pentosan

REMS

Management of symptoms (bladder pain/discomfort) of chronic interstitial cystitis (IC).

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity.

Use Cautiously in:

Underlying coagulopathy, concurrent medications that ↑ bleeding risk, history of aneurysms. thrombocytopenia, hemophilia, GI ulceration/bleeding, polyps, diverticula;
History of heparin-induced thrombocytopenia; risk of bleeding may be ↑
Hepatic insufficiency;
OB: Use during pregnancy only if clearly needed;
Lactation: Safety not established in breastfeeding;
Pedi: Children <16 yr (safety and effectiveness not established).

Adv. Reactions/Side Effects ⬆ ⬇

Derm: alopecia, ecchymosis, rash

EENT: blurred vision, epistaxis, retinal pigment changes

GI: ↑liver enzymes, abdominal pain, diarrhea, dyspepsia, gum bleeding, nausea, rectal bleeding

Hemat: ↑bleeding time, bleeding

Neuro: dizziness, headache

Interactions ⬆ ⬇

Drug-drug:

Concurrent use of anticoagulants, heparins, thrombolytics, high dose aspirin, or NSAIDs may ↑ risk of bleeding.

Availability ⬆ ⬇

Capsules: 100 mg

Route/Dosage ⬆ ⬇

PO (Adults ): 100 mg three times daily.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Adheres to uroepithelium, providing a protective barrier against irritating solutes in urine.
Has anticoagulant and fibrinolytic properties.

Therapeutic effects:

↓pain and discomfort in chronic IC.

Classifications ⬆ ⬇

Therapeutic Classification: interstitial cystitis agents

Pharmacologic Classification: heparin like compounds

Pharmacokinetics ⬆ ⬇

Absorption: 6% absorbed following oral administration.

Distribution: Distributes into uroepithelium of the genitourinary tract with less found in liver, spleen, lung, skin, periosteum, and bone marrow.

Metabolism/Excretion: Metabolized by saturable enzyme systems in liver, spleen and kidney. Majority (58–84%) excreted in feces as unchanged (unabsorbed drug). Metabolites of absorbed drug are renally excreted; minimal renal excretion of unchanged drug.

Half-Life: 27 hr.

Time/Action Profile ⬆ ⬇

(↓ symptoms)

ROUTE	ONSET	PEAK	DURATION
PO	within 4 wk-6 mos	unknown	unknown

Patient/Family Teaching ⬆ ⬇

Instruct patient to take pentosan as directed, taking no more or no more frequently than prescribed. Advise patient to read Medication Guide before starting therapy and with Rx refills in case of changes.
Inform patient of potential visual changes. Advise patient to notify health care professional if visual changes occur.
Advise patient to notify health care professional if surgery, anticoagulant therapy (warfarin, heparin), or therapy with high doses of aspirin or NSAIDs is planned.
Advise patient to notify health care professional if pregnancy is planned or suspected or if breast feeding.

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Indications ⬇