Pentosan Polysulfate Sodium

Also known as: Elmiron (oral brand), PPS, semisynthetic glycosaminoglycan

Other

In plain English

Pentosan polysulfate is used for the bladder-pain condition interstitial cystitis (painful bladder syndrome). It is thought to help repair the bladder's protective lining. Oral pentosan is the only FDA-approved oral drug for this condition, though how well it works varies. Long-term use has been linked to a specific eye (retina) problem, so periodic eye exams are advised.

The science

Pentosan polysulfate sodium is a semisynthetic sulfated polysaccharide believed to replenish the deficient glycosaminoglycan mucous layer of the bladder urothelium, reducing permeability to irritants. Evidence is mixed: some randomized trials and a systematic review show benefit over placebo for bladder pain, urgency, and frequency, while other trials found no significant difference, so response is variable.

References

• van Ophoven A et al., efficacy of pentosan polysulfate for interstitial cystitis/BPS (systematic review of RCTs), Curr Med Res Opin 2019
• Yuan Z et al., pigmentary maculopathy/retinopathy with pentosan polysulfate (retrospective study), PLoS One 2025