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What Are the Side Effects of Elmiron (Pentosan Polysulfate Sodium)?
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Article source: Seagull Pharmacy
Nov 12, 2025

Elmiron (pentosan polysulfate sodium), as a specific medication for the treatment of interstitial cystitis, plays a crucial role in relieving bladder pain. With the extension of its clinical application duration, its safety profile has increasingly gained attention.

What Are the Side Effects of Elmiron (Pentosan Polysulfate Sodium)?

Gastrointestinal Reactions

Diarrhea: Incidence rate is approximately 4%.

Nausea: Incidence rate is approximately 4%.

Dyspepsia: Incidence rate is approximately 2%.

Abdominal pain: Incidence rate is approximately 2%.

Skin and Related Reactions

Alopecia (hair loss) is a relatively prominent adverse reaction, with an incidence rate of approximately 4%.

Alopecia typically occurs within the first 4 weeks after starting treatment; 97% of cases present as alopecia areata, limited to a single area of the scalp.

Other Common Adverse Reactions

Headache: Incidence rate is approximately 3%.

Rash: Incidence rate is approximately 3%.

Dizziness: Incidence rate is approximately 1%.

Warnings for Severe Adverse Reactions of Elmiron (Pentosan Polysulfate Sodium)

Risk of Retinal Pigment Changes

Retinal pigment changes (reported in literature as pigmentary maculopathy) are severe adverse reactions that require special vigilance.

Although most cases occur after 3 or more years of medication use, there are also reports of cases occurring with shorter medication durations.

Clinical manifestation characteristics:Difficulty reading.

Prolonged time to adapt to low-light environments.

Retinal monitoring requirements:Obtain a detailed ophthalmic medical history before starting treatment.

Genetic testing is recommended for patients with a family history of hereditary pattern dystrophy.

Increased Bleeding Risk

Elmiron has weak anticoagulant activity (approximately 1/15 of the activity of heparin).

At a daily dose of 300 mg, the incidence rate of rectal bleeding as an adverse event is 6.3%.

High-risk populations include:Patients with aneurysms

Patients with thrombocytopenia

Patients with hemophilia

Patients with gastrointestinal ulcers, polyps, or diverticula

Precautions for Using Elmiron (Pentosan Polysulfate Sodium)

Pregnant Women

Animal studies have not found evidence of impaired fertility or fetal harm.

Elmiron should be used in pregnant women only when clearly needed.

Lactating Women

It is unknown whether this medication is excreted into human milk.

Caution should be exercised when administering Elmiron to lactating women.

Management of Drug Interactions

When used in combination with warfarin, the pharmacokinetic parameters of warfarin remain similar.

Special caution is required when using Elmiron in patients receiving other therapies with anticoagulant effects.

Regular Examination Items

Ophthalmic examinations: Including optical coherence tomography and fundus autofluorescence imaging.

Liver function tests: Regular monitoring before starting treatment and during treatment.

Coagulation function assessment: Especially in patients with a tendency to bleed.

Note: For internal discussion among medical personnel only. For specific medication, please consult the attending physician. Drug information may change over time. For the latest information, we recommend adding a medical consultant or consulting for free online.
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