National Institute for Health and Care Excellence has recommended pentosan polysulfate sodium (Elmiron) as a treatment option for bladder pain syndrome.
Pentosan polysulfate sodium is recommended for the treatment of adults with bladder pain syndrome manifesting as glomerulations or Hunner's lesions with urinary urgency and frequency and moderate-to-severe pain, if the following conditions are fulfilled:
- The condition has responded inadequately to standard oral treatments.
- Treatment is not offered in combination with bladder instillations.
- Any previous treatment with bladder instillations was not discontinued due to lack of response.
- Treatment is given in secondary care.
Recommended dose for pentosan polysulfate sodium is 300 mg/day orally taken as 1 × 100 mg capsules three times daily. Treatment should be discontinued in the absence of improvement after six months. Therapeutic response should be reassessed every six months and treatment should be continued as long as the response is maintained.
Evidence suggests that pentosan polysulfate sodium may be more effective at pain relief than placebo; however, it may have a modest benefit over best supportive care and bladder instillations.
The drug is to be used only when provided by the company in agreement with the commercial arrangement. The recommendations should not affect patients whose treatment with the drug was started before the publication of the guidance.