Polidocanol

Class: Sclerosing Agents
Chemical Name: Polyethylene glycol monododecyl ether
CAS Number: 9002-92-0
Brands: Asclera

Medically reviewed by Drugs.com on May 18, 2022. Written by ASHP.

Introduction

Sclerosing agent; nonionic detergent.

Uses for Polidocanol

Sclerotherapy

Treatment of uncomplicated spider veins (varicose veins ≤1 mm in diameter) in lower extremity.

Treatment of uncomplicated reticular veins (varicose veins 1–3 mm in diameter) in lower extremity.

Not studied in varicose veins >3 mm in diameter.

Polidocanol Dosage and Administration

Administration

IV Administration

Administer only by IV injection. Avoid extravasation. (See Administration Precautions under Cautions.)

Commercially available as 0.5 or 1% solution in single-use ampuls (containing a total of 10 or 20 mg, respectively, in each 2-mL ampul). Has been administered as an endovenous foam or microfoam; these preparations not commercially available in US and extemporaneous preparation of polidocanol foam not approved by FDA.

Administration Procedure

Use a syringe (glass or plastic) with a fine needle (typically, 26- or 30-gauge). Insert needle tangentially into target vein and inject solution slowly while needle is still in vein. To prevent vein rupture, only apply gentle pressure during injection.

After removing needle from target vein and covering injection site, apply compression in the form of a stocking or bandage. After treatment session, have patient walk for 15–20 minutes and observe patient to detect any anaphylactic or allergic reaction. (See Sensitivity Reactions under Cautions.)

Advise patient to maintain compression (stocking or bandage) for 2–3 days after treatment of spider veins or 5–7 days after treatment of reticular veins. For extensive varicosities, longer compression treatment with compression bandages or gradient compression stocking of a higher compression class is recommended.

If small intravaricose blood clots (thrombi) develop, they may be removed by stab incision and thrombus expression (microthrombectomy).

Dosage

Adults

Sclerotherapy

Uncomplicated Varicose Veins in Lower Extremity

Concentration of polidocanol solution (0.5 or 1%) and injection volume depend on type and size of varicose veins. After polidocanol treatment, compression is necessary to reduce risk of deep vein thrombosis. (See IV Administration under Dosage and Administration.)

Spider veins (varicose veins ≤1 mm in diameter): 0.1–0.3 mL (0.5–1.5 mg) of 0.5% solution for each injection. Do not exceed 10 mL (50 mg) per treatment session.

Reticular veins (varicose veins 1–3 mm in diameter): 0.1–0.3 mL (1–3 mg) of 1% solution for each injection. Do not exceed 10 mL (100 mg) per treatment session.

Repeat treatments may be necessary if extent of varicose veins requires >10 mL of solution. Separate treatment sessions by 1–2 weeks.

Prescribing Limits

Adults

Sclerotherapy

Uncomplicated Varicose Veins in Lower Extremity

Maximum 0.3 mL of 0.5 or 1% solution (1.5 or 3 mg, respectively) per injection site