Pentosan polysulfate is a semi-synthetic polysulfated xylan used for the relief of Osteoarthritis. The mechanism of PPS action in osteoarthritis is stimulation of cartilage matrix synthesis and prevention of cartilage breakdown. There are also systemic effects on blood lipid and fibrinolysis that may help clear the subchondral circulation. This is a subcutaneous injection self-administered twice a week for 6 weeks. Most patients have relief from symptoms within 1-2 weeks and may achieve full remission of symptoms in 2-6 months. The nasal spray is used once your symptoms have been in remission to prevent a relapse of inflammation and pain.