Heparin is a compound that has both anti-inflammatory and surface protective actions. Heparin can mimic the activity of the bladder’s mucous lining, temporarily “repairing” the GAG layer, which may be defective in interstitial cystitis (IC).

Clinical studies on the effectiveness of heparin are limited. In one uncontrolled investigation, intravesical heparin resulted in some improvement of symptoms in about 50 percent of patients. Another study of patients undergoing DMSO treatments indicated that heparin might help reduce their relapse rate. Patients treated with DMSO alone had a relapse rate of 52 percent, while those maintained with monthly instillations of heparin and followed for 12 months had a relapse rate of 20 percent.

Dosage & Treatment Plan

While this drug can be given either by injection or by bladder instillation, the method of choice for the treatment of IC is bladder instillation. It can be used as a primary treatment method, as a component of an instilled “bladder cocktail” or as a “maintenance medicine” to supplement other types of treatment. Heparin is also combined with alkalinized lidocaine to form a “rescue remedy” for use during IC flares.

A heparin solution of 10,000 units diluted with saline solution is instilled intravesically daily, and held in the bladder for 20 to 30 minutes. Patients can be taught to self-catheterize and administer the treatments at home. After 3 to 4 months the frequency of instillations is reduced to 3 to 4 times per week.

It takes 3 to 6 months to begin to see improvement, but therapy should continue for at least 12 months. If there is no improvement in symptoms after 3 months, the dosage is increased to 20,000 units. Therapy can be continued indefinitely.

Potential Side Effects

The side effects of bladder instillation of heparin are limited primarily to pain, irritation, or discomfort resulting from frequent catheterization.

Revised Monday, July 6th, 2015