Some of the views expressed in the following notes on newly approved products should be regarded as preliminary, as there may have been limited published data at the time of publication, and little experience in Australia of their safety or efficacy. However, the Editorial Executive Committee believes that comments made in good faith at an early stage may still be of value. Before new drugs are prescribed, the Committee believes it is important that more detailed information is obtained from the manufacturer's approved product information, a drug information centre or some other appropriate source.
Elmiron (Arthropharm)
100 mg capsules
Indication: interstitial cystitis
Interstitial cystitis develops when the bladder epithelium loses its protective layer of glycosaminoglycans and becomes irritated by urine. Pentosan polysulphate sodium resembles the glycosaminoglycans and restores the bladder's protection by binding to the transitional epithelium.
The product is a heparinoid. In addition to its anticoagulant effect, it also has fibrinolytic and anti inflammatory activity.
Approximately half the oral dose is absorbed and most of it is excreted in the faeces. Only about 11% of a radio labelled dose is excreted by the kidneys and only 3% is unchanged when it reaches the bladder. The half-life is about one hour and a 3 times daily regimen is recommended.
Pentosan polysulphate sodium will relieve symptoms such as frequency and urgency in some patients, however, relief may take 6-8 weeks of treatment. Patients are likely to gradually relapse when treatment is discontinued.
Few adverse reactions have been reported. Although the anticoagulant properties of the molecule are weak, caution is advised if the patient has a bleeding tendency or is taking other anticoagulants.
