Dimethyl sulfoxide

DMSO/Drug Interactions:

  • AnalgesicsAnalgesics: Information from available clinical trials suggests that topical dimethyl sulfoxide (DMSO) may aid in the pain associated with complex regional pain syndrome (1; 2; 3), interstitial cystitis (88; 38; 23; 22; 77; 75), extracorporeal shock wave lithotripsy (ESWL) (89; 90), and cancer (91; 92). In animal research, DMSO had analgesic effects (93). DMSO has also been reported to block the conduction of nerve signals in nerves responsible for chronic pain (94).
  • AntiarthriticsAntiarthritics: In human research, results of clinical trials were mixed with respect to the effect of DMSO on osteoarthritis symptoms (36; 35). Evidence from a poor-quality study evaluating topical DMSO for arthritis shows promise (70).
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: According to a review, DMSO decreased platelet aggregation (7). In a review, de la Torre et al. suggested that normalizing tissue perfusion involving the prostaglandin-thromboxane and platelet systems plays a role in the prevention of cerebral ischemia by DMSO (4). One clinical trial reported hematuria and red urine discoloration following DMSO exposure (38).
  • AntihistaminesAntihistamines: In animal research, DMSO had antihistamine effects (95).
  • AntihypertensivesAntihypertensives: Use of DMSO in clinical trials and case reports, or as part of other treatments, has resulted in cardiovascular adverse effects such as hypotension and hypertension (37).
  • Anti-inflammatoriesAnti-inflammatories: According to a review, DMSO has anti-inflammatory effects (7). Symptomatic relief was reported in a clinical trial of DMSO in patients with inflammatory bladder disease (78).
  • AntilipemicsAntilipemics: According to a review, DMSO had antilipemic effects (7).
  • AntineoplasticsAntineoplastics: In human research, DMSO prevented toxicity after extravasation associated with antineoplastics (28; 34; 69). In vitro, human bone marrow mesenchymal stem cells and peripheral blood lymphocytes pretreated with DMSO reduced micronucleus frequency (96).
  • Antiulcer agentsAntiulcer agents: One randomized controlled trial suggested that DMSO in combination with cimetidine may be beneficial for duodenal ulcers (97). In a separate study, DMSO prevented the relapse rate in patients with healed duodenal ulcers (63).
  • Cardiovascular agentsCardiovascular agents: In vitro, DMSO along with ascorbic acid and 5-aza-2'-deoxycytidine enhanced cardiomyocyte differentiation from human embryonic stem cells (98). Use of DMSO in clinical trials and case reports, or as part of other treatments, has resulted in cardiovascular adverse effects such as stroke and heart attack (42; 43), trigeminocardiac reflex (44; 45), and bradycardia and hypotension or tachycardia and hypertension (37).
  • Cholinesterase inhibitorsCholinesterase inhibitors: In animal research, DMSO had cholinesterase inhibitor effects (99).
  • Dermatologic agentsDermatologic agents: Use of DMSO in clinical trials and case reports, or as part of other treatments, has resulted in dermatologic adverse effects; erythema, pruritus, burning, drying, scaling, blistering, dermatitis, crusting and rash, redness, flakiness, and wheals have been reported with DMSO or with other agents dissolved in DMSO (27; 28; 29; 30; 31; 32; 33; 34; 35; 36). In human research, DMSO had some effect on the healing of diabetic ulcers (100). In early research, massage therapy with a DMSO cream did not appear to effectively prevent pressure ulcers (also called bedsores) (71).
  • DiureticsDiuretics: According to a review, DMSO had diuretic effects (7). One clinical trial reported increased urgency and dysuria following DMSO exposure (38)
  • Gastrointestinal agentsGastrointestinal agents: Use of DMSO in clinical trials and case reports, or as part of other treatments, has resulted in gastrointestinal adverse effects; nausea, vomiting, constipation, halitosis (garlic-like breath), garlic taste, dyspepsia, and diarrhea have been reported with DMSO or with other agents dissolved in DMSO (52; 53; 54; 55; 56; 30; 35; 36; 37; 39). One randomized controlled trial suggested that DMSO in combination with cimetidine may be beneficial for duodenal ulcers (97). In a separate study, DMSO prevented the relapse rate in patients with healed duodenal ulcers (63).
  • Hematologic agentsHematologic agents: Eosinophilia and hemolysis have been reported to result from intravenous administration of DMSO (55).
  • ImmunostimulantsImmunostimulants: According to a review, DMSO increased resistance to infection (7).
  • ImmunosuppressantsImmunosuppressants: According to a review, DMSO increased resistance to infection (7).
  • Muscle relaxantsMuscle relaxants: According to a review, DMSO has muscle relaxant effects (7).
  • Neurologic agentsNeurologic agents: Use of DMSO in clinical trials and case reports, or as part of other treatments, has resulted in neurological adverse effects; headache, dizziness, sedation, agitation, and encephalopathy have been reported (54; 42; 39), as have transient loss of consciousness (57), transient global amnesia (58), somnolence (59), general neurotoxicity (47; 50) and encephalopathy (48).
  • Nonsteroidal anti-inflammatories (NSAIDs)Nonsteroidal anti-inflammatories (NSAIDs): According to a review, DMSO is an effective penetration enhancer of NSAIDs (101). According to a manufacturer of sulindac, concomitant use of DMSO and sulindac may cause peripheral neuropathy. DMSO may inhibit the conversion of sulindac to the sulfide metabolite by competitive inhibition of sulfide reductase. Animal studies have reported that the action of sulindac may be decreased by DMSO. Although human data are lacking, this drug combination should be avoided.
  • Ophthalmic agentsOphthalmic agents: Temporary vision loss because of DMSO has been reported after DMSO was used in stem cell transplantation (60).
  • Renally eliminated agentsRenally eliminated agents: The authors of a randomized controlled trial of DMSO for interstitial cystitis have recommended avoiding DMSO in patients with hepatic or renal dysfunction, or in patients taking renally eliminated drugs (38). In a case report, a patient with acute renal failure and subsequent nephrotic syndrome recovered after treatment for two years with prednisolone, aspirin, and DMSO (102).
  • Respiratory agentsRespiratory agents: Respiratory depression (59) and chest tightness (37) have been reported after DMSO was used in stem cell transplantations. Toxicities to DMSO during onyx treatment have been discussed in case reports and include pulmonary edema resulting in acute respiratory distress syndrome (61).
  • SulindacSulindac: According to a manufacturer of sulindac, concomitant use of DMSO and sulindac may cause peripheral neuropathy. DMSO may inhibit the conversion of sulindac to the sulfide metabolite by competitive inhibition of sulfide reductase. Animal studies have reported that the action of sulindac may be decreased by DMSO. Although human data are lacking, this drug combination should be avoided.
  • VasodilatorsVasodilators: According to a review, DMSO has vasodilatory effects (7).

    • DMSO/Herb/Supplement Interactions:

  • AnalgesicsAnalgesics: Information from available clinical trials suggests that topical DMSO may aid in the pain associated with complex regional pain syndrome (1; 2; 3), interstitial cystitis (88; 38; 23; 22; 77; 75), extracorporeal shock wave lithotripsy (ESWL) (89; 90), and cancer (91; 92). In animal research, DMSO had analgesic effects (93). DMSO has also been reported to block the conduction of nerve signals in nerves responsible for chronic pain (94).
  • AntiarthriticsAntiarthritics: In human research, the results of clinical trials are mixed with respect to the effect of DMSO on osteoarthritis symptoms (36; 35). Evidence from a poor-quality study evaluating topical DMSO for arthritis shows promise (70).
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: According to a review, DMSO decreased platelet aggregation (7). In a review, de la Torre et al. suggested that normalizing tissue perfusion involving the prostaglandin-thromboxane and platelet systems plays a role in the prevention of cerebral ischemia by DMSO (4). One clinical trial reported hematuria and red urine discoloration following DMSO exposure (38).
  • AntihistaminesAntihistamines: In animal research, DMSO had antihistamine effects (95).
  • Anti-inflammatoriesAnti-inflammatories: According to a review, DMSO has anti-inflammatory effects (7). Symptomatic relief was reported in a clinical trial of DMSO in patients with inflammatory bladder disease (78).
  • AntilipemicsAntilipemics: According to a review, DMSO had antilipemic effects (7).
  • AntineoplasticsAntineoplastics: In human research, DMSO prevented toxicity after extravasation associated with antineoplastics (28; 34; 69). In vitro, human bone marrow mesenchymal stem cells and peripheral blood lymphocytes pretreated with DMSO reduced micronucleus frequency (96).
  • AntioxidantsAntioxidants: In vitro, the antioxidant effects of DMSO on gene expression was examined (further details are lacking) (103). According to secondary sources, DMSO acts as an antioxidant.
  • Antiulcer agentsAntiulcer agents: One randomized controlled trial suggested that DMSO in combination with cimetidine may be beneficial for duodenal ulcers (97). In a separate study, DMSO prevented the relapse rate in patients with healed duodenal ulcers (63).
  • Cardiovascular agentsCardiovascular agents: In vitro, DMSO along with ascorbic acid and 5-aza-2'-deoxycytidine enhanced cardiomyocyte differentiation from human embryonic stem cells (98). Use of DMSO in clinical trials and case reports, or as part of other treatments, has resulted in cardiovascular adverse effects such as stroke and heart attack (42; 43), trigeminocardiac reflex (44; 45), and bradycardia and hypotension or tachycardia and hypertension (37).
  • CholinergicsCholinergics: In animal research, DMSO had cholinesterase inhibitor effects (99).
  • Dermatologic agentsDermatologic agents: Use of DMSO in clinical trials and case reports, or as part of other treatments, has resulted in dermatologic adverse effects; erythema, pruritus, burning, drying, scaling, blistering, dermatitis, crusting and rash, redness, flakiness, and wheals have been reported with DMSO or with other agents dissolved in DMSO (27; 28; 29; 30; 31; 32; 33; 34; 35; 36). In human research, DMSO had some effect on the healing of diabetic ulcers (100). In early research, massage therapy with a DMSO cream did not appear to effectively prevent pressure ulcers (also called bedsores) (71).
  • DiureticsDiuretics: According to a review, DMSO has diuretic effects (7). One clinical trial reported increased urgency and dysuria following DMSO exposure (38)
  • Gastrointestinal agentsGastrointestinal agents: Use of DMSO in clinical trials and case reports, or as part of other treatments, has resulted in gastrointestinal adverse effects; as nausea, vomiting, constipation, halitosis (garlic-like breath), garlic taste, dyspepsia, and diarrhea have been reported with DMSO or with other agents dissolved in DMSO (52; 53; 54; 55; 56; 30; 35; 36; 37; 39). One randomized controlled trial suggested that DMSO in combination with cimetidine may be beneficial for duodenal ulcers (97). In a separate study, DMSO prevented the relapse rate in patients with healed duodenal ulcers (63).
  • Hematologic agentsHematologic agents: Eosinophilia and hemolysis have been reported to result from intravenous administration of DMSO (55).
  • HypotensivesHypotensives: Use of DMSO in clinical trials and case reports, or as part of other treatments, has resulted in cardiovascular adverse effects such as hypotension and hypertension (37).
  • ImmunomodulatorsImmunomodulators: According to a review, DMSO increased resistance to infection (7).
  • Methylsulfonylmethane (MSM)Methylsulfonylmethane (MSM): According to a review, 15% of DMSO is converted to MSM in the body (104).
  • Muscle relaxantsMuscle relaxants: According to a review, DMSO has muscle relaxant effects (7).
  • Neurologic agentsNeurologic agents: Use of DMSO in clinical trials and case reports, or as part of other treatments, has resulted in neurological adverse effects, such as headache, dizziness, sedation, agitation, and encephalopathy (54; 42; 39), as well as transient loss of consciousness (57), transient global amnesia (58), somnolence (59), general neurotoxicity (47; 50) and encephalopathy (48).
  • Ophthalmic agentsOphthalmic agents: Temporary vision loss because of DMSO has been reported after DMSO was used in stem cell transplantations (60).
  • OxymatrineOxymatrine: In vitro, oxymatrine, isolated from Ku Shen (the dried root of Sophora flavescens Ait.) protected against cytotoxicity of DMSO (85).
  • Renally eliminated agentsRenally eliminated agents: The authors of a randomized controlled trial of DMSO in interstitial cystitis have recommended avoiding DMSO in patients with hepatic or renal dysfunction, or in patients taking renally eliminated drugs (38). In a case report, a patient with acute renal failure and subsequent nephrotic syndrome recovered after treatment for two years with prednisolone, aspirin, and DMSO (102).
  • Respiratory agentsRespiratory agents: Respiratory depression (59) and chest tightness (37) have been reported after DMSO was used in stem cell transplantations. Toxicities to DMSO during onyx treatment have been discussed in case reports and include pulmonary edema resulting in acute respiratory distress syndrome (61).
  • VasodilatorsVasodilators: According to a review, DMSO has vasodilatory effects (7).
  • Vitamin AVitamin A: In a study of long-term retinoic acid-based neural induction methods of bone marrow human mesenchymal stem cells, retinoic acid treatment alone was determined as being the most reliable with respect to differentiation and protein expression stability (details of DMSO were lacking) (105).

    • DMSO/Food Interactions:

  • Insufficient available evidence.

    • DMSO/Lab Interactions:

  • Blood lipidsBlood lipids: According to a review, DMSO had antilipemic effects (7).
  • Blood pressureBlood pressure: Use of DMSO in clinical trials and case reports, or as part of other treatments, has resulted in cardiovascular adverse effects such as hypotension and hypertension (37).
  • Echinocandin susceptibility testingEchinocandin susceptibility testing: Using European Committee on Antibiotic Susceptibility Testing EDef 7.1 and 7.2 methodologies (EUCAST) methodology, when DMSO was used as a solvent, the MICs were lower and the ranges were narrower during echinocandin susceptibility testing (106)
  • Platelet effectsPlatelet effects: According to a review, DMSO decreased platelet aggregation (7). In a review, de la Torre et al. suggested that normalizing tissue perfusion involving the prostaglandin-thromboxane and platelet systems plays a role in the prevention of cerebral ischemia by DMSO (4).