Pentosan Polysulfate Sodium as a Treatment for Interstitial Cystitis
This first oral drug developed as a treatment for
interstitial cystitis was approved by the U.S. Food and Drug Administration (FDA) in 1996. In clinical trials, the drug improved symptoms in 30 percent of patients treated. 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 pain associated with interstitial cystitis for the first two to four months, and a decrease in urinary frequency may take up to six months. Patients are urged to continue with this treatment for interstitial cystitis for at least six months to give the drug an adequate chance to relieve symptoms.
Side effects of 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 a 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.
Other Oral Medications Used as Treatment for Interstitial Cystitis
Aspirin and
ibuprofen may be a first line of defense against mild bladder discomfort. Doctors may recommend other drugs to relieve pain.
Some patients have experienced improvement in their urinary symptoms by taking
tricyclic antidepressants (
amitriptyline) or antihistamines. Amitriptyline may help to reduce pain, increase bladder capacity, and decrease urination frequency and nocturia (frequent urination at night). However, some patients may not be able to take it 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. Therefore, patients should always consult a doctor before using any drug for an extended amount of time.
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