Interstitial Cystitis, Elmiron and Vision Damage

While most people walking into a restaurant are on the lookout for the best table to enjoy a meal with their friends and loved ones, there are others who are scoping out where the nearest bathroom is.

For those who suffer from interstitial cystitis (IC), an umbrella term for painful bladder syndrome, knowing where the restroom is located is vital. Many have chosen to take the drug Elmiron, the only FDA-approved medication to treat IC, with much success.

However, it has come at a cost, as new research has revealed that vision damage can be a serious side effect of taking the drug that was never mentioned, leading to Elmiron lawsuits against Jansseen Pharmaceuticals (the manufacturer of the drug).

It is vital that urologists and urogynecologists be informed of the now serious risk of eye disease in patients who are using Elmiron®. At a minimum, patients should be encouraged to have annual eye examinations to determine if any retinal changes are occurring. And, as recommended in almost every study, the medication should be discontinued if eye damage is occurring.

What is Interstitial Cystitis?

A chronic bladder condition, it affects up to 12 million men and women in the United States - more often women -  and most people who have the condition suffer from pelvic pain and urinary urgency. It can be disruptive, as those who suffer from IC can turn down social invitations or stress over a backup plan for every scenario they are in to avoid a potentially embarrassing situation. The condition can even go so far as to impact their ability to work, getting a good night’s rest, or enjoying a healthy sex life.

Unfortunately, doctors aren’t sure what causes IC, but some people are able to manage their symptoms with exercise and changing their diet. According to the Interstitial Cystitis Association, patients have found that light exercises such as yoga, Pilates, walking and Tai Chi can be helpful in managing their symptoms. When it comes to diet, there isn’t a one-size-fits-all list of foods to avoid, so patients should talk to their doctor about any allergies they have that might be exacerbating their IC symptoms.

Because cranberry is a natural remedy to help avoid urinary tract infections, it can seem like a logical step to use it to treat IC. However, for those with IC, the acid can actually be an irritant and even cause further damage to the bladder. Other remedies for dealing with IC include pelvic floor physical therapy, pain relievers, and stress management exercises, although some take more drastic measures such as bladder augmentation or removal. As always, talk to your doctor before starting a new regimen.

Damaging Side Effects of Elmiron

When natural remedies, exercise, and a change of diet don’t alleviate the pain and urgency caused by IC, many choose to go the route of taking medication for treatment. Enter Elmiron (pentosan polysulfate sodium), a medication introduced in 1996 and the only FDA-approved medication to treat IC. Although it is not clear what exactly about it helps with bladder pain, it is believed that the mild blood thinner protects the bladder.

But, the medication has come at a cost for some patients, with many filing lawsuits against Elmiron for allegedly damaging their vision, or more specifically, pigmentary maculopathy. Symptoms include difficulty reading, difficulty adapting to dim or dark light, dark spots, eye pain, and even blindness. Because those who are taking Elmiron tend to be older, the vision damage tends to be misdiagnosed in many cases for age-related maculopathy or just natural vision deterioration.

According to a 2018 study published in Ophthalmology, the journal of the American Academy of Ophthalmology, the patients studied all complained of difficulty reading and even more serious vision problems in the time they took Elmiron. This breakthrough has led to more physicians taking a serious look at the link between vision loss and Elmiron along with further research studies being created to examine this link.

In 2019, a much larger study found that one-quarter of those who were taking Elmiron experienced vision problems. Those behind the study believe the medication is toxic to the retina and that is the cause of the vision damage.

Elmiron Adds A Warning Label

Finally, a few weeks ago after rising pressure from the scientific community and consumers, Janssen Pharmaceuticals placed a warning label on the Elmiron packaging and on the drug’s website. The company states that if you are taking Elmiron you are advised to tell your doctor if you notice a change in your vision, particularly in the retina. However, vision issues are not listed as a common side effect.

What is most upsetting to learn is that based on the findings of the research conducted the European European Medicines Agency (EMA) requested in the summer of 2019 that the Elmiron packaging include a warning label to address the risk of vision damage. In October 2019 Health Canada followed suit and Janssen updated the warning labels of Elmiron in both of those Countries however, no mention of vision loss was placed on the U.S label of the drug until now.

The Future for IC Patients

Researchers have been studying other drugs as an alternate means to treat IC. For example, patients in a study who took Humira (adalimumab), which is typically prescribed for patients suffering from rheumatoid arthritis, had a “statistically significant improvement” in their IC. Women who participated in a study of tanezumab - a drug used to manage pain due to osteoporosis - also felt improvement, although the men who took part in the study did not.

Still, at the moment, Elmiron is the only approved drug on the market when it comes to treating IC. Patients who are concerned about the possible side effects to their vision should discuss this with their doctors to balance the risk and reward of the drug, and as always, patients should never stop taking a drug without talking to their physician first.

If you believe that you or a loved one’s vision has been impacted by using Elmiron, we invite you to fill in our form below to see if we can help you.