Drug Interactions between antithrombin (recombinant) and pentosan polysulfate sodium

MONITOR: Theoretically, pentosan polysulfate sodium may potentiate the risk of bleeding in patients treated with agents that affect hemostasis such as anticoagulants, platelet inhibitors, thrombin inhibitors, thrombolytic agents, or agents that commonly cause thrombocytopenia. Pentosan polysulfate sodium is a weak anticoagulant with approximately 1/15 the activity of heparin. Increased prothrombin time, increased partial thromboplastin time, and bleeding complications including ecchymosis, epistaxis, and gum hemorrhage have been reported in association with its use.

MANAGEMENT: Caution is advised if pentosan polysulfate sodium is used in combination with other drugs that affect hemostasis. Close clinical and laboratory observation for hematologic complications is recommended. Patients should be advised to promptly report any signs of bleeding to their doctor, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.