The Medical Letter on Drugs and Therapeutics
Polidocanol (Varithena) for Varicose Veins
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An injectable foam formulation of the sclerosing agent polidocanol (Varithena – Provensis/BTG) has been approved by the FDA for treatment of incompetent veins and visible varicosities of the great saphenous vein system. It is the first foam therapy to be approved for this indication, but polidocanol and other sclerosants have been used for years as foam formulations compounded by physicians. Polidocanol is also available in a liquid formulation (Asclera) to treat smaller veins. Sodium tetradecyl sulfate (Sotradecol) is FDA-approved in a liquid formulation for use in sclerotherapy.

MECHANISM OF ACTION — Intravenous injection of polidocanol displaces blood from the vein. The foam attaches to the lipid cell membrane of the venous endothelium, which leads to endothelial damage, thrombus formation, and venous occlusion. The occluded vein is eventually replaced by fibrous tissue. Delivering ... more      

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Title: Polidocanol (Varithena) for Varicose Veins
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