Usage
Mucopolysaccharide polysulfate (MPS) is prescribed for the symptomatic relief of pain and inflammation associated with musculoskeletal conditions. These include:
- Muscular pain and stiffness
- Sprains and strains
- Pain from rheumatic conditions
- Pain from non-serious arthritic conditions
- Superficial thrombophlebitis
- Bruising
- Scars (including keloids and hypertrophic scars)
It is classified as an antithrombotic, anti-inflammatory, and analgesic agent. The mechanism of action involves multiple pathways, including inhibiting thrombin (a key enzyme in blood clot formation), reducing inflammation, and promoting fibrinolysis (the breakdown of blood clots). It also exhibits anti-exudative activity by inhibiting hyaluronidase and stimulates tissue regeneration.
Alternate Names
- MPS
- Heparinoid
- Ateroid
- Hirudoid (brand name)
- Movelat (brand name, in combination with salicylic acid)
How It Works
Pharmacodynamics: MPS acts primarily as a topical antithrombotic, anti-inflammatory, and analgesic agent. It reduces inflammation by weakly inhibiting prostaglandin E2 (PGE2) synthesis and indirectly affecting leukotriene B4 (LTB4) production. It also enhances skin hydration and elasticity. The analgesic effect results from reducing inflammation and improving blood circulation.
Pharmacokinetics: When applied topically, MPS shows limited systemic absorption (0.3-4% within the first eight hours, reaching 1.7-4.6% within two to four days). It binds intracellularly within the subcutis. Peak serum concentrations after topical application are generally below levels that significantly affect coagulation.
Mode of Action: MPS inhibits thrombin, a key enzyme in clot formation. It also has anti-inflammatory and fibrinolytic properties, although the exact mechanisms of these effects are not fully understood. Salicylic acid, when present in combination preparations, enhances MPS absorption through its keratolytic action and contributes to the overall anti-inflammatory and analgesic effect.
Elimination Pathways: Due to its primarily topical use and limited systemic absorption, information on the elimination pathways of MPS is limited. Available data suggest that absorbed MPS likely undergoes metabolism and is eventually excreted via renal or hepatic routes.
Dosage
Standard Dosage
Adults:
Apply a 2-6 inch (5-15cm) ribbon of cream or gel to the affected area up to four times daily. Gently massage into the skin.
Children:
Not recommended for children under 12 years of age. Some sources suggest contraindication under 5 years of age.
Special Cases:
- Elderly Patients: No specific dose adjustments, but start with the lower end of the dosing range and monitor for adverse effects.
- Patients with Renal Impairment: Exercise caution.
- Patients with Hepatic Dysfunction: Exercise caution.
- Patients with Comorbid Conditions: Caution is advised in patients with asthma or allergies to NSAIDs or salicylates.
Clinical Use Cases
MPS is not typically indicated for use in clinical settings like intubation, surgical procedures, mechanical ventilation, ICU, or emergency situations. Its primary use is for localized musculoskeletal pain and inflammation.
Dosage Adjustments
Dose adjustments might be considered for patients with renal or hepatic impairment, though specific recommendations are lacking. Adjust based on patient response and tolerance.
Side Effects
Common Side Effects
- Local skin irritation (redness, burning sensation, rash)
Rare but Serious Side Effects
- Allergic reactions (in individuals sensitive to MPS, salicylates, or other components of the formulation)
Long-Term Effects
No significant long-term effects have been reported with topical use.
Adverse Drug Reactions (ADR)
Severe allergic reactions are rare but require immediate medical attention.
Contraindications
- Hypersensitivity to MPS, salicylates, or any component of the formulation
- Broken skin, infected skin, eczema
- Application on large areas of skin
- Application on or near sensitive areas (mouth, eyes, ano-genital regions)
- Lactation (avoid application on the breast area)
- Pregnancy (not recommended during the first and third trimesters)
Drug Interactions
May potentially increase the effect of coumarin anticoagulants with excessive use. Interactions with other anticoagulant or antiplatelet medications are also possible.
Pregnancy and Breastfeeding
Avoid use during the first and third trimesters of pregnancy. Not recommended for use on the breast area during breastfeeding.
Drug Profile Summary
- Mechanism of Action: Antithrombotic, anti-inflammatory, analgesic; inhibits thrombin, reduces inflammation, improves blood circulation.
- Side Effects: Local skin irritation (redness, burning, rash), rarely allergic reactions.
- Contraindications: Hypersensitivity, broken skin, pregnancy (1st & 3rd trimesters), breastfeeding (on breast area).
- Drug Interactions: May potentiate coumarin anticoagulants.
- Pregnancy & Breastfeeding: Avoid in 1st and 3rd trimesters of pregnancy and on breast area during lactation.
- Dosage: Apply 2-6 inches of cream/gel up to four times daily.
- Monitoring Parameters: Observe for local skin reactions and allergic reactions.
Popular Combinations
MPS is often combined with salicylic acid (e.g., in Movelat) for enhanced penetration and synergistic anti-inflammatory and analgesic effects.
Precautions
- For external use only. Do not ingest.
- Avoid contact with eyes, mucous membranes, and broken skin.
- Wash hands after application.
- Pregnant women should not use MPS during the first and third trimesters.
- Avoid applying MPS to the breast area during breastfeeding.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Mucopolysaccharide Polysulfate?
A: Apply a 2-6 inch ribbon of cream or gel to the affected area up to four times daily.
Q2: Can MPS be used during pregnancy?
A: It is not recommended during the first and third trimesters.
Q3: Is MPS safe for children?
A: Not generally recommended for children under 12.
Q4: What are the common side effects of MPS?
A: Local skin irritation, such as redness, burning, and rash.
Q5: What should I do if I experience skin irritation?
A: Discontinue use and consult a physician.
Q6: Can MPS be used on open wounds?
A: No, avoid application on broken or damaged skin.
Q7: How does MPS work to relieve pain?
A: It reduces inflammation and improves blood circulation, leading to pain relief.
Q8: How long does it take for MPS to work?
A: The onset of pain relief varies depending on the individual and the condition being treated.
Q9: Can MPS be used with other topical medications?
A: Consult your doctor before using MPS with other topical medications, especially other anti-inflammatory or analgesic products.
Q10: Can I use MPS if I am allergic to aspirin?
A: Use with caution, as cross-sensitivity with salicylates may occur. Consult your physician.
