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Pregnancy Category: C
ClassificationTherapeutic: sclerosing agents
Treatment of uncomplicated spider veins (varicose veins ≤1 mm in diameter) and uncomplicated reticular veins (varicose veins 1 to 3 mm in diameter) in legs.
Causes local endothelial damage following intravenous administration, followed by platelet aggregation and attachment to the venous wall, resulting in a dense network of platelets, cellular debris, and fibrin, which occludes the vein. This is followed by replacement with connective fibrous tissue.
Improved appearance of spider/reticular veins.
Absorption: Local IV administration results in low systemic blood levels.
Distribution: Action is primarily local.
Metabolism and Excretion: Unkown.
Half-life: 1.5 hr.
Time/action profile (vessel occlusion)
Contraindicated in: Known allergy; Known thromboembolic disease; Obstetric / Should not be used during pregnancy; Lactation: Avoid breastfeeding.
Use Cautiously in: Pediatric: Safe and effective use in children has not been established.
Adverse Reactions/Side Effects
- mild injection site reactions
- allergic reactions including anaphylaxis (life-threatening)
Drug-Drug interactionNone noted.
Local: Intravenous (Adults) Spider veins—0.1–0.3 mL of 0.5% solution for each injection into each varicose vein; Reticular veins—0.1–0.3 mL of 1% solution for each injection into each varicose vein. Not to exceed 10 mL/treatment session.
Solution for local intravenous injection (contains ethanol): 5 mg/mL in 2 mL ampules (0.5%), 10 mg/mL in 2 mL ampules (1.0%)
- Assess extent of spider and/or reticular veins in lower extremities.
- Monitor for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing) for at least 15–20 min following administration.
Potential Nursing DiagnosesActivity intolerance (Indications)
Disturbed body image (Indications)
- Administer undiluted. Using a fine-gauge (26 or 30 gauge) needle, insert needle tangentially into affected vein and inject solution slowly while needle is still in vein. Apply only gently pressure during injection to prevent vein rupture. If repeated treatments are needed, separate by 1–2 wks.
- Inadvertent perivascular injection may cause pain. If severe, inject local anesthetic.
- Intra-arterial injection can cause severe necrosis, ischemia, or gangrene; consult a vascular surgeon immediately if this occurs.
- Following injection, apply compression via stocking or bandage to reduce risk of deep vein thrombisis. After treatment session, encourage patient to walk for 15–20 minutes.
- Instruct patient to wear compression stockings or support hose on treated legs continuously for 2–3 days and for 2–3 wks during daytime. Compression stockings or support hose should be thigh high or knee high depending on area treated.
- Advise patient to walk for 15–20 min immediately after procedure and daily for next few days.
- Advise patient to avoid heavy exercise, sunbathing, long plane flights, and hot baths or sauna for 2–3 days following treatment.
- Advise patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
- ↓ in size and visibility of spider and/or uncomplicated reticular veins in lower extremities.