FDA-filed SPL labeling · retrieved through openFDA

Pentosan Polysulfate

Pentosan polysulfate sodium is an oral medication used to relieve bladder pain and discomfort caused by interstitial cystitis.

Brand names ElmironZycosan
Drug class Glycosaminoglycans
Rx Form 1 Route Oral
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveSep 18, 2024
AvailabilityRx
Earliest approval/marketing year 1996
FDA-listed product records 16
Boxed warningNone found in compared labels
How we combine label and product data →
No current FDA shortage listed · checked Sep 21, 2026
Pentosan Polysulfate at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Elmiron (pentosan polysulfate sodium) is the only FDA-approved oral capsule for relieving bladder pain from interstitial cystitis. Long-term use carries a real risk of permanent retinal (eye) damage, so regular eye exams are important during treatment. It also has mild blood-thinning effects, so always tell your prescriber and pharmacist about any other medications you take.

📖 Pentosan Polysulfate: Patient Information Guide

A plain-language walkthrough of Pentosan Polysulfate — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Pentosan polysulfate sodium is used to treat one confirmed condition in the supported product evidence:

  • Interstitial cystitis: Elmiron (pentosan polysulfate sodium) oral capsules are FDA-approved specifically to relieve bladder pain and discomfort caused by interstitial cystitis, a chronic bladder condition.
⚙️How it works

Exactly how pentosan polysulfate sodium relieves bladder pain is not fully known. In preliminary studies, the drug appeared to adhere to the mucosal lining of the bladder wall — the inner surface that comes into contact with urine. It may work by acting as a protective buffer, blocking irritating substances in the urine from penetrating bladder cells and triggering pain. The drug also has anticoagulant (blood-thinning) and fibrinolytic (clot-dissolving) properties, though whether these contribute to its effect on interstitial cystitis symptoms is unclear.

💊How it's taken

Elmiron capsules are taken by mouth three times a day, spaced throughout the day. Each dose must be taken with water on an empty stomach — either at least 1 hour before eating or 2 hours after a meal. The effect of food on how the drug is absorbed is not fully known, which is why this timing is recommended.

  • Take each dose with a full glass of water.
  • Try to take doses at consistent times each day.
  • Your prescriber will check your progress at 3 months — and again at 6 months if you haven't improved — to decide whether to continue treatment.
  • Follow your prescriber's instructions closely; do not change your dose on your own.
🤒Side effects — in detail

Most people who take Elmiron tolerate it well, but some side effects do occur. Common ones reported include:

  • Hair loss (alopecia)
  • Diarrhea
  • Nausea
  • Headache
  • Skin rash
  • Stomach upset or indigestion (dyspepsia)
  • Abdominal pain
  • Dizziness
  • Abnormal liver enzyme levels (seen in lab tests)

More serious reactions — including rectal bleeding, signs of unusual bruising or bleeding (due to anticoagulant effects), or any changes in vision — should prompt you to contact your doctor right away. Vision changes in particular can signal retinal damage that may be permanent.

⚠️Warnings & precautions
  • Retinal pigmentary changes (pigmentary maculopathy): Long-term use of Elmiron has been linked to damage to the retina — the light-sensitive tissue at the back of the eye. These changes can be irreversible and may even progress after stopping the drug. Most cases have occurred after 3 or more years of use, but shorter exposure has also been reported. Watch for difficulty reading, slow adjustment to low light, or blurry vision. Eye exams — including retinal imaging — are recommended before starting treatment and periodically throughout.
  • Anticoagulant (blood-thinning) effects: Pentosan polysulfate sodium can thin the blood and may increase the risk of bleeding, especially when combined with other blood thinners. Report unusual bruising, prolonged bleeding, or rectal bleeding to your doctor.
  • Liver function: Abnormal liver enzyme levels have been reported. If you have pre-existing liver problems, discuss the risks carefully with your prescriber.
  • Limited benefit window: If your pain has not improved after 6 months, the benefit of continuing treatment is uncertain. Discuss the risks and benefits of ongoing use with your prescriber.
🔀What it interacts with

Pentosan polysulfate sodium has anticoagulant properties, so it's especially important to watch for interactions with other medications that affect bleeding:

  • Warfarin and other anticoagulants (blood thinners): Use with caution. Although a study showed warfarin's blood levels were not significantly changed by pentosan polysulfate sodium at standard doses, combining agents with anticoagulant effects may increase the risk of bleeding.
  • Other therapies with anticoagulant effects: Tell your prescriber and pharmacist about all medications, including over-the-counter products and supplements, especially anything that may also thin the blood.

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it
  • Allergy: Do not take Elmiron if you are allergic to pentosan polysulfate sodium, related compounds, or any inactive ingredient in the capsule.
  • Eye conditions: Tell your doctor about any existing retinal or eye conditions before starting treatment — they may make it harder to monitor for drug-related retinal changes.
  • Family history of hereditary eye disease: If you have a family history of hereditary pattern dystrophy (a genetic retinal condition), genetic testing should be considered before starting Elmiron.
  • Liver problems: Use with caution if you have hepatic (liver) impairment, as the drug is metabolized partly in the liver. The pharmacokinetics of the drug in patients with liver impairment have not been formally studied.
  • Kidney impairment: The drug's behavior in people with kidney disease has not been specifically studied — discuss this with your prescriber.
  • Older adults: The drug has not been specifically studied in geriatric patients — your prescriber should assess the appropriate approach for you.
  • Blood-thinning medications: Tell your doctor if you take warfarin or any other anticoagulant or medication that affects bleeding.
🚑If you take too much

Overdose with pentosan polysulfate sodium has not been reported in clinical practice. However, based on how the drug works, taking too much would most likely cause signs of excessive anticoagulation (increased bleeding risk), low platelet counts (thrombocytopenia), liver enzyme abnormalities, and stomach or digestive distress. If an overdose is suspected, the recommended approach is gastric lavage (stomach pumping) if possible, along with close observation and supportive care — contact emergency services or Poison Control right away.

📡Pharmacodynamics — effects in the body

Pentosan polysulfate sodium appears to adhere to the inner lining (mucosal membrane) of the bladder wall. It may protect bladder cells by acting as a buffer — essentially forming a barrier that prevents irritating substances in the urine from penetrating the bladder lining and causing pain. The drug also has measurable anticoagulant (blood-thinning) and fibrinolytic (clot-dissolving) effects, although the connection between these properties and its effect on bladder symptoms has not been established.

🔬Pharmacokinetics — how your body processes it

Only about 6% of an oral dose of pentosan polysulfate sodium is actually absorbed into the bloodstream — the majority passes through the digestive tract and is excreted in the stool unchanged. After absorption, the drug is metabolized (broken down) in the liver and spleen, and further processed by the kidneys. The drug clears from the body with a half-life (the time it takes for the body to eliminate half of it) of roughly 20 to 27 hours. Most of the absorbed portion is excreted in the urine as metabolites, with only a very small amount leaving the body as intact, unaltered drug.

📦How to store it

Store at 20 °C to 25 °C (68 °F to 77 °F); excursions permitted to 15 °C to 30 °C (59 °F to 86 °F). Keep out of reach of children.

📄 Written from Pentosan Polysulfate’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

17

Supplements & herbs that interact with Pentosan Polysulfate

17 supplements and herbal products have documented interactions with Pentosan Polysulfate in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.

Severity mix
  • Major · 1
  • Moderate · 7
  • Minor · 9
Every supplement checked against Pentosan Polysulfate — ranked by severity The full interaction hub: 1 major · 7 moderate · 9 minor · every one linked to its full report. Check Pentosan Polysulfate against your exact supplements

Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Pentosan Polysulfate — the kind of thing our pharmacy team would talk through with you at the counter.

What exactly is Elmiron used for?
Elmiron is the brand name for pentosan polysulfate sodium, and it's specifically approved to relieve bladder pain and discomfort caused by interstitial cystitis — a chronic condition where your bladder wall becomes irritated or inflamed. It's taken by mouth as a capsule, three times a day. It won't cure interstitial cystitis, but it can help reduce the pain associated with it.
How long does it take for Elmiron to start working?
Elmiron is not a fast-acting drug. Your prescriber will typically check in with you after 3 months to see if it's helping. If you haven't noticed improvement by 6 months, the evidence for continuing treatment becomes less clear, and you and your doctor should discuss whether to keep going. Patience is key — and open communication with your provider about your symptoms matters a lot.
Can Elmiron hurt my eyes?
Yes — this is the most important thing to know about long-term Elmiron use. The drug has been linked to changes in the retina (the back of the eye) called pigmentary maculopathy, which can affect your vision permanently. Most cases occurred after 3 or more years of use, though it can happen sooner. Watch for trouble reading, difficulty adjusting when you go into a darker room, or blurry vision, and report any of those to your doctor immediately. Your doctor should do baseline eye exams before you start and check your eyes periodically while you're taking it.
Should I take Elmiron with food or on an empty stomach?
Take each Elmiron capsule with a glass of water on an empty stomach — at least 1 hour before you eat, or at least 2 hours after a meal. The exact effect of food on absorption isn't fully known, but this is the timing used in clinical trials and recommended on the label, so it's best to follow it consistently.
I take a blood thinner — is Elmiron safe for me?
This is a really important question to bring to your prescriber. Elmiron itself has mild blood-thinning properties, so combining it with warfarin or other anticoagulant medications could increase your risk of bleeding. A study did show that standard Elmiron doses didn't significantly change warfarin's blood levels, but your prescriber should still monitor you carefully. Tell them — and your pharmacist — about every medication and supplement you take before starting Elmiron.
What side effects should I actually expect — and which ones mean I should call my doctor?
The most common side effects are hair loss, diarrhea, nausea, headache, and rash — these are generally mild and often manageable. Call your doctor if you notice any vision changes (that's urgent), rectal bleeding or blood in your stool, unusual bruising, or severe abdominal pain. These could signal more serious problems that need attention.
Is Pentosan Polysulfate available over the counter?
Pentosan Polysulfate is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.
When was Pentosan Polysulfate first available?
Pentosan Polysulfate has been available in the United States since at least 1996, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Pentosan Polysulfate?
Pentosan Polysulfate is supplied by 13 manufacturers listed in the FDA NDC Directory, including Indena SpA, Janssen Pharmaceuticals, Inc., Swati Spentose Private Limited.

💬 Answers drafted from Pentosan Polysulfate’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

💊 How Pentosan Polysulfate comes

Pentosan Polysulfate is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Capsule

By mouth
Brands Elmiron
How this form is used
What it may be used for
  • Elmiron capsules are used to relieve bladder pain and discomfort associated with interstitial cystitis.
Important instructions
  • Elmiron capsules are taken three times daily by mouth.
  • Elmiron should be swallowed with water at least 1 hour before meals or 2 hours after meals.
  • Your prescriber will reassess whether Elmiron is working after 3 months of treatment.
  • Do not change your Elmiron dose or stop taking it without talking to your prescriber first.
Available strengths 1 strength
2 FDA-listed product records

📊 Pentosan Polysulfate across the U.S. market

How Pentosan Polysulfate appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

1
Dose forms
13
Manufacturers
1
Brand names
16
FDA-listed product records
1996
First marketed

Also listed with the FDA, not a patient dose form: Powder (14) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.

Indena SpA13%
Janssen Pharmaceuticals, Inc.13%
Swati Spentose Private Limited13%
Apicore Pharmaceuticals Private Limited6%
Aragen Life Sciences Limited6%
Darmerica, LLC6%
Other makers44%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Pentosan Polysulfate is used

A general measure of how commonly Pentosan Polysulfate is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Pentosan Polysulfate is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

9,962
Medicaid prescriptions filled (Q1–Q4 2025)
$11.1M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Pentosan Polysulfate prescribed? Of the 1,596 medications we measure, Pentosan Polysulfate ranks #937 by Medicaid prescriptions — more than 41% of them.

Where Pentosan Polysulfate ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

Utilization by Pentosan Polysulfate product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

pentosan polysulfate 100 MG Oral Capsule

9,962 Medicaid prescriptions (Q1–Q4 2025) 100% of Pentosan Polysulfate prescriptions shown $11.1M gross reimbursement (before rebates) ≈ $1,116 per prescription (gross)

Summed across the 1 of 1 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 199498

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Pentosan Polysulfate, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 1 of 1 listed Pentosan Polysulfate NDCs with Medicaid activity.

🔍 Compare Pentosan Polysulfate products

A representative set of FDA-listed product records for Pentosan Polysulfate — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Showing 16 of 16 products — FDA National Drug Code Directory. See every product, package size and price: browse all 16 Pentosan Polysulfate NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Pentosan Polysulfate RxCUI 155046 2 dose forms · 2 strengths
  1. Dose form (SCDF) Injection RxCUI 2635090 No current FDA listing
    Clinical drug / strength (SCD) 7.5 ML pentosan polysulphate sodium 250 MG/ML RxCUI 2635091
  2. Dose form (SCDF) Oral Capsule RxCUI 373284 In current FDA listings
    Clinical drug / strength (SCD) 100 MG RxCUI 199498

Look up RxCUI 155046 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Elmiron Zycosan

🏭 Manufacturers & labelers

Indena SpA 2 Janssen Pharmaceuticals, Inc. 2 Swati Spentose Private Limited 2 Apicore Pharmaceuticals Private Limited 1 Aragen Life Sciences Limited 1 Darmerica, LLC 1 Kalchem International inc 1 Letco Medical, Llc 1 Medisca Inc. 1 Micro Labs Limited 1 Molclone Labs Private Limited 1 Professional Compounding Centers of America dba PCCA 1 Sentio Biosciences, LLC 1

RxNorm drug class

Pentosan Polysulfate belongs to the Glycosaminoglycan class.

Pharmacologic class Glycosaminoglycan
Drug family (ATC) Heparins or heparinoids for topical use, Other urologicals

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Sep 18, 2024
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Pentosan Polysulfate.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Pentosan Polysulfate after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
1
NDC products indexed
16
Distinct labelers/manufacturers represented
13
Linked representative label
Janssen Pharmaceuticals, Inc.
Linked label effective
Sep 18, 2024
Composite sections available
19
Linked SPL Set ID
f0ba651e-3d8a-11df-8fbe-119855d89593
Linked SPL Document ID
2268b774-ecba-3038-e063-6394a90a9210
Open the linked representative label on DailyMed ↗

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 1 FDA-filed SPL label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Janssen Pharmaceuticals, Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.