Glycosaminoglycan-like agent (interstitial cystitis)
Pentosan polysulfate sodium
Brand names: Elmiron
Adult dose
Dose: 100mg TDS on empty stomach (1 hour before or 2 hours after food)
Route: Oral
Frequency: TDS
Clinical pearls
- Bladder pain syndrome / interstitial cystitis — restores GAG layer of bladder urothelium
- MHRA Drug Safety Update (2019): pigmentary maculopathy with long-term use — annual ophthalmic review
- EAU urology and ESSIC interstitial cystitis guidelines
- NICE recommends specialist urological supervision; clinical trial data modest
Contraindications
- Active bleeding (excluding menstruation)
- Severe hepatic impairment
- Hypersensitivity
Side effects
- GI upset
- Headache
- Hair loss
- Bleeding (rare)
- Pigmentary maculopathy (long-term — MHRA safety alert)
- Hepatic dysfunction
Interactions
- Anticoagulants/antiplatelets (bleeding)
Monitoring
- Symptoms (visual analogue scale)
- Annual ophthalmic review (retinal imaging)
- LFTs
- FBC if bleeding history
Reference: BNF; MHRA Drug Safety Update; EAU/ESSIC interstitial cystitis guidelines; SmPC; https://bnf.nice.org.uk/drugs/pentosan-polysulfate-sodium/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators