Multipass ozone therapy is a systemic ozone method in which the major autohemotherapy cycle — drawing blood, exposing it to an ozone-oxygen mixture and returning it — is repeated several times within a single session. It is also called sequential ozone. The total ozone dose reaching the body in one session is increased this way; ozone gas is not inhaled.
I am a specialist in anaesthesiology and reanimation. I have practised ozone since 2010, and since 2019 with a Ministry of Health certificate. On this page I explain when and why multipass departs from the standard procedure. The general framework of ozone and its evidence status are on the ozone therapy page; the standard single-cycle procedure is on the major ozone therapy page.
How does it work?
The mechanism is the same as major autohemotherapy: ozone meets the blood inside the set, is consumed instantly, and the short-lived compounds it leaves carry a controlled oxidative stimulus to the tissues; the cell responds by increasing its antioxidant defences 1. In multipass this cycle is repeated through the same venous line. The difference is not in the method but in the total dose given in one session.
I plan the number of cycles as 3, 5 or 10 according to the purpose, and reserve 10 for selected resistant pictures. Few cycles mean a stimulus slightly above the standard dose; many cycles mean an intensive stimulus for resistant pictures. The dose-effect relationship is decisive in ozone: the line between stimulus and burden is drawn by physician supervision and the person’s tolerance 1.
Why not always more?
More cycles are not always better; I plan the number as 3, 5 or 10 according to the purpose, and I do not recommend multipass to someone for whom the standard dose is enough. I consider multipass in resistant pictures where standard major autohemotherapy has not been sufficient; I do not bring it up at a first visit.
A multi-cycle procedure requires good venous access, a long session and good hydration on the day. If these conditions are not met, fewer cycles or the standard procedure is the better choice.
When do I consider it?
The situations I assess in my practice: resistant chronic fatigue with a limited response to the standard dose, widespread pain and fibromyalgia accompanied by a high inflammatory burden, and prolonged recovery periods. What I consistently observe in these pictures in clinical practice is a reduction in the burden of fatigue and pain; I write this as experience, not as a promise.
Being honest about the level of evidence
A separate clinical outcome literature for multipass is still limited; the method rests on the mechanistic studies of major autohemotherapy and on studies of the dose-effect relationship 1. I do not rely on a comparative trial showing that a high dose outperforms the standard dose; the decision on the number of cycles is made on clinical observation and the person’s tolerance. I do not give unsourced percentages.
The procedure and pain management
Topical anaesthetic cream is standard. Because I am an anaesthesiologist, I treat pain management as a separate part of the procedure.
I plan venous access and the infusion as part of this; what you feel is a brief sting as the line is placed.
Aftercare
Same day
- You can return to daily life; you can drive
- Drink plenty of water; avoid alcohol and heavy exercise
Expected findings A small bruise or tenderness at the venous access site may last 1–2 days. Mild tiredness or sleepiness may occur on the evening of the procedure and passes by the next day. If redness, warmth or swelling develops at the access site, contact the clinic.
Additional advice
- After a multi-cycle procedure, tiredness on the evening of the procedure may be slightly more noticeable
Safety and anatomy
Because allergic reactions can occur rarely, treatments are carried out under medical supervision.
Because the same venous line is used throughout a long session, I manage the venous access and clotting myself.
Legal framework: In Türkiye, ozone therapy is performed by certified physicians within the framework of the Traditional and Complementary Medicine (GETAT) Regulation. My clinic is routinely inspected by the district health directorate of the Ministry of Health and is inspected separately under its health tourism authorisation certificate. The products I use are recorded.
Who is not suitable
Treatment is not performed, or is postponed, in the following situations:
- Active infection or inflammation in the treatment area
- Autoimmune disease in an active phase
- Pregnancy and breastfeeding
- Known hypersensitivity to the product components
- Uncontrolled chronic illness
- Untreated bleeding disorder or unregulated anticoagulant use
I do not perform these treatments during active cancer treatment. For a person with a history of cancer, I make the decision together with the treating specialist.
In systemic ozone, treatment is also not performed in G6PD enzyme deficiency (favism), uncontrolled hyperthyroidism, or during an acute heart attack or stroke.
Without being a medical contraindication, I also consider expectation and treatment to be mismatched in these situations:
- People with difficult venous access — the standard procedure or the rectal route is considered in that situation
- People for whom the standard dose is enough
- People expecting a lasting result from a single session
Suitability is determined by consultation in every case.
Pricing
Under the applicable regulations, price information cannot be published on our website. The cost of a treatment depends on the product used, the technique chosen and the extent of the treatment. You can call the clinic for detailed information.
Frequently asked questions
What is the difference between multipass and major ozone?
Same method, different dose. In major ozone the blood is ozonated and returned once; in multipass this cycle is repeated 3, 5 or 10 times in the same session. I consider multipass in resistant pictures where the standard dose is not enough.
Why 3, 5 or 10 cycles?
I set the number according to the purpose: 3 for a mildly increased stimulus, 5 for a marked stimulus, 10 for selected resistant pictures. More is not always better; the person’s tolerance and venous access draw the line.
My veins are thin — can it be done?
A multi-cycle procedure needs good venous access. With difficult access, fewer cycles, standard major ozone or the rectal route is the better choice; I decide at consultation.
Will I feel tired after multipass ozone?
Tiredness or sleepiness may occur on the evening of the procedure; after a multi-cycle procedure it may be slightly more noticeable, and it passes by the next day. You can return to daily life the same day.
Planning your visit
My clinic is in Nişantaşı, Şişli, on the European side of Istanbul, approximately 45 minutes from Istanbul Airport.
For multipass ozone therapy I suggest planning a stay of two to three days: arrival, consultation and treatment, and departure. Because this treatment may be planned as more than one session, it may require more than one visit. The first session takes place in Istanbul, and we plan the schedule of any following sessions together according to your travel arrangements, with remote follow-up in between. Flying is generally appropriate 24 hours after an injectable treatment.
Consultations are conducted in English. Follow-up after you return home is arranged remotely, and I remain reachable for any questions during the period in which the result develops.
You can read how I offer this treatment at my clinic, IV Point, on the ozone therapy page.
Dr. Ömer Fatih Şahin — Specialist in Anaesthesiology and Reanimation Diploma Registration No: 113606 Ozone Therapy Certificate — Republic of Türkiye Ministry of Health, 2019
Published: 22 February 2026 · Last updated: 2026-09-21 This content has been medically reviewed by Dr. Ömer Fatih Şahin.
References
- Bocci V, Borrelli E, Travagli V, Zanardi I. The ozone paradox: ozone is a strong oxidant as well as a medical drug. Med Res Rev. 2009;29(4):646–682. https://pubmed.ncbi.nlm.nih.gov/19260079/