Pentosan Polysulfate Sodium with Garlic Interaction Details
Brand Names Associated with Pentosan Polysulfate Sodium
- Elmiron®
- Pentosan Polysulfate
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jan 02, 2024
Interaction Effect
Increased risk of bleeding
Interaction Summary
The antiplatelet effect of garlic may add to the effect of anticoagulants, increasing the risk for bleeding complications. Elevated international normalized ratio (INR) has been reported in patients initiating garlic who had previously been stabilized on warfarin. Garlic has been shown to inhibit platelet aggregation when taken orally . Epidural hematoma and other bleeding consequences have been described in case reports when patients consumed garlic without concomitant medications known to affect blood coagulation . Given orally to humans, garlic increased fibrinolytic activity possibly through activated plasminogen . The ability of garlic to affect platelet aggregation depends on the product preparation, with different products containing different active constituents .
Severity
Major
Onset
Delayed
Evidence
Probable
How To Manage Interaction
Concomitant use of garlic and anticoagulants is not recommended. If garlic is taken with an anticoagulant, monitor bleeding time and signs and symptoms of excessive bleeding. Obtain baseline bleeding times in patients on garlic therapy prior to initiating anticoagulants. Regular ingestion of food products containing small amounts of garlic should not pose a problem. If excessive garlic is consumed with concomitant use of anticoagulants, monitor the INR and/or bleeding time and signs and symptoms of excessive bleeding. Garlic supplements should be discontinued at least 10 days prior to elective surgery (German et al, 1995).
Mechanism Of Interaction
Additive anticoagulant effects; garlic may inhibit platelet aggregation through reduced thromboxane B2, increased fibrinolytic activity
Literature Reports
A) Two cases of increased international normalized ratios (INR) have been reported in patients previously stabilized on warfarin who started garlic supplements. The author attributed the doubling of "clotting times" to ingestion of garlic pearls or tablets, which was the only change introduced into the patients' regimens. Doses and timeframes for this observation were not provided .
Pentosan Polysulfate Sodium Overview
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Pentosan polysulfate is used to relieve bladder pain and discomfort related to interstitial cystitis, a disease that causes swelling and scarring of the bladder wall. Pentosan polysulfate is similar to a class of medications called low molecular weight heparins. It works by preventing irritation of the bladder walls.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.