polidocanol


Also found in: Wikipedia.

polidocanol

(po-li-doe-ka-nole) ,

Ascelera

(trade name)

Classification

Therapeutic: sclerosing agents
Pregnancy Category: C

Indications

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.

Action

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.

Therapeutic effects

Improved appearance of spider/reticular veins.

Pharmacokinetics

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)

ROUTEONSETPEAKDURATION
IVrapid3–6 wkunknown

Contraindications/Precautions

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

Local

  • mild injection site reactions

Miscellaneous

  • allergic reactions including anaphylaxis (life-threatening)

Interactions

Drug-Drug interaction

None noted.

Route/Dosage

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.

Availability

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%)

Nursing implications

Nursing assessment

  • 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 Diagnoses

Activity intolerance (Indications)
Disturbed body image (Indications)

Implementation

  • Intravenous Administration
  • 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.

Patient/Family Teaching

  • 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.

Evaluation/Desired Outcomes

  • ↓ in size and visibility of spider and/or uncomplicated reticular veins in lower extremities.
Mentioned in ?
References in periodicals archive ?
Varithena(TM) is a uniform, low-nitrogen, polidocanol microfoam, dispensed from a proprietary canister device.
A systematic review of four injections therapies for lateral epicondylosis: prolotherapy, polidocanol, whole blood, and platelet-rich plasma.
28) The mucocele was aspirated while polidocanol 1% was injected into the gland.
Sclerosing agents such as polidocanol have been shown to be superior to normal saline in both obliterating incompetent varicose veins and improving venous haemodynamics at 12 weeks.
Spider veins, without corresponding venous insufficiency, are typically simple cosmetic issues and are relatively easily treated by experienced practitioners with injections of new mild vein irritants such as polidocanol or sotradecol.
Sclerosant injections: These injections of 5 mg/mL polidocanol (sclerosing agent usually use to treat varicose veins) have been used to block target tendon blood flow, resulting in sclerosis in small blood vessels, sometimes termed "neovessels".
In 2010, the Food and Drug Administration approved 21 new chemical entities, 3 of which have human pregnancy data: polidocanol (Asclera; pregnancy risk category C), tocilizumab (Actemra; C), and velaglucerase alfa (VPRIV; B).
Polidocanol injection was approved March 31 for treatment of varicose veins, the FDA said.
All patients had undergone varicose vein sclerotherapy with polidocanol (Laurath-9; Aethoxysklerol, BSN Medical, Mount Waverley, Victoria, Australia) at a clinic of a single cosmetic surgeon.
Suppression of intrinsic resistance to penicillins in Staphylococcus aureus by polidocanol, a dodecyl polyethyleneoxid ether.
Revenue Growth Driven by FDA Approval of Polidocanol, According to Millennium Research Group
if you are allergic to polidocanol or have clots in your blood vessels.