Linked Life Data

Elmiron (Capsule)

Source:http://www4.wiwiss.fu-berlin.de/dailymed/resource/drugs/3989

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
rdfs:label
Elmiron (Capsule)
dailymed-instance:dosage
The recommended dose of ELMIRON is 300 mg/day taken as one 100 mg capsule orally three times daily. The capsules should be taken with water at least 1 hour before meals or 2 hours after meals. Patients receiving ELMIRON should be reassessed after 3 months. If improvement has not occurred and if limiting adverse events are not present, ELMIRON may be continued for another 3 months. The clinical value and risks of continued treatment in patients whose pain has not improved by 6 months is not known.
dailymed-instance:descripti...
Pentosan polysulfate sodium is a semi-synthetically produced heparin-like macromolecular carbohydrate derivative, which chemically and structurally resembles glycosaminoglycans. It is a white odorless powder, slightly hygroscopic and soluble in water to 50% at pH 6. It has a molecular weight of 4000 to 6000 Dalton with the following structural formula: ELMIRON is supplied in white opaque hard gelatin capsules containing 100 mg pentosan polysulfate sodium, microcrystalline cellulose, and magnesium stearate. It also contains pharmaceutical glaze (modified) in SD-45, synthetic black iron oxide, FD&C Blue No. 2 aluminum lake, FD&C Red No. 40 aluminum lake, FD&C Blue No. 1 aluminum lake, D&C Yellow No. 10 aluminum lake, n-butyl alcohol, propylene glycol, SDA-3A alcohol, and titanium dioxide. It is formulated for oral use.
dailymed-instance:clinicalP...
General:: Pentosan polysulfate sodium is a low molecular weight heparin-like compound. It has anticoagulant and fibrinolytic effects. The mechanism of action of pentosan polysulfate sodium in interstitial cystitis is not known.<br/>Pharmacokinetics::<br/>Absorption:: In a clinical pharmacology study in which healthy female volunteers received a single oral 300 or 450 mg dose of pentosan polysulfate sodium containing radiolabeled drug as a solution under fasted conditions, maximal levels of plasma radioactivity were seen approximately at a median of 2 hours (range 0.6-120 hours) after dosing. Based on urinary excretion of radioactivity, a mean of approximately 6% of a radiolabeled oral dose of pentosan polysulfate sodium is absorbed and reaches the systemic circulation. Food Effects: In clinical trials, ELMIRON was administered with water 1 hour before or 2 hours after meals; the effect of food on absorption of pentosan polysulfate sodium is not known.<br/>Distribution:: Preclinical studies with parenterally administered radiolabeled pentosan polysulfate sodium showed distribution to the uroepithelium of the genitourinary tract with lesser amounts found in the liver, spleen, lung, skin, periosteum, and bone marrow. Erythrocyte penetration is low in animals.<br/>Metabolism:: The fraction of pentosan polysulfate sodium that is absorbed is metabolized by partial desulfation in the liver and spleen, and by partial depolymerization in the kidney to a large number of metabolites. Both the desulfation and depolymerization can be saturated with continued dosing<br/>Excretion:: Following administration of an oral solution of a 300 or 450 mg dose of pentosan polysulfate sodium containing radiolabeled drug to groups of healthy subjects, plasma radioactivity declined with mean half-lives of 27 and 20 hours, respectively. A large proportion of the orally administered dose of pentosan polysulfate sodium (mean 84% in the 300 mg group and 58% in the 450 mg group) is excreted in feces asunchanged drug. A mean of 6% of an oral dose is excreted in the urine, mostly as desulfated and depolymerized metabolites. Only a small fraction of the administered dose (mean 0.14%) is recovered as intact drug in urine.<br/>Special Populations:: The pharmacokinetics of pentosan polysulfate sodium has not been studied in geriatric patients or in patients with hepatic or renal impairment. See also PRECAUTIONS-Hepatic Insufficiency.<br/>Drug-Drug Interactions:: In a study in which healthy subjects received pentosan polysulfate sodium 100 mg capsule or placebo every 8 hours for 7 days, and were titrated with warfarin to an INR of 1.4 to 1.8, the pharmacokinetic parameters of R-warfarin and S-warfarin were similar in the absence and presence of pentosan polysulfate sodium. INR for warfarin + placebo and warfarin + pentosan polysulfate sodium were comparable. See also PRECAUTIONS on the use of ELMIRON in patients receiving other therapies with anticoagulant effects.<br/>Pharmacodynamics:: The mechanism by which pentosan polysulfate sodium achieves its effects in patients is unknown. In preliminary clinical models, pentosan polysulfate sodium adhered to the bladder wall mucosal membrane. The drug may act as a buffer to control cell permeability preventing irritating solutes in the urine from reaching the cells.
dailymed-instance:activeIng...
dailymed-instance:contraind...
ELMIRON is contraindicated in patients with known hypersensitivity to the drug, structurally related compounds, or excipients.
dailymed-instance:supply
ELMIRON is supplied in white opaque hard gelatin capsules imprinted���BNP7600���containing 100 mg pentosan polysulfate sodium. Supplied in bottles of 100 capsules. NDC NUMBER 0062-9800-01<br/>Storage: Store at controlled room temperature 15��-30��C (59��-86��F). ELMIRON is a Registered Trademark of IVAX Research, LLC under license to ORTHO-McNEIL PHARMACEUTICAL, INC. ��OMP 2002, 1998 Manufactured by: Janssen Ortho LLC Gurabo, Puerto Rico 00778 Distributed by: ORTHO-McNEIL PHARMACEUTICAL, INC. Raritan, New Jersey 08869 Issued July 2008 Part Number 10110401 Patent #5,180,715
dailymed-instance:activeMoi...
dailymed-instance:inactiveI...
dailymed-instance:precautio...
General:: ELMIRON is a weak anticoagulant (1/15 the activity of heparin). At a daily dose of 300 mg (n = 128), rectal hemorrhage was reported as an adverse event in 6.3% of patients. Bleeding complications of ecchymosis, epistaxis, and gum hemorrhage have been reported . Patients undergoing invasive procedures or having signs/symptoms of underlying coagulopathy or other increased risk of bleeding (due to other therapies such as coumarin anticoagulants, heparin, t-PA, streptokinase, high dose aspirin, or nonsteroidal anti-inflammatory drugs) should be evaluated for hemorrhage. Patients with diseases such as aneurysms, thrombocytopenia, hemophilia, gastrointestinal ulcerations, polyps, or diverticula should be carefully evaluated before starting ELMIRON . A similar product that was given subcutaneously, sublingually, or intramuscularly (and not initially metabolized by the liver) is associated with delayed immunoallergic thrombocytopenia with symptoms of thrombosis and hemorrhage. Caution should be exercised when using ELMIRON in patients who have a history of heparin induced thrombocytopenia. Alopecia is associated with pentosan polysulfate and with heparin products. In clinical trials of ELMIRON, alopecia began within the first 4 weeks of treatment. Ninety-seven percent (97%) of the cases of alopecia reported were alopecia areata, limited to a single area on the scalp.<br/>Hepatic Insufficiency:: Pentosan polysulfate sodium is desulfated by both the liver and the spleen. The extent to which hepatic insufficiency or splenic disorders may increase the bioavailability of the parent or active metabolites of pentosan polysulfate sodium is not known. Caution should be exercised when using ELMIRON in these patients. Mildly (<2.5 x normal) elevated transaminase, alkaline phosphatase,��-glutamyl transpeptidase, and lactic dehydrogenase occurred in 1.2% of patients. The increases usually appeared 3 to 12 months after the start of ELMIRON therapy, and were not associated with jaundice or other clinical signs or symptoms. These abnormalities are usually transient, may remain essentially unchanged, or may rarely progress with continued use. Increases in PTT and PT (<1% for both) or thrombocytopenia (0.2%) were noted.<br/>Information for Patients:: Patients should take the drug as prescribed, in the dosage prescribed, and no more frequently than prescribed. Patients should be reminded that ELMIRON has a weak anticoagulant effect. This effect may increase bleeding times.<br/>Laboratory Test Findings:: Pentosan polysulfate sodium did not affect prothrombin time (PT) or partial thromboplastin time (PTT) up to 1200 mg per day in 24 healthy male subjects treated for 8 days. Pentosan polysulfate sodium also inhibits the generation of factor Xa in plasma and inhibits thrombin-induced platelet aggregation in human platelet rich plasma ex vivo. (See PRECAUTIONS-Hepatic Insufficiency Section for additional information.)<br/>Carcinogenicity, Mutagenesis, Impairment of Fertility:: Long term carcinogenicity studies of ELMIRON in F344/N rats and B6C3F1 mice have been conducted. In these studies, ELMIRON was orally administered once daily via gavage, 5 days per week, for up to 2 years. The dosages administered to mice were 56, 168 or 504 mg/kg. The dosages administered to rats were 14, 42, or 126 mg/kg for males, and 28, 84, or 252 mg/kg for females. The dosages tested were up to 60 times the maximum recommended human dose (MRHD) in rats, and up to 117 times the MRHD in mice, on a mg/kg basis. The results of these studies in rodents showed no clear evidence of drug-related tumorigenesis or carcinogenic risk. Pentosan polysulfate sodium was not clastogenic or mutagenic when tested in the mouse micronucleus test or the Ames test (S. typhimurium). The effect of pentosan polysulfate sodium on spermatogenesis has not been investigated.<br/>Pregnancy Category B:: Reproduction studies have been performed in mice and rats with intravenous daily doses of 15 mg/kg, and in rabbits with 7.5 mg/kg. These doses are 0.42 and 0.14 times the daily oral human doses of ELMIRON when normalized to body surface area. These studies did not reveal evidence of impaired fertility or harm to the fetus from ELMIRON. Direct in vitro bathing of cultured mouse embryos with pentosan polysulfate sodium (PPS) at a concentration of 1 mg/mL may cause reversible limb bud abnormalities. Adequate and well-controlled studies have not been performed in pregnant women. Because animal studies are not always predictive of human response, this drug should be used in pregnancy only if clearly needed.<br/>Nursing Mothers:: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when ELMIRON is administered to a nursing woman.<br/>Pediatric Use:: Safety and effectiveness in pediatric patients below the age of 16 years have not been established.
dailymed-instance:overdosag...
Overdose has not been reported. Based upon the pharmacodynamics of the drug, toxicity is likely to be reflected as anticoagulation, bleeding, thrombocytopenia, liver function abnormalities, and gastric distress. At a daily dose of 900 mg for 32 weeks (n = 127) in a clinical trial, rectal hemorrhage was reported as an adverse event in 15% of patients. At a daily dose of ELMIRON 900 mg for 16 weeks in a clinical trial that enrolled 51 patients in the ELMIRON group and 49 in the placebo group, elevated liver function tests were reported as an adverse event in 11.8% of patients in the ELMIRON group and 2% of patients in the placebo group. In the event of acute overdosage, the patient should be given gastric lavage if possible, carefully observed and given symptomatic and supportive treatment.
dailymed-instance:genericMe...
pentosan polysulfate sodium
dailymed-instance:fullName
Elmiron (Capsule)
dailymed-instance:adverseRe...
ELMIRON was evaluated in clinical trials in a total of 2627 patients (2343 women, 262 men, 22 unknown) with a mean age of 47 [range 18 to 88 with 581 (22%) over 60 years of age]. Of the 2627 patients, 128 patients were in a 3 month trial and the remaining 2499 patients were in a long term, unblinded trial. Deaths occurred in 6/2627 (0.2%) patients who received the drug over a period of 3 to 75 months. The deaths appear to be related to other concurrent illnesses or procedures, except in one patient for whom the cause was not known. Serious adverse events occurred in 33/2627 (1.3%) patients. Two patients had severe abdominal pain or diarrhea and dehydration that required hospitalization. Because there was not a control group of patients with interstitial cystitis who were concurrently evaluated, it is difficult to determine which events are associated with ELMIRON and which events are associated with concurrent illness, medicine, or other factors. The adverse events described below were reported in an unblinded clinical trial of 2499 interstitial cystitis patients treated with ELMIRON. Of the original 2499 patients, 1192 (48%) received ELMIRON for 3 months; 892 (36%) received ELMIRON for 6 months; and 598 (24%) received ELMIRON for one year, 355 (14%) received ELMIRON for 2 years, and 145 (6%) for 4 years. Frequency (1 to 4%): Alopecia (4%), diarrhea (4%), nausea (4%), headache (3%), rash (3%), dyspepsia (2%), abdominal pain (2%), liver function abnormalities (1%), dizziness (1%). Frequency (���1%): Digestive: Vomiting, mouth ulcer, colitis, esophagitis, gastritis, flatulence, constipation, anorexia, gum hemorrhage. Hematologic: Anemia, ecchymosis, increased prothrombin time, increased partial thromboplastin time, leukopenia, thrombocytopenia. Hypersensitive Reactions: Allergic reaction, photosensitivity. Respiratory System: Pharyngitis, rhinitis, epistaxis, dyspnea. Skin and Appendages: Pruritus, urticaria. Special Senses: Conjunctivitis, tinnitus, optic neuritis, amblyopia, retinal hemorrhage.<br/>Post-Marketing Experience::<br/>Rectal Hemorrhage:: ELMIRON was evaluated in a randomized, double-blind, parallel group, Phase 4 study conducted in 380 patients with interstitial cystitis dosed for 32 weeks. At a daily dose of 300 mg (n = 128), rectal hemorrhage was reported as an adverse event in 6.3% of patients. The severity of the events was described as���mild���in most patients. Patients in that study who were administered ELMIRON 900 mg daily, a dose higher than the approved dose, experienced a higher incidence of rectal hemorrhage, 15%.<br/>Liver Function Abnormality:: A randomized, double-blind, parallel group, phase 2 study was conducted in 100 men (51 ELMIRON and 49 placebo) dosed for 16 weeks. At a daily dose of 900 mg, a dose higher than the approved dose, elevated liver function tests were reported as an adverse event in 11.8% (n = 6) of ELMIRON treated patients and 2% (n = 1) of placebo treated patients.
dailymed-instance:warning
None.
dailymed-instance:indicatio...
ELMIRON (pentosan polysulfate sodium) is indicated for the relief of bladder pain or discomfort associated with interstitial cystitis.
dailymed-instance:represent...
dailymed-instance:routeOfAd...
dailymed-instance:name
Elmiron