ELMIRON®
IC Symptoms Misdiagnosis is Common How IC is Diagnosed IC Self Screener
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IC Self Screener
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The following IC Self-Screener was developed specifically to help evaluate the symptoms of interstitial cystitis and to help doctors come to a quicker diagnosis of the condition. If you've already been diagnosed with IC, the Self-Screener can be used as a helpful tool for tracking the progress of your treatment.

This short questionnaire will measure the symptoms associated with IC, based on pain, urgency and frequency of urination. Complete all of the questions and then take it to your doctor.

For each question, please select the response that best describes how you feel. Then click SEE RESULTS to go to a printable page you can take to your next appointment.

1 How many times do you go to the bathroom during the day?
 
 3-6   7-10   11-14   15-19   20+
   
     
2 a.   How many times do you go to the bathroom at night?
 
 0   1   2   3   4+
     
  b. If you get up at night to go to the bathroom, does it bother you?
 
 Never   Mildly   Moderately   Severely
     
 
3 Are you currently sexually active?
 
Yes  No
   
     
4 a.  If you are sexually active, do you now or have you ever had pain or the urge to urinate during or after sexual intercourse?
 
 Never   Occasionally   Usually   Always
     
  b. If you have pain or the urge to urinate, does it make you avoid sexual intercourse?
 
 Never   Occasionally   Usually   Always
     
 
5 Do you have pain associated with your bladder or in your pelvis (vagina, lower abdomen, urethra, perineum, testes, or scrotum)?
 
 Never   Occasionally   Usually   Always
   
     
6 a.  If you have pain, is it usually:
 
 Mild   Moderate   Severe
     
  b. Does your pain bother you?
 
 Never   Occasionally   Usually   Always
     
 
7 Do you have urgency after going to the bathroom?
 
 Never   Occasionally   Usually   Always
   
     
8 a.  If you feel the urge to urinate, is it usually:
 
 Mild   Moderate   Severe
     
  b. Does this urge bother you?
 
 Never   Occasionally   Usually   Always
     
 
See Results


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ELMIRON® is indicated for the relief of bladder pain or discomfort associated with interstitial cystitis.
ELMIRON® is available by prescription only.

IMPORTANT SAFETY INFORMATION

ELMIRON® is a weak anticoagulant (blood thinner) which may increase bleeding. Call your doctor if you will be undergoing surgery or will begin taking anticoagulant therapy such as warfarin, heparin, high doses of aspirin, or anti-inflammatory drugs such as ibuprofen.

ELMIRON® should not be taken if you have a known hypersensitivity to the drug or similar drugs.

The most common side effects observed in clinical trials were blood in stool, diarrhea, nausea, hair loss, headache, rash, upset stomach, abdominal pain, liver function abnormalities, and dizziness. Hair loss, when it occurred, was almost always limited to a single area of the scalp, and grew back when ELMIRON® was discontinued.

The mechanism of action of ELMIRON® in interstitial cystitis is not fully understood.

Please see full Product Information for ELMIRON®.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

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Ortho Women's Health and Urology © Ortho-McNeil-Janssen Pharmaceuticals, Inc. 2009. All rights reserved. Your use of the information on this site is subject to the terms of our Legal Notice. This site is published by Ortho Women's Health & Urology™, Division of Ortho-McNeil-Janssen

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ELMIRON® is a registered trademark of IVAX Research, Inc, under license to Ortho-McNeil-Janssen Pharmaceuticals, Inc.

This information is intended for use by our customers, patients and healthcare professionals in the United States only. Ortho Women's Health & Urology™ recognizes that the Internet is a global communications medium; however, laws, regulatory requirements and medical practices for pharmaceutical products vary from country to country. The Full Product  Information included here may not be appropriate for use outside the United States.  
Last modified November 12, 2009