Pentosan Polysulfate SP 54 is a medicine used for the prevention and treatment of thrombo-ebolic, thrombotic, atherosclerotic diseases in chronic, subacute and acute forms.
In what cases is a medication prescribed?
The list of indications for use of "Pentosan Polysulfate SP 54" is quite extensive. The drug is prescribed in the following cases:
- Supportive therapy for blood flow disorders in the peripheral arteries in order to improve the patient's ability to tolerate physical activity when walking.
- Therapy of chronic, acute, subacute thromboembolic, thrombotic, atherosclerotic diseases.
- As a prophylactic, with the likelihood of complications of a thromboembolic, thrombotic nature.
How to take this drug?
A detailed description of the drug "Pentosan Polysulfate SP 54" is presented in the instructions. Adopt tablets for adult patients is shown three times a day for 3-4 pieces. The recommended time of use is 2 hours before eating, the average duration of a therapeutic course is up to 8 weeks.
Tablets should be swallowed whole, not allowing crushing or grinding. It should be washed down with water in a volume of 200 ml.
The need for continuous use of the drug for several weeks is due to the fact that the therapeutic effect occurs only after the accumulation of the active substance in the body.
If there is a need for a faster effect, it is indicated to begin therapy with the drug in injection form. A few weeks after the start of therapy, the dose of the drug can be reduced to 2 tablets. The multiplicity of applications remains the same - three times a day.
According to the instructions "Pentosan Polysulfate SP 54" in tablets can be used with prolonged therapy, and the dosage in such cases can also be reduced on the recommendation of a doctor.
Injections
Injection medication is usually prescribed for acute conditions:
- SC injection. With this method of administration, the drug is indicated to be used twice a day, 100 mg each. If the situation is critical (for example, acute embolism) and there is an acute life-threatening blood flow in the arteries that is life-threatening to the patient, administration of the drug in an amount of 100 mg every 8 hours on the first day of therapy may be recommended. As soon as the severity of the symptoms of the acute condition decreases, the dosage begins to gradually decrease by a factor of three (to 100 mg / day). This dosage is used for therapy for the next 10 days. The needle must be inserted into the skin fold, formed by the thumb and forefinger of the side or front wall of the peritoneum, at a right angle. It is allowed to inject in the thigh, shoulder. The drug should be administered at a slow pace. The duration of therapy depends on how severe the patient's condition is and what is the etiology of the disease. If the disease is in acute and severe form, then infusions and injections must be prescribed in the indicated doses. The maximum duration of therapy is 10 days.
- IV injection. Before injection, the drug must be diluted using glucose solution (5%) or isotonic solution (0.9%). In the first two days of therapy, it is indicated to administer 300 mg per day, on the 3-6th days of therapy - 200 mg / day. The dose can be adjusted by the attending physician taking into account the patient's condition. In acute life-threatening episodes, 100 mg of the drug as an initial bolus dose is allowed. Use the solution immediately after its preparation. Storage is not allowed.
In chronic and subacute conditions, three times daily administration of 100 mg of the drug is indicated. The duration of therapy can be up to 4 weeks. The following injections are indicated to be administered at longer time intervals, especially if the tablet is used in parallel formulations of the drug.
Overdose
In case of an overdose of Pentosan Polysulfate SP 54, the patient may experience hematomas, external, internal bleeding.
Therapy of an overdose depends on the severity of the negative symptoms. First of all, it is necessary to reduce the dosage of the drug or completely cancel it.
The sodium salt of pentosan polysulfate can be neutralized by introducing an appropriate amount of protamine sulfate.
Negative effects of the drug
During the use of the drug Pentosan Polysulfate SP 54, various negative effects may develop:
- Thromboembolism, thrombocytopenia - from the lymphatic system, blood.
- Cerebral ischemia, transient ischemic attack - from the side of the National Assembly.
- Alopecia, erythematous rash - from the subcutaneous, skin tissues.
- When using the injectable form of the drug in rare cases, the development of a hematoma and the appearance of soreness are observed at the injection site.
- Renal dysfunction, itching, allergies, arthralgia, hyperpnea, fever, heart failure, deep vein thrombophlebitis, hematoma, an increase in bleeding time.
Clinical practice shows that the drug is generally well tolerated. In some cases, the use of large doses of sodium salt of pentosan polysulfate causes vomiting and nausea. In rare cases, the occurrence of hypersensitivity reactions (for example, allergic skin manifestations, increased fatigue).
In some cases, the development of hemorrhage and reversible alopecia is noted (as is often the case if drugs based on heparin are used).
In extremely rare cases, with the use of a medication, transient ischemic attacks, cerebral ischemia, cerebral infarction, intermittent claudication, heart disease, myocardial infarction, aortic stenosis, embolism, thrombosis, and an increase in blood levels of liver enzymes can occur.
It is important to note that the causal relationship between the use of "Pentosan Polysulfate SP 54" and the resulting negative reactions have not been established and are doubtful. Experts are inclined to believe that such negative phenomena were triggered by the clinical condition of the patient.
The occurrence of a stroke, headache, bullous rash, vertigo is not excluded. An increased level of gamma-glutamyl transferase may also be observed.
In some cases, at the initial stages of drug therapy, insignificant thrombocytopenia of the first type is noted, which is caused by transient activation of platelets. In such situations, as a rule, no complications develop, and therefore it is permissible to continue therapy without changing the dosage.
In rare cases, severe thrombocytopenia of the second type, which is mediated by antibodies, is noted.
Patients suffering from thrombocytopenia should not be prescribed high molecular weight or low molecular weight heparin without prior testing (the likelihood of cross-reactivity reaches 98%).
The "Pentosan Polysulfate SP 54" contains E110 (orange-yellow dye), which can provoke the development of allergic manifestations.
Contraindications
The use of this drug from the list of anticoagulants by patients having the following pathological or physiological conditions is unacceptable:
- Hypersensitivity to the sodium salt of pentosan polysulfate or any other component of the drug (including the individual hypersensitivity of patients taking the tablet medication to E110).
- A history of thrombocytopenia of the second type, which is caused by exposure to the sodium salt of pentosan polysulfate or heparin.
- Bleeding.
- The risk of placental abruption and other risks associated with pregnancy.
- Suspicion of placenta previa.
- Tendency to a miscarriage.
- Threatening abortion.
- Subacute endocarditis of infectious origin.
- Severe pathologies of the pancreas, kidneys, liver.
- Suspicion of the presence of tumor formations that have a risk of bleeding.
- Spinal anesthesia.
- Operations on the eyes, spinal cord, brain.
- Recent cerebral hemorrhage.
- Gastrointestinal ulcers, bleeding in the gastrointestinal tract.
- Hemophilic conditions.
- Hemorrhagic diathesis.
special instructions
Before starting therapy, as in the case of other anticoagulants, it is important to exclude the presence of hemorrhagic diathesis in the patient by determining the partial thromboplastin period and prothrombin index.
During therapy, the patient needs to control the platelet count. A control measurement of their blood level should be carried out before starting therapy using Pentosan Polysulfate SP 54, on the first day of use, every 4 days during the first three weeks of therapy, at the end of therapy.
The tablet preparation contains lactose in its composition, and therefore, a medication should not be prescribed to patients suffering from hereditary galactose intolerance, Lapp lactase deficiency, glucose-galactose malabsorption syndrome.
Sucrose is also present in the tablets of the drug, in connection with which its purpose is limited to patients suffering from fructose intolerance, sucrose-isomaltase deficiency, glucose-galactose malabsorption syndrome.
During pregnancy and lactation
There is no information on the experience of using Pentosan Polysulfate SP 54 during pregnancy and in the lactation period. The pentosan polysulfate sodium salt is unable to penetrate the placental barrier. The fetotoxic and embryotoxic effects of the drug were not found in animal studies. In this regard, the use of the drug is allowed during pregnancy, but there must be good evidence.
If you need to use the drug in the lactation period, you must first stop breastfeeding.
If a woman receives therapy with the drug, then during childbirth, epidural anesthesia is contraindicated.
There is no experience using the medicine in the treatment of pediatric patients, so experts do not recommend using it in the treatment of children. The dosage of “Pentosan Polysulfate SP 54” must be strictly observed.
Interaction with alcohol, other medicines
When used concurrently with heparin or other anticoagulants, there is a chance of increased anticoagulant effects.
The drug is incompatible with alcohol. Compatibility with other drugs is unknown, therefore, it is recommended not to mix the injection drug with other drugs in the same bottle or syringe.
The composition of the drug
The active component of any form of "Pentosan" is pentosan sodium polysulfate. The tablets contain 25 mg of the active substance, in solution - 100 mg / 1 ml.
Pharmacological forms
The manufacturer produces the drug in two pharmacological forms - tablets, solution. Tablets are packaged in blisters, each package contains 100 tablets. The solution is packaged in glass ampoules, each package contains 10 ampoules.
What other drugs are included in the list of anticoagulant drugs?
Analogues of a drug
If necessary, “Pentosan” can be replaced by “Clopidogrel”, “Ticlopidine”, “Zilt”, “Trombone”, “Atherocard”.
It is important to remember that all of these analogues of the drug have their own list of contraindications, so their use should be agreed with the doctor.
Analogs of “Pentosan Polysulfate SP 54” can be purchased at any pharmacy.
Reviews
There are practically no feedback on the experience of using the drug on the Internet, however, doctors recommend this drug as an effective tool to stop acute conditions and normalize the patient's condition in a short time. Separately, in the reviews of "Pentosan Polysulfate SP 54", the drug is well tolerated, the possibility of use during pregnancy.