The recommended dose of ELMIRON® (pentosan polysulfate sodium, capsules) 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.

Effect of pentosan polysulfate (PPS) on p38, ERK1/2 and JNK MAPK activation was studied. Canine chondrocytes were plated onto 6-well culture plates in serum free DMEM for 24 hr. Cells were pre-treated with 100 µg/ml of PPS for 1 hr and then incubated with 10 ng/ml of recombinant human (rh) IL-1β for 5, 15, 30, 60 or 240 min. It was shown, that phosphorylation of p38 and ERK were inhibited by 100 mg/ml of PPS, while JNK remained constant despite PPS pretreatment prior to rhIL-1β stimulation. Effect of PPS on NF-κB translocation induced by rhIL- 1β: Under control conditions, a diffuse cytoplasmic staining was seen and the average percentage of NF-κB positive nuclei cells was 9.5%. On the other hand, 78.2% of chondrocytes incubated with rhIL- 1β had a nuclear staining pattern, indicating NF-κB nuclear translocation. Preincubation with 10 and 100 µg/ml PPS reduced NF-κB translocation rate.