Pentosan polysulfate sodium (PPS) is a semi-synthetic, heparin-like macromolecular carbohydrate derivative derived from beechwood hemicellulose. It is classified as a disease-modifying agent for interstitial cystitis/bladder pain syndrome (IC/BPS). In India, it is primarily indicated for the relief of bladder pain and discomfort associated with IC/BPS. It acts by replenishing the glycosaminoglycan (GAG) layer of the bladder urothelium, providing a protective barrier against urinary solutes.
Adult: 100 mg, three times daily, taken 1 hour before or 2 hours after meals with water.
Note: Administer on an empty stomach (1 hour before or 2 hours after meals) to maximize absorption. Swallow capsule whole with a full glass of water. Do not crush or chew. Consistency in timing is important.
Pentosan polysulfate sodium is believed to act as a synthetic analog of the naturally occurring glycosaminoglycan (GAG) layer that lines the bladder urothelium. In IC/BPS, this protective layer is thought to be defective. PPS adheres to the bladder wall, replenishing this layer and forming a barrier that prevents irritating urinary solutes (like potassium ions) from penetrating into the submucosal tissue, thereby reducing pain, inflammation, and mast cell activation.
Pregnancy: Category B (Animal studies show no risk, but no adequate human studies). Use only if clearly needed and potential benefit justifies potential risk to the fetus, considering its weak anticoagulant properties.
Driving: Dizziness has been reported. Patients should be cautioned about operating machinery or driving until they know how the medication affects them.
| Warfarin, Acenocoumarol | Increased risk of bleeding due to additive anticoagulant effect. | Major |
| Heparin, LMWH (Enoxaparin, etc.) | Potentiates anticoagulant effect, high bleeding risk. | Major |
| Antiplatelets (Aspirin, Clopidogrel, Ticagrelor) | Increased risk of bleeding. | Moderate |
| NSAIDs (Ibuprofen, Diclofenac, Naproxen) | Increased risk of GI bleeding and general bleeding tendency. | Moderate |
| SSRIs (Sertraline, Escitalopram) | May increase bleeding risk. | Moderate |
| Herbal (Ginkgo biloba, Garlic, Ginseng) | May increase bleeding risk. | Moderate |