Tissue RepairModerate Evidence

Pentosan Polysulfate

Also known as: PPS, Elmiron

Semi-synthetic polysaccharide that protects and repairs cartilage in osteoarthritis and joint disorders.

Benefits

6

Conditions

5

Evidence

Multiple preclinical studies, clinical trials in equine and human OA+ studies

Source

Semi-synthetic derivative from beechwood hemicellulose

Overview

Semi-synthetic polysaccharide that protects and repairs cartilage in osteoarthritis and joint disorders.

Mechanism of Action

Stimulates proteoglycan synthesis and incorporation into cartilage ECM, inhibits MMP-3 and other degradative enzymes, enhances TIMP-3 levels, reduces inflammatory cytokines (IL-1, TNF-α), improves subchondral bone blood flow, exhibits mild antithrombotic and fibrinolytic activity.

Key Benefits

  • Protects cartilage from degradation
  • Stimulates cartilage matrix production
  • Reduces joint inflammation
  • Improves synovial fluid quality
  • Enhances joint nutrition and microcirculation
  • Reduces pain and stiffness in osteoarthritis

Clinical Applications

Osteoarthritis (knee, hip, other joints)Interstitial cystitisDegenerative joint diseasePost-traumatic arthritisCartilage injuries

Dosing Guidelines

Intramuscular injection

Typical Dose100-300 mg
FrequencyOnce or twice weekly
Duration4-8 weeks initial course

Oral (for interstitial cystitis)

Typical Dose100 mg three times daily
FrequencyThree times daily
DurationLong-term maintenance

* Dosing should be individualized. Always consult with a qualified healthcare practitioner.

Research & Evidence

Evidence Level
Moderate
Studies

Multiple preclinical studies, clinical trials in equine and human OA

Summary

FDA approved for interstitial cystitis. Strong preclinical evidence for cartilage protection. Human clinical trials show benefit for knee OA with good safety profile.

Safety Information

Potential Side Effects

  • Injection site pain
  • Mild bleeding risk
  • Gastrointestinal upset
  • Hair loss (rare)
  • Retinal pigmentary changes (long-term oral use)

Contraindications

  • Bleeding disorders
  • Active gastric ulcers
  • Severe hepatic or renal impairment

Interactions

  • Anticoagulants (increased bleeding risk)
  • Aspirin and NSAIDs

Quick Facts

CategoryTissue Repair
SourceSemi-synthetic derivative from beechwood hemicellulose
Legal StatusFDA approved for interstitial cystitis; off-label for osteoarthritis
Gabriel Brain Score
75/ 100

Source Your Protocol

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