Pentosan polysulfate sodium

Pentosan polysulfate (PPS) is medication used for interstitial cystitis and osteoarthritis.

It is a semi-synthetic polysulfated xylan.

Trade name Elmiron.



Adult dosing is 100mg orally 3 times daily until symptoms resolve, for a minimum of 4 weeks. 

Pregnancy category B

Routes of administration- oral, intramuscular, intra-articular, intraventricular

Excretion by Urine

It is used either by mouth or in the bladder to treat interstitial cystitis/painful bladder syndrome.

Previous reviews found improvements in pain (36%), urgency (28%), and frequency (54%), but that it does not change the frequency of urination.

More recent trials, however, found the agent be of no benefit.

Side effects include diarrhea, gastrointestinal bleeding, nausea, headache, rash, bruising, abdominal pain, and liver inflammation.

It is believed to work by being a protective coating to the damaged bladder wall.

Its structure is similar to the natural glycosaminoglycan coating of the inner lining of the bladder.

As PPS can bind to the cellular isoform of the prion protein, it may stabilize this form and prevent its conversion to the pathological (scrapie) isoform.

A weak anticoagulant which may increase bleeding.

May be associated with alopecia, with 97% of cases being alopecia areata.

Most Common Adverse Reactions: Alopecia (4%), diarrhea (4%), nausea (4%), headache (3%), rash (3%), dyspepsia (2%), abdominal pain (2%), liver function abnormalities (1%), dizziness (1%).

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