Tissue Repair & Recovery

Pentosan Polysulfate Sodium

Also known as PPS · Elmiron · Pentosan · SP54

Clinically studiedOralSubcutaneous injection (off-label)Intramuscular injection (off-label)FDA-approved (Elmiron) for interstitial cystitis in humans; osteoarthritis/joint use is off-label. Injectable pentosan is FDA-approved only for equine use.

Pentosan polysulfate sodium is a semi-synthetic, heparin-like polysaccharide. It is FDA-approved in oral form (Elmiron) for the bladder pain of interstitial cystitis. Beyond its approved use, it has been investigated as a potential disease-modifying agent in osteoarthritis, where research describes effects on cartilage, bone-marrow lesions, and inflammation; these joint applications are off-label in humans, and an injectable form is FDA-approved only for equine (horse) osteoarthritis.

Studied / used for

FDA-approved for interstitial cystitis bladder pain (oral)
Studied off-label as a potential disease-modifying agent in osteoarthritis
Investigated for cartilage protection and bone-marrow lesions
Studied for anti-inflammatory and mild anticoagulant effects

Commonly reported side effects

Gastrointestinal upset (nausea, dyspepsia, diarrhea)
Hair loss (alopecia)
Increased bruising or bleeding (mild blood-thinning effect)
Pigmentary maculopathy (retinal changes) reported with long-term oral use

Clinically studied. Supported by human clinical trials. This reflects the strength of the research base, not effectiveness or a recommendation.

Not medical advice.

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