pentosan

Therapeutic Classification: interstitial cystitis agents

Pharmacologic Classification: heparin like compounds

Indications ⬆ ⬇

REMS

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

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.

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

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.

Route/Dosage ⬆ ⬇

PO (Adults ): 100 mg three times daily.

Availability ⬆ ⬇

Capsules: 100 mg

Assessment ⬆ ⬇

Assess pain intensity, frequency, and duration in patient with interstitial cystitis.

Lab Test Considerations:

Doses of <1200 mg/day are unlikely to affect PT or PTT.
- May cause liver function abnormalities.
- May rarely cause anemia, ↑ PT, ↑ PTT, leukopenia, and thrombocytopenia.

Implementation ⬆ ⬇

PO: Administer on an empty stomach 3 times daily, at least 1 hr before or 2 hr after meals.

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.

Evaluation/Desired Outcomes ⬆ ⬇

↓in pain and discomfort of interstitial cystitis. Reassess after 3 mo of therapy. If no improvement but no limiting adverse events are present, may be continued for 3 more mo.

US Brand Names ⬆ ⬇

Code ⬆

NDC Code

50458- Janssen Pharmaceuticals, Inc.
- 50458-098- ELMIRON
  - 50458-098-01- 100 CAPSULE, GELATIN COATED in 1 BOTTLE (50458-098-01)

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Pronunciation ⬇

Classifications ⬆ ⬇