Bacteriostatic water comes under both proprietary and generic names. Each type is called "bacteriostaticwater," but the proprietary name is "Bacteriostatic Water for Injection, USP." Both versions are sterile, with 0.9% benzyl alcohol added to inhibit the growth and reproduction of bacteria; therefore, the alcohol is considered a preservative. It is also important to note that bacteriostatic water is not the same thing as sterile saline solution. While both are sterile, sterile saline water does not contain benzyl alcohol.

Bacteriostatic water is made to be given parenterally, after being mixed with solute. This basically means that it is injected intramuscularly, intravenously or subcutaneously.

Because of the potential presence of particulates, contamination or even a particular drug that is being dissolved in the water, care has to be taken thoroughly to examine the solution before administering it. Without any diluted compound, bacteriostatic water is not isotonic; therefore, the newly created (or enhanced) chemical imbalance between the intracellular and extracellular environments will act to pull the contents out of the cells through a process called lysis, in which the cell walls are breached, burst and exude their contents into the surrounding environment.

The development of this kind of problem can evolve into other problems, such as hypoxia, bacterial meningitis, septicemia, venous thrombosis, phlebitis, tissue necrosis, and a wide array of possible infections. The list of other, more limited potential issues include cutaneous abscess, malaise, fever and chills. Of course, all are serious because they involve treatments that have been administered internally, requiring more extensive management.

It is essential that bacteriostatic water be properly administered in strict adherence to the guidelines given by the manufacturer of the drug that is being used as solute. One reason for this is that solutes act to buffer against possible hemolysis; therefore, bacteriostatic water should never be administered by injection without solute.

A recent voluntary recall of one potentially contaminated lot of bacteriostatic water was made by a company called Hospira, Inc., a Pfizer company. The product was deemed unsafe because of a potential failure to monitor the safe manufacturing guidelines all the way through the process. Hospira's direct customers were advised of potential side effects that included invasive bacterial infection.

Although no adverse reactions have been reported until now, this example highlights the inherent risks that exist around the manufacture and use of this water, and why it is so important to handle it with care. Specifically because it is made to be an invasive carrier for the administration of medications in IV or injectable form, product purity and integrity is paramount.

Bacteriostatic water has few side effects to speak of in adults. On the rare occasion when they do occur in adults, they are usually related to the drug or drugs that are being administered in the water.

Other potential side-effects can stem from the presence of foreign substances or undissolved particulates from the medications themselves. These are basically contaminants, and their potential to interfere with the treatment creates real risk.

Bacteriostatic water mixes uneventfully with many medications and usually interacts with none. However: some drugs are incompatible with this water. Therefore, you should tell your doctor about any and all drugs or medications you may be taking, in order to avoid delays or other complications that may compromise your treatment.

This is especially true if you are pregnant. Although tests have proven that bacteriostatic water solutions will not affect adults, it is not completely known whether the water can affect the fetus when mixed with any of the incompatible medications. Due to its tendency to raise blood pressure, bacteriostatic water is contraindicated for new-born.