It is a sclerosing agent. It is given as an injection in your doctor’s office, hospital, or clinic.
Ethoxysclerol should be used as directed by the doctor. The drug label should be consulted for exact dosing instructions.
Ethoxysclerol comes as 20 and 40 mg Lauromacrogol injection ampoules.
Ethoxisclerol is indicated for the treatment of incompetent great saphenous veins, accessory saphenous veins, and visible varicosities of the great saphenous vein system above and below the knee.
Ethoxysclerol improves the symptoms of superficial venous incompetence and the appearance of visible varicose veins.
Ethoxysclerol is also indicated in the sclerosing therapy of hemorrhoids.
Polidocanol solution, 180 mg / 18 ml (10 mg / ml) must be activated before use. Once activated, ethoxysclerol is an injectable white foam that provides a 1% polidocanol solution. Each ml of Ethoxysclerol injectable foam contains 1.3 mg of polidocanol.
Once an Ethoxysclerol transfer unit is in place, and foam is generated it is transferred to a syringe. The contents of the syringe should be discarded if bubbles are visible.
The injectable foam must be administered within 75 seconds of removal from the can to maintain the properties of the injectable foam.
A new sterile syringe should be used after each injection. And use a new ethoxysclerol transfer unit for each treatment session.
The newly generated ethoxysclerol foam is injected slowly (approximately 1 ml / second into the GSV and 0.5 ml / second into accessory veins or varicose veins) while monitoring with ultrasound. Venospasm of the vein treated with ultrasound should be confirmed.
Injection should be stopped when ethoxysclerol is 3–5 cm from the saphenous-femoral junction.
After treatment, bandages and compression stockings are applied and the patient is asked to walk for at least 10 minutes while being monitored.
Compression should be maintained for 2 weeks after treatment and bandages kept dry, in place for the indicated time.
After treatment, you will need to wear compression stockings on your treated legs and walk every day for a while. But strenuous exercise and long periods of time doing nothing should be avoided for some time after treatment.
Things like sunbathing, hot baths, and saunas may need to be avoided.
Physicians administering Ethoxysclerol should have experience in venous procedures, a working knowledge of the use of duplex ultrasound in venous disease.
Local anesthesia can be administered prior to cannula insertion, but tumescent anesthesia or sedation of the patient is not required and the vein to be treated cannulate using ultrasound guidance to confirm venous access.
It may be necessary to repeat the treatment if the size and extension of the veins to be treated require more than 15 ml of ethoxysclerol. Treatment sessions separated by a minimum of 5 days.
The retained clot can be removed by aspiration (microthrombectomy) to improve comfort and reduce skin blemishes.
Mechanism of action
Ethoxysclerol acts on the walls of the vessels, it works by blocking certain veins, which are then replaced by connective tissue, always using the lowest concentration of sclerosant necessary.
The specific dose of Ethoxysclerol should be used according to the indications of the venous disease to be treated.
Ethoxysclerol is intended for intravenous injection by ultrasound guidance, administered through a single cannula into the lumen of target incompetent trunk veins or by direct injection into varicose veins.
You should use up to 5 ml per injection and no more than 15 ml per session.
At too high concentrations necrosis or some other adverse side effect can occur.
Warnings and Contraindications
Ethoxysclerol should not be used in the following cases:
- If the patient has a fever.
- If the patient suffers from respiratory crisis.
- If the patient has a predisposition to allergies or is allergic to the other components of the drug.
- If the general state of health of the patient is bad.
- If the patient is to undergo sclerosing treatment for spider veins or in patients with arterial circulation disorders (Fontaine stage II arterial occlusive diseases).
- If the patient suffers from inflammatory skin disease in the area to be treated, the legs are swollen due to accumulation of fluid (edema) and cannot be modified by compression.
- If the patient has occlusion of the blood vessels such as microangiopathy and neuropathy or severe alteration of the arterial circulation or vascular occlusion or due to thromboembolic diseases.
- If the patient has a degree of reduced mobility.
- If the patient frequently suffers from migraines.
- If the patient has multiple risk factors such as: the use of hormonal contraceptives, hormonal treatment, overweight, smoking among others.
Other medications taken by mouth or injected are not likely to have an effect on ethoxysclerol when used to treat varicose veins.
But many drugs can interact with each other, and this includes prescription, over-the-counter, vitamins, and herbal products, so the doctor should be informed of the medications that are taken.