Yes, that’s true but significantly increasing the oral dose (x7)...

Yes, that’s true but significantly increasing the oral dose (x7) could theoretically provide an equivalent systemic effect while staying under the AE threshold (eg macular problems). It would be actually quite interesting to know the prevalence of OA in long term users of Elmiron for cystitis.

As we know, when taken for cystitis the drug works not as a systemic treatment but rather the opposite - it goes straight to the bladder where it hangs around long enough to reduce inflammation, before being excreted through the normal channels.

It might be possible at some point to tweak the Elmiron formula to provide greater bioavailability when taken orally, especially given the size of the potential market.