Comprehensive medication guide to RIMSO-50 including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$150 cost-sharing when billed under medical benefit (HCPCS J1212); Medicare Part D does not cover RIMSO-50, but Part B may when administered in an outpatient setting. Prior authorization may be required.
Estimated Cash Pricing
$869–$878 average retail for brand RIMSO-50 per 50 mL dose; as low as $742 with GoodRx or $715 with SingleCare coupons. Generic dimethyl sulfoxide (Sandoz) is available at lower cost through specialty channels.
Medfinder Findability Score
55/100
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RIMSO-50 is the brand name for a sterile 50% dimethyl sulfoxide (DMSO) aqueous solution. FDA-approved since 1978, it holds the distinction of being the only FDA-approved bladder instillation therapy specifically indicated for interstitial cystitis (IC), also known as bladder pain syndrome (BPS).
Interstitial cystitis is a chronic bladder condition characterized by persistent pain, pelvic pressure, and urinary urgency and frequency without evidence of bacterial infection. RIMSO-50 is instilled directly into the bladder by a healthcare provider using a catheter, held for 15 minutes, and then expelled by urination. Treatments are given every two weeks initially, with maintenance intervals increasing as symptoms are controlled.
A generic version — dimethyl sulfoxide 50% intravesical solution manufactured by Sandoz — is also FDA-approved and bioequivalent to brand-name RIMSO-50. RIMSO-50 is manufactured by Mylan and billed under HCPCS code J1212 when administered in a clinical setting.
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RIMSO-50 works through multiple mechanisms simultaneously. Its active ingredient, dimethyl sulfoxide, is a highly polar, amphiphilic molecule that penetrates biological membranes with extraordinary ease. When instilled into the bladder, DMSO rapidly crosses the bladder mucosa and is absorbed into the bloodstream and body tissues.
Key mechanisms include: (1) anti-inflammatory effects on Hunner lesions and bladder wall tissue, particularly through radical scavenging and protection against ischemic damage; (2) analgesic effects through depletion of substance P from bladder sensory nerve endings; (3) antispasmodic effects that relax bladder smooth muscle; and (4) collagen dissolution that may help restore bladder capacity reduced by fibrosis. DMSO also enhances bladder penetration of co-administered agents, making it a useful component of bladder cocktails.
DMSO is metabolized to dimethyl sulfone (excreted in urine/feces) and dimethyl sulfide (eliminated via breath and skin, causing the characteristic garlic-like odor for up to 72 hours after treatment). No residual accumulation occurs with repeated dosing.
50% w/w (27 g per 50 mL) — intravesical solution
50 mL instilled into bladder via catheter, held 15 minutes, every 2 weeks initially
RIMSO-50 is not available at standard retail pharmacies. As an intravesical solution administered by healthcare providers in clinical settings, it flows through a specialty supply chain — stocked primarily by urology practices, hospital pharmacies, and specialty pharmaceutical distributors. This limits the number of locations that carry it and creates regional or localized availability gaps that can affect treatment schedules.
As of 2026, RIMSO-50 does not have an active FDA drug shortage designation. However, patients and providers continue to report intermittent supply challenges. The generic from Sandoz may be available when brand RIMSO-50 is not, providing an important fallback option. Patients who need RIMSO-50 should check with their urology clinic 1–2 weeks before each scheduled treatment rather than the day of.
If your clinic is having difficulty sourcing RIMSO-50, medfinder contacts pharmacies near you to check which ones have it in stock and texts you the results, saving hours of phone calls.
RIMSO-50 is not a controlled substance and requires no DEA scheduling or special prescribing registration. Any licensed healthcare provider with prescribing authority can write a prescription for dimethyl sulfoxide. In practice, however, the medication is almost exclusively prescribed and administered by specialists who perform the intravesical catheterization procedure in their offices.
Urologists — most common prescribers; routinely perform bladder instillations
Urogynecologists — pelvic floor specialists with deep IC experience; common prescribers in female patients
Female Pelvic Medicine & Reconstructive Surgery (FPMRS) Specialists — subspecialists with comprehensive IC/BPS management expertise
Gynecologists (select practices) — some OB/GYN practices with IC experience may administer bladder instillations
Telehealth is not appropriate for RIMSO-50 administration, which requires in-person catheterization. However, telehealth can assist with IC diagnosis, oral medication management, and follow-up care between instillation appointments. Patients can use the Interstitial Cystitis Association (ichelp.org) provider directory to find IC-experienced specialists near them.
No. RIMSO-50 (dimethyl sulfoxide) is not a controlled substance and is not scheduled by the U.S. Drug Enforcement Administration (DEA). It is a prescription medication that requires a written or electronic order from a licensed prescriber, but there are no DEA-imposed restrictions on prescribing, dispensing, or refilling based on scheduling.
Any licensed physician, nurse practitioner, or physician assistant with prescribing authority can prescribe RIMSO-50. However, because the medication must be administered by bladder catheterization in a clinical setting, it is almost exclusively managed by urologists and urogynecologists who perform the instillation procedure.
Garlic-like taste in the mouth (within minutes, lasting several hours)
Garlic/onion-like odor on breath and skin (lasting up to 72 hours after treatment)
Bladder discomfort or pain during and after instillation (typically decreases with repeat treatments)
Transient chemical cystitis (temporary increase in bladder urgency and frequency)
Anaphylactoid/hypersensitivity reaction (rare; DMSO can trigger histamine release): difficulty breathing, swelling, hives — seek immediate care
Potential lens/eye changes with prolonged high-dose exposure (observed in animals; precautionary eye exams recommended during long-term therapy)
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Elmiron (pentosan polysulfate sodium)
Only FDA-approved oral IC medication. Restores bladder lining. Slow onset (2–6 months). Long-term use linked to rare pigmentary maculopathy; requires regular eye exams.
Intravesical heparin
Off-label bladder instillation; anti-inflammatory and GAG layer-protective. Often used as bridge or maintenance therapy alongside DMSO. Can sometimes be self-administered at home.
Intravesical lidocaine cocktail
Alkalinized lidocaine with sodium bicarbonate; provides bladder surface analgesia. Off-label; frequently combined with heparin or steroids. May be prescribed for home self-instillation.
Amitriptyline
Tricyclic antidepressant used off-label for IC. Relaxes bladder, blocks pain signals, reduces urgency. AUA guideline-recommended oral therapy. Start at 10–25 mg nightly.
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Warfarin and oral anticoagulants
moderateDMSO may alter the absorption or metabolism of anticoagulants such as warfarin (Coumadin), apixaban (Eliquis), or rivaroxaban (Xarelto). Closer monitoring of anticoagulation levels may be warranted.
Immunosuppressants (cyclosporine, tacrolimus)
moderateDMSO's membrane-permeability enhancement may affect absorption or distribution of narrow-therapeutic-index immunosuppressants. Disclose to prescribing physician before starting RIMSO-50.
Other concurrent medications (general)
minorFDA labeling states that DMSO may change the effectiveness of other medications. Complete disclosure of all prescription drugs, OTC medications, vitamins, and supplements to the provider is essential before each treatment.
RIMSO-50 (dimethyl sulfoxide) has been a cornerstone of interstitial cystitis treatment for nearly 50 years — and for good reason. As the only FDA-approved bladder instillation therapy for IC, it offers a multi-mechanism approach to reducing pain, urgency, and frequency that remains clinically relevant even as the IC treatment landscape has evolved. Studies show it is particularly effective for Hunner-type IC, and clinical experience reflects success rates ranging from 25% to 90% depending on patient subtype.
The most common challenges with RIMSO-50 are cost and availability. At $700–$900 per dose without insurance, it can be financially burdensome — but insurance typically covers it when properly billed as a procedure under J1212. Availability through specialty channels means patients and providers must plan ahead and maintain relationships with reliable distributors.
When RIMSO-50 is difficult to find, medfinder helps patients and providers locate pharmacies that have it in stock by calling pharmacies on their behalf and texting results — removing one of the most frustrating barriers to consistent IC care.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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