Generally, the dose of 2 mg lauromacrogol 400 (polidocanol) per kg body weight and day should not be exceeded (for a patient weighing 70 kg, this means a daily dose of up to 14 ml Aethoxysklerol 1%).
Aethoxysklerol may be used for foam sclerotherapy. The physician has access to more detailed information in the Summary of Product Characteristics for healthcare professionals. When administering as standardised sclerosing foam, the total dose of 10 ml foam per session and day - irrespective of body weight - should not be exceeded.
In the initial treatment, patients prone to hypersensitivity reactions should be given no more than one injection. Depending on the response, several injections may be given in subsequent treatment sessions, provided that the maximum dose is not exceeded.
Depending on the size of the area to be sclerosed, 0.1-0.3 mL Aethoxysklerol 1% is given as a liquid into the veins (intravascularly).
When using Aethoxysklerol as sclerosing foam, e.g. for the treatment of collateral varices, up to 4 ml (maximum 6 ml) is injected per injection. For veins connecting to the deep vein system, up to 2 ml (maximum 4 ml) is injected per injection. The total daily dose must not be exceeded. (See Table 1.)
Click on icon to see table/diagram/image
Method of Administration:
Usually, the injections should only be carried out in a leg placed horizontally or elevated to approximately 30-45° above the horizontal.
Injections of Aethoxysklerol 1% must be given into the blood vessel (intravascularly).
Extra fine needles (eg, insulin needles) and smooth-moving syringes are used. Using the narrowest puncture angle possible, the needle is inserted until its tip is securely located within the blood vessel.
When performing foam sclerotherapy, ultrasound imaging (preferably with duplex) should be used to monitor direct puncture and injection into non-visible main (truncal) veins, veins connecting to the deep vein system (perforating veins) and varicose veins (varices) located in the groin or hollow of the knee. When treating other non-visible varicose veins (varices), guidance of the puncture and injection by means of ultrasound is recommended.
When using sclerosing foam, the needle must be no smaller than 25G.
Compression treatment after injection of liquid Aethoxysklerol:
Once the injection site has been covered, a tight compression bandage or compression stocking must be applied. Thereafter, the patient should walk for 30 minutes, preferably within reach of the practice.
Compression treatment after injection of Aethoxysklerol sclerosing foam:
Once the injection site has been covered, the patient's leg is immobilised for 2-5 minutes. Valsalva's manoeuvre and muscle activation should be avoided in the patient, as should immediate compression in the injection site area. Compression is applied after approximately 10 minutes when treating the great and small saphenous vein (vena saphena magna/vena saphena parva) and after approximately 5 minutes when treating collateral varicose veins, recurrent varicose veins (occurring again after previous varicose vein treatment) or veins connecting to the deep vein system.
Compression should be applied for 5-7 days. For extensive varicose veins, prolonged compression treatment with short-traction bandages is recommended.
To ensure that the bandage does not slip, especially on the thigh and conical limbs, it is recommended that a form bandage support is applied under the actual compression bandage.
The success of sclerotherapy is largely dependent on thorough and careful follow-up compression treatment.
Frequency and duration of use:
Depending on the extent of the varicose veins, several courses of repeated treatment may be required.
If more is used than recommended:
An overdose can cause local tissue destruction, particularly if injected into the surrounding tissue.
If patient forgets to use Aethoxysklerol 1%:
If patient has any further questions on the use of this product, ask the doctor or pharmacist.