Medications Used for Interstitial Cystitis
This first oral drug developed as a treatment for interstitial cystitis was approved by the FDA in 1996. In clinical trials, the drug improved symptoms in 30 percent of patients. Doctors do not know exactly how it works, but one theory is that it may repair defects that might have developed in the lining of the bladder.
The FDA-recommended oral dosage of pentosan polysulfate sodium (Elmiron) is 100 mg, three times a day. Patients may not feel relief from interstitial cystitis pain for the first two to four months with this drug. A decrease in urinary frequency may take up to six months. Patients are often urged to continue with this treatment for at least six months to give the drug an adequate chance to relieve symptoms.
Side effects with Elmiron are limited primarily to minor gastrointestinal discomfort. A small minority of patients experienced some hair loss, but hair grew back when they stopped taking the drug. Researchers have found no negative interactions between Elmiron and other medications.
Elmiron may affect liver function, which should, therefore, be monitored by the doctor. Because Elmiron has not been tested in pregnant women, the manufacturer recommends that it not be used during pregnancy, except in the most severe cases.
Aspirin and ibuprofen may be a first line of defense against mild discomfort. Doctors may initially recommend these or other drugs to relieve pain caused by interstitial cystitis.
Some patients have experienced an improvement in their urinary symptoms by taking tricyclic antidepressants (amitriptyline) or antihistamines. Amitriptyline may help to reduce pain, increase bladder capacity, and decrease frequency and nocturia (frequent urination at night). Some patients may not be able to take it, however, because it makes them too tired during the day.
In patients with severe pain, narcotic analgesics, such as acetaminophen (Tylenol®) with codeine, or longer-acting narcotics may be necessary.
All drugs -- even those sold over-the-counter -- have side effects. Patients should always consult a doctor before using any drug for an extended amount of time.