Ethoxysclerol 0.5% injection solution is used for the following indications:
vascular meshes (in the form of a solution); varicose veins of the branches of the central vein (in the form of a solution).
Composition
The active substance is lauromacrogol 400 (2 ml of solution for injection contains lauromacrogol 400 - 10 mg).
Excipients: ethanol 96%; sodium hydrogen phosphate, dihydrate; potassium dihydrogen phosphate; water for injections.
Contraindication
In the treatment of varicose veins, the drug is contraindicated in the following cases:
Absolute contraindications to the use of the drug: known hypersensitivity to Lauromacrogol 400 or other components of the drug; acute severe systemic diseases (especially incurable); bedridden; obliterating endarteritis III and IV degrees; thromboembolic disease; high risk of thrombosis (for example, with hereditary thrombophilia or in the presence of multiple risk factors, such as hormone replacement therapy, use of hormonal contraceptives, obesity, smoking, all diseases and conditions that are accompanied by restriction of free movement); relative contraindications to the use of the drug: febrile conditions; bronchial asthma or known predisposition to allergies; general weakness of the body; obliterating endarteritis II degree; leg edema (which is not corrected by the compression method); inflammatory skin diseases at the injection site; symptoms of microangiopathy or neuropathy; limited mobility in the patient.
Method of application
The concentration of the drug is selected depending on the diameter of the vein and the individual condition of the patient.
It is necessary to use the minimum possible concentration of the drug.
The dose of Lauromacrogol 400 should not exceed 2 mg/kg of body weight per day.
For example, a patient weighing 70 kg can receive a maximum dose of 140 mg (except for dosage in case of hemorrhoids).
140 mg of Lauromacrogol 400 contains 28 ml of solution for injection.
Large varicose veins need to be treated in several sessions.
For patients with varicose veins who are prone to hypersensitivity reactions, only one injection is used during the first treatment session. Depending on the results of the treatment and the size of the obliteration zone, several injections can be made during the next treatment session, without exceeding the maximum dose.
Sclerotherapy of vascular networks: depending on the size of the varicose veins, 0.1-0.2 ml of the solution for injection "ethoxysclerol 0.5%" is prescribed intravascularly.
Method of use
Sclerotherapy of vascular networks, sclerotherapy of varicose veins of the branches of the central vein. Sclerosis is performed when the leg is in a horizontal position or slightly raised at an angle of 30-45 °. All injections are administered only intravenously, including in the treatment of vascular networks. Very thin needles (for example, insulin) and syringes with a smooth piston are used. The puncture is performed tangentially, the drug is administered slowly. When using the drug in the form of foam, the needle size must be at least 25 G.
Compression therapy after administration of the drug in the form of a solution. After administration of the drug in the form of a solution, the injection site should be firmly clamped with a gauze pad and a tight elastic compression bandage should be applied. The patient should walk for at least 30 minutes immediately after administration of the drug, preferably within the hospital.
Duration of compression therapy. The bandage should be worn for 2-3 days after sclerotherapy of vascular meshes, in other cases - for 5-7 days. Patients with extensive varicose veins are recommended compression therapy with short-stretch bandages for several months. To avoid slipping of the bandage, especially on the thigh, it is recommended to apply a non-slip bandage made of porous synthetic material under the compression bandage. The success of sclerotherapy depends on subsequent proper compression treatment.
Application features
Pregnant women
There are insufficient data on the use of the drug in pregnant women. In animal studies, the drug showed reproductive toxicity, but did not have a teratogenic effect. The drug should be used in pregnant women only if the potential benefit outweighs the risk to the fetus.
It is not known whether Lauromacrogol 400 passes into breast milk.
If sclerotherapy is necessary, breastfeeding should be discontinued for 2-3 days.
Children
The drug is not used in children.
Drivers
There were no reports of negative effects on the ability to drive vehicles and operate other mechanisms.
Overdose
First aid measures and antidotes
Anaphylactic reactions are rare but can be potentially life-threatening. Countermeasures should always be available for sclerotherapy.
Treatment of local intoxication after incorrect use of a drug for the treatment of varicose veins of the legs:
Intraarterial injection:
Leave the cannula in the insertion site if the cannula has already been removed, move the puncture. Inject 5-10 ml of local anesthetic without the addition of adrenaline. Inject heparin 10,000 IU. The ischemic leg should be wrapped in cotton wool and lowered down. Hospitalize the patient in the vascular surgery department.
Paravenous injection: depending on the dose and concentration of the drug administered Paravenously, 5-10 ml of 0.9% sodium chloride solution is injected, if possible - together with hyaluronidase; in case of acute pain, a local anesthetic is injected (without adrenaline).
Side effects
From the vascular system: often (≥ 1% to <10%) - the appearance of vessels in the area of sclerosing, hematoma.
Skin and subcutaneous tissue disorders: common (≥ 1% to < 10%) - skin discoloration (hyperpigmentation, ecchymoses).
Storage conditions
Store in the original packaging at a temperature not exceeding 25 °C, out of the reach of children.
Shelf life - 3 years.
