of DMSO reported a lack of definitive evidence against osteoarthritis (3) and painful bladder syndrome/interstitial cystitis (4) (5) (14).

DMSO has been used to prevent or treat extravasations of chemotherapeutic agents (6) (7). It may also slow down the progression of cancer cells; however, data are inconsistent (2) (8).

DMSO has been shown to cause neural damage in animals (9). Topical application of DMSO leads to a strong garlic taste in the mouth (10). Intravesical DMSO is an approved prescription drug for the treatment of interstitial cystitis. DMSO is not approved for use in other forms due to lack of studies analyzing its efficacy and potential toxicities.

Purported Uses
  • Cancer treatment
  • Chemotherapy side effects
  • Pain
  • Rheumatoid arthritis
  • Sedation
Mechanism of Action

DMSO is diluted on exposure to air. Upon topical application, it rapidly penetrates the skin; however, unlike most penetrating solvents, it is not associated with irreversible membrane damage. DMSO can enhance the skin penetration of other drugs. Analgesic and anti-inflammatory effects may benefit patients with rheumatoid arthritis (2). In addition, DMSO traps free radical hydroxide; its antioxidant properties are thought to be responsible for the prevention of chemotherapy extravasations (7). A strong garlic taste in the mouth following DMSO administration comes from the exhaled dimethylsulfide (DMS) metabolite (11).

Pharmacokinetics

Absorption
After topical application, DMSO can be located in the blood within five minutes, all organs within 20 minutes and bones within an hour (2).

Metabolism/Excretion
Elimination half-time is about four days, however cutaneous application prolongs elimination by about one third. Excretion of DMSO is primarily via urine (2).

Warnings

DMSO is an approved prescription drug for the treatment of interstitial cystitis intravesically only. It is not approved for over-the-counter use in any form due to inadequate evidences of efficacy and potential toxicities. The industrial form of DMSO may be contaminated with other chemicals.

Contraindications

Do not use if pregnant (12).

Adverse Reactions

Reported (Topical): Garlic taste in mouth, dry skin, erythema and pruritis (2) urine discoloration, halitosis, agitation, hypotension, sedation dizziness (13). Changes in eye lens have been reported in animals following administration of DMSO (12).

Literature Summary and Critique

Most of the clinical studies done on DMSO were published in the 1980s and early 1990s. Reliable data to verify its purported uses are limited.

Dosage (Inside MSKCC Only)
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References
  1. Kingery WS. A critical review of controlled clinical trials for peripheral neuropathic pain and complex regional pain syndromes. Pain 1997;73:123-39.
  2. Brayton CF. Dimethyl sulfoxide (DMSO): a review. Cornell Vet. 1986;76:61-90.
  3. Brien S, Prescott P, Bashir N, Lewith H, Lewith G. Systematic review of the nutritional supplements dimethyl sulfoxide (DMSO) and methylsulfonylmethane (MSM) in the treatment of osteoarthritis.Osteoarthritis Cartilage. Nov 2008;16(11):1277-1288.
  4. Dawson TE, Jamison J. Intravesical treatments for painful bladder syndrome/ interstitial cystitis. Cochrane Database Syst Rev. 2007(4):CD006113.
  5. Dimitrakov J, Kroenke K, Steers WD, et al. Pharmacologic management of painful bladder syndrome/interstitial cystitis: a systematic review. Arch Intern Med. Oct 8 2007;167(18):1922-1929.
  6. Bertelli G. Prevention and management of extravasation of cytotoxic drugs. Drug Saf 1995;12:245-55.
  7. Dorr RT. Antidotes to vesicant chemotherapy extravasations. Blood Rev. 1990;4:41-60.
  8. Jacob SW,.Herschler R. Pharmacology of DMSO. Cryobiology 1986;23:14-27.
  9. Hanslick JL, Lau K, Noguchi KK, et al. Dimethyl sulfoxide (DMSO) produces widespread apoptosis in the developing central nervous system. Neurobiol Dis. Apr 2009;34(1):1-10.
  10. Prior D, Mitchell A, Nebauer M, Smith M. Oncology nurses' experience of dimethyl sulfoxide odor. Cancer Nurs 2000;23:134-40.
  11. Rosenstein ED. Topical agents in the treatment of rheumatic disorders. Rheum.Dis.Clin North Am 1999;25:899-918, viii.
  12. Physicians' Desk Reference. Montvale, NJ: Thomson, 2004.
  13. MICROMEDEX(R) Healthcare Series. 120. Thomson, 2004.
  14. French LM, Bhambore N. Interstitial cystitis/painful bladder syndrome. Am Fam Physician. 2011 May 15;83(10):1175-81.

Consumer Information

How It Works

Bottom Line: DMSO may help relieve pain but more studies are needed to confirm its safety and efficacy. There is no evidence that DMSO can treat cancer in humans.
DMSO is a widely used chemical solvent. It is rapidly absorbed when applied to the skin and has been shown to reduce pain and inflammation. However, there are concerns of adverse effects including damage to the nerves. DMSO is used as a prescription drug to treat inflammation and pain of the bladder and as an antidote for chemotherapy drugs that leak and are trapped inside the body. DMSO has not been shown to be an effective treatment for cancer in humans.

Purported Uses
  • To reduce pain
    Applying DMSO to the skin appears to reduce pain in humans.
  • To treat arthritis and osteoarthritis
    A few studies show that application of DMSO to the skin reduces pain and inflammation in humans; however, more studies are needed to determine the optimal dose to be used.
  • As a cancer treatment
    Some laboratory studies have shown that DMSO may slow down the progression of cancer; however, no clinical studies have been performed.
  • To treat chemotherapy extravasations (chemotherapy that has leaked and become trapped in surrounding tissue)
    DMSO may be used to treat this condition in a hospital setting.
  • To treat interstitial cystitis (inflammation and pain of the bladder of unknown origin)
    DMSO is an accepted treatment for interstitial cystitis; however, more studies are needed to establish this use.
Research Evidence

Most of the clinical studies done on DMSO were published in the 1980s and early 1990s. Available data are limited to verify its effects.

Side Effects
  • Garlic taste in mouth
  • Dry, itchy, scaly skin
  • Urine discoloration
  • Agitation
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