Pentosan polysulfate

Pentosan polysulfate

Clinical data
Pregnancy category	?
Routes of administration	Oral, intramuscular, intra-articular, intraventricular
ATC code	C05BA04 (WHO)
Legal status
Legal status	?
Pharmacokinetic data
Bioavailability	?
Metabolism	?
Elimination half-life	?
Excretion	urine
Identifiers
CAS Number	37300-21-3
PubChem CID	37720
E number	{{#property:P628}}
ECHA InfoCard	{{#property:P2566}}
Chemical and physical data
Formula	C14H26O21S4
Molar mass	658.608

WikiDoc Resources for Pentosan polysulfate
Articles
Most recent articles on Pentosan polysulfate Most cited articles on Pentosan polysulfate Review articles on Pentosan polysulfate Articles on Pentosan polysulfate in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Pentosan polysulfate Images of Pentosan polysulfate Photos of Pentosan polysulfate Podcasts & MP3s on Pentosan polysulfate Videos on Pentosan polysulfate
Evidence Based Medicine
Cochrane Collaboration on Pentosan polysulfate Bandolier on Pentosan polysulfate TRIP on Pentosan polysulfate
Clinical Trials
Ongoing Trials on Pentosan polysulfate at Clinical Trials.gov Trial results on Pentosan polysulfate Clinical Trials on Pentosan polysulfate at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Pentosan polysulfate NICE Guidance on Pentosan polysulfate NHS PRODIGY Guidance FDA on Pentosan polysulfate CDC on Pentosan polysulfate
Books
Books on Pentosan polysulfate
News
Pentosan polysulfate in the news Be alerted to news on Pentosan polysulfate News trends on Pentosan polysulfate
Commentary
Blogs on Pentosan polysulfate
Definitions
Definitions of Pentosan polysulfate
Patient Resources / Community
Patient resources on Pentosan polysulfate Discussion groups on Pentosan polysulfate Patient Handouts on Pentosan polysulfate Directions to Hospitals Treating Pentosan polysulfate Risk calculators and risk factors for Pentosan polysulfate
Healthcare Provider Resources
Symptoms of Pentosan polysulfate Causes & Risk Factors for Pentosan polysulfate Diagnostic studies for Pentosan polysulfate Treatment of Pentosan polysulfate
Continuing Medical Education (CME)
CME Programs on Pentosan polysulfate
International
Pentosan polysulfate en Espanol Pentosan polysulfate en Francais
Business
Pentosan polysulfate in the Marketplace Patents on Pentosan polysulfate
Experimental / Informatics
List of terms related to Pentosan polysulfate

For patient information, click here

Overview

Pentosan polysulfate (sold under the name Elmiron by Ortho-McNeil Pharmaceutical, inc.) was the first --and only-- oral medication approved by the U.S. FDA for the treatment of interstitial cystitis, also known as painful bladder syndrome.

Uses

Interstitial cystitis

Interstitial cystitis patients struggle with symptoms of urinary frequency, urgency, pressure and/or pain, as well as nocturia (frequent urination at night), dyspareunia (painful intercourse), pain and/or discomfort while sitting in a car, while driving and/or travelling.

The origin/cause of IC is unknown though a number of theories are currently under consideration. Urine cultures are typically negative for infection, yet it is not unusual for patients to believe that they have had infections for years rather than IC, because the symptoms of an infection are nearly identical to the symptoms of IC.

Pentosan polysulfate is available as pills or directly infused into the bladder.

Transmissible spongiform encephalopathies

Recently pentosan polysulfate has gained attention as possibly being effective in the treatment of Creutzfeldt-Jakob disease (CJD), although there is as yet no definitive evidence for this other than results of the ongoing treatment (published) of one patient in Northern Ireland and around six other patients in mainland Britain.

Around 15 other patients in non-UK countries have also received this treatment in an attempt to halt or slow down CJD and related disease progression.

Pharmacology

Pentosan is believed to work by providing a protective coating to the damaged bladder wall. The critical flaw of the medication, however, is its exceptionally poor bioavailability when taken orally. Research presented late in 2005 by Alza Pharmaceuticals demonstrates that more than 94% of the medication is excreted, intact, in feces without providing any beneficial effect. Their research found that only 6% was excreted through urine. The drug must be taken for several months for most patients to achieve some benefit.

More recently, however, pentosan polysulfate has been studied as part of a "rescue instillation" which is placed directly in the bladder and can, perhaps, provide better effectiveness. C. Lowell Parsons has presented a research study which shows a 90% effectiveness in reducing the symptoms of IC patients by using this instillation.

Side effects

Patients who have taken pentosan orally report a variety of side effects, primarily GI complaints such as diarrhea, heartburn, stomach pain. Hair loss, headache, rash, insomnia have also been reported. One concern is the potential for blood thinning with this medication. Some patients have reported that they bruise more easily. In some cases, patients are asked to stop medication before any major surgical procedures to reduce the likelihood of bleeding.

External links

• "Meet the IC Expert" Guest Lecture by C. Lowell Parsons, MD
• Elmiron FAQ (For Interstitial Cystitis patients)
• Template:PDF.