Pentosan

Class: Protective Agents
ATC Class: C05BA
VA Class: GU900
Chemical Name: 4-O-Methyl-α-d-glucurono)-(1→2)-(1→4)-β-d-xylopyran hydrogen sulfate sodium salt
Molecular Formula: [C₅H₆Na₂O₁₀S₂]_n (n = 6 to 12)
CAS Number: 140207-93-8
Brands: Elmiron

Medically reviewed by Drugs.com on Dec 1, 2021. Written by ASHP.

Introduction

Semisynthetic low molecular weight heparinoid; a uroprotective agent resembling glycosaminoglycans.

Uses for Pentosan

Interstitial Cystitis

Symptomatic relief of bladder pain or discomfort associated with interstitial cystitis; designated an orphan drug by FDA for this use.

Pentosan Dosage and Administration

Administration

Oral Administration

Administer with water ≥1 hour before or 2 hours after meals.

Dosage

Available as pentosan polysulfate sodium; dosage expressed in terms of the salt.

Adults

Interstitial Cystitis

Oral

100 mg 3 times daily for 3 months. If after 3 months no improvement and no dose-limiting adverse effects occur, may continue therapy for another 3 months.

Manufacturer states that if no improvement of pain is observed by 6 months, the clinical benefits and risks of continued therapy are unknown. However, data from a long-term clinical study indicate overall continued symptomatic improvement (e.g., pain, urgency, urinary frequency, nocturia) during 1–2 years of therapy.

Some clinicians recommend a dosage of 200 mg twice daily†; this dosage appears to be effective and promotes greater patient compliance.

Special Populations

Hepatic Impairment

No specific dosage recommendations. (See Hepatic Impairment under Cautions.)

Renal Impairment

No specific dosage recommendations.

Geriatric Patients

No specific dosage recommendations.

Cautions for Pentosan

Contraindications

• Known hypersensitivity to pentosan polysulfate, structurally related compounds, or any ingredient in formulation.

Warnings/Precautions

Hematologic Effects

Pentosan polysulfate is weak anticoagulant.

Rectal hemorrhage and bleeding complications of ecchymosis, epistaxis, and gum hemorrhage reported.

Evaluate patients at increased risk for hemorrhage including those undergoing invasive procedures, with signs and symptoms of coagulopathy, or receiving concomitant drugs that affect hemostasis. (See Specific Drugs under Interactions.)

Delayed immunoallergic th...