Pentosan polysulfate Brand Name– Elmiron
What is Pentosan polysulfate
Pentosan polysulfate sodium is a weak anticoagulant (1/15 the activity of heparin). It is a semi-synthetically produced heparin-like derivative that chemically and structurally resembles glycosaminoglycans.
Pentosan polysulfate sodium is administered orally for the relief of pain and discomfort associated with interstitial cystitis (IC).
Pentosan appeared effective in relieving symptoms of pain, urgency, and frequency in one study.
Other studies have been conflicting, with some studies showing efficacy and other studies not reporting significant improvements versus placebo. One double-blind, randomized controlled trial revealed no treatment benefit for pentosan polysulfate sodium versus placebo at the currently established dose or at a lower dose; however, the study included patients that had milder IC symptoms and other design factors may have influenced the results.
Pentosan is one of the few available drug treatments for IC, and is used as a second-line agent per guidelines as part of a multimodal approach.
Pentosan was FDA-approved in 1996.
Indications
- interstitial cystitis
For the relief of bladder pain or discomfort associated with interstitial cystitis
Side Effects
- abdominal pain
- alopecia
- amblyopia
- anemia
- anorexia
- bleeding
- blurred vision
- colitis
- conjunctivitis
- constipation
- dehydration
- depression
- diarrhea
- dizziness
- dyspepsia
- dyspnea
- ecchymosis
- elevated hepatic enzymes
- emotional lability
- epistaxis
- esophagitis
- flatulence
- gastritis
- GI bleeding
- headache
- hyperhidrosis
- hyperkinesis
- insomnia
- lacrimation
- leukopenia
- nausea
- nystagmus
- optic neuritis
- oral ulceration
- pharyngitis
- photosensitivity
- pruritus
- rash
- retinal hemorrhage
- retinal pigment changes
- retinopathy
- rhinitis
- thrombocytopenia
- tinnitus
- urticaria
- vaginitis
- visual impairment
- vomiting
Monitoring Parameters
- CBC with differential
- LFTs
- urinalysis
Contraindications
- aneurysm
- anticoagulant therapy
- bleeding
- breast-feeding
- children
- coagulopathy
- diverticulitis
- hemophilia
- heparin-induced thrombocytopenia (HIT)
- hepatic disease
- infants
- neonates
- obstetric delivery
- ocular disease
- peptic ulcer disease
- pregnancy
- retinitis pigmentosa
- surgery
- thrombocytopenia
- thrombolytic therapy
- visual disturbance
- visual impairment
Interactions
- Abciximab
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Ado-Trastuzumab emtansine
- Alteplase
- Altretamine
- Aminosalicylate sodium, Aminosalicylic acid
- Amlodipine; Celecoxib
- Anagrelide
- Antithrombin III
- Antithymocyte Globulin
- Apixaban
- Argatroban
- Arsenic Trioxide
- Aspirin, ASA
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Aspirin, ASA; Dipyridamole
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Betrixaban
- Bismuth Subsalicylate
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Bivalirudin
- Caplacizumab
- Carbenicillin
- Celecoxib
- Chlorambucil
- Choline Salicylate; Magnesium Salicylate
- Cilostazol
- Clofarabine
- Clopidogrel
- Collagenase
- Cytarabine, ARA-C
- Dabigatran
- Dalteparin
- Danaparoid
- Danazol
- Dasatinib
- Decitabine
- Deferasirox
- Defibrotide
- Denileukin Diftitox
- Desirudin
- Dextran
- Diclofenac
- Diclofenac; Misoprostol
- Diflunisal
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Dipyridamole
- Drotrecogin Alfa
- Edoxaban
- Eltrombopag
- Enoxaparin
- Epoprostenol
- Eptifibatide
- Esomeprazole; Naproxen
- Esterified Estrogens; Methyltestosterone
- Estramustine
- Etodolac
- Famotidine; Ibuprofen
- Fenoprofen
- Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
- Floxuridine
- Fluorouracil, 5-FU
- Flurbiprofen
- Folate analogs
- Fondaparinux
- Garlic, Allium sativum
- Gefitinib
- Ginger, Zingiber officinale
- Ginkgo, Ginkgo biloba
- Green Tea
- Hemin
- Heparin
- Hydrocodone; Ibuprofen
- Hydroxyurea
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibritumomab Tiuxetan
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Icosapent ethyl
- Iloprost
- Imatinib
- Indomethacin
- Inotersen
- Interferon Alfa-2a
- Interferon Alfa-2b
- Interferon Alfa-2b; Ribavirin
- Interferon Alfa-n3
- Interferon Alfacon-1
- Intravenous Lipid Emulsions
- Ketoprofen
- Ketorolac
- Lansoprazole; Naproxen
- Lepirudin
- Lomustine, CCNU
- Magnesium Salicylate
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Methoxsalen
- Methylsulfonylmethane, MSM
- Methyltestosterone
- Mifepristone
- Miltefosine
- Mycophenolate
- Nabumetone
- Nandrolone Decanoate
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Natural Antineoplastics
- Nelarabine
- Nintedanib
- Nonsteroidal antiinflammatory drugs
- Obinutuzumab
- Omacetaxine
- Oxandrolone
- Oxaprozin
- Phentermine; Topiramate
- Piperacillin
- Piperacillin; Tazobactam
- Piroxicam
- Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
- Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
- Prasugrel
- Reteplase, r-PA
- Rivaroxaban
- Rofecoxib
- Salicylates
- Salsalate
- Selective serotonin reuptake inhibitors
- Serotonin norepinephrine reuptake inhibitors
- Sodium Hyaluronate, Hyaluronic Acid
- Sodium Iodide
- Streptokinase
- Sulfinpyrazone
- Sulindac
- Telavancin
- Tenecteplase
- Thrombolytic Agents
- Ticagrelor
- Ticarcillin
- Ticarcillin; Clavulanic Acid
- Ticlopidine
- Tinzaparin
- Tipranavir
- Tirofiban
- Tolmetin
- Topiramate
- Trazodone
- Treprostinil
- Tretinoin, ATRA
- Urokinase
- Valdecoxib
- Verteporfin
- Vilazodone
- Vorapaxar
- Vorinostat
- Vortioxetine
- Warfarin
