Massive bleeding on a bladder protectant: a case report of pentosan polysulfate sodium-induced coagulopathy

Gill S, Naiman SC, Jamal A, Vickars LM · Archives of Internal Medicine

Systemic anticoagulation and serious bleeding on the oral form, which had not been reported before — a caution the authors raise precisely because the parenteral heparin-like effect was assumed not to apply by mouth.

Population

A young woman taking oral PPS for interstitial cystitis

Intervention

Oral pentosan polysulfate at licensed doses

Comparator

None

Limitations

A single case, and it was publicly contested: Parsons published a letter in the same journal the following year arguing the report was misleading. Oral bioavailability studies make systemic anticoagulation on oral PPS hard to explain, which is the substance of the dispute.