Pentosan Polysulfate Sodium

Pronunciation: PEN-toe-san
Class: Interstitial cystitis agent

Trade Names

Elmiron
- Capsules 100 mg

Pharmacology

Unknown. Adheres to and may protect the mucosal membrane of the bladder.

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Pharmacokinetics

Absorption

Absorption is approximately 3% of dose.

Distribution

Distributed to the uroepithelium of the GU tract with lesser amounts in liver, spleen, lung, skin, periosteum, and bone marrow. Erythrocyte penetration is low.

Metabolism

68% of dose undergoes desulfation in liver and spleen 1 h after IV administration; partial depolymerization occurs in the kidney.

Elimination

Renal excretion is 3% as unchanged drug. The t _½ is 24 h (IV) and 4.8 h (oral).

Indications and Usage

For relief of bladder pain or discomfort associated with interstitial cystitis.

Contraindications

Standard considerations.

Dosage and Administration

PO 100 mg 3 times daily.

Storage/Stability

Store at room temperature (68° to 77°F) in tightly closed container.

Drug Interactions

Pentosan has weak anticoagulant properties and may potentiate the pharmacological action of other anticoagulants, antiplatelet, or thrombolytic drugs.

Laboratory Test Interactions

None reported.

Adverse Reactions

CNS

Headache; emotional lability; depression; dizziness.

Dermatologic

Alopecia; rash.

GI

Nausea; abdominal pain; diarrhea; dyspepsia.

Hepatic

Liver function abnormalities.

Precautions

Pregnancy

Category B .

Lactation

Unknown.

Children

Safety and efficacy not established.

Anticoagulant effects

Since drug has weak anticoagulant effects, carefully evaluate patients with diseases such as aneurysms, thrombocytopenia, hemophilia, GI ulcerations, polyps, or diverticula before initiating therapy.

Hepatic/Splenic function impairment

Use with caution.

Thrombocytopenia

Use with caution in patients with a history of heparin-induced thrombocytopenia.

Overdosage

Symptoms

Unknown. Based on its pharmacology, overdose is likely to manifest as an increased risk of anticoagulation, thrombocytopenia, gastric pain, and liver function abnormalities.

Patient Information

• Instruct patient to take as prescribed and not more frequently than directed.
• Instruct patient to take pentosan polysulfate sodium at least 1 h before or 2 h after meals with a full glass of water.
• Inform patient of possible adverse reactions with other drugs or foods they may be taking.
• Advise patient to consult with health care provider before taking any other medications including OTCs.
• Instruct patient to assess pain relief or improvement and report to the primary care provider at least every 3 mo to determine effectiveness of treatment.
• Instruct patient to be aware of adverse effects such as bleeding complications (eg, ecchymosis, epistaxis, gum hemorrhage) and alopecia areata. Inform health care provider if noted.
• Instruct patient to inform health care provider if needing invasive dental work, surgery, or other procedures that might expose patient to increased risk for bleeding.
• Advise the patient to notify primary caregiver if experiencing jaundice or other signs of liver disease.

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