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laureth-9 (polidocanol)

Generic Name: laureth-9 (polidocanol) (LAWR eth-9 (pol i DOE ka nol))
Brand Name: Asclera, Varithena

What is laureth-9?

Laureth-9 is a sclerosing (skler-OH-sing) agent. It works by increasing the formation of blood clots and scar tissue inside certain types of veins. This helps decrease dilation of enlarged veins.

Laureth-9 is used to treat small uncomplicated spider veins and varicose veins in the legs. Laureth-9 will not treat varicose veins that are larger than 3 millimeters (about one-eighth of an inch) in diameter.

Laureth-9 is not a cure for varicose veins and the effects of this medication may not be permanent.

Laureth-9 may also be used for purposes not listed in this medication guide.

What is the most important information I should know about laureth-9?

You should not receive this medication if you have a blood clot disorder such as deep vein thrombosis (DVT), swelling of a vein caused by a blood clot, or Buerger's disease.

What should I discuss with my healthcare provider before receiving laureth-9?

You should not receive this medicine if you are allergic to laureth-9, lauromacrogol 400, or polidocanol, or if you have:

  • a blood clot disorder such as deep vein thrombosis (DVT) or thrombophlebitis (swelling of a vein caused by a blood clot); or

  • Buerger's disease (a blood clotting disorder affecting the arms and legs).

To make sure laureth-9 is safe for you, tell your doctor about all of your medical conditions or allergies.

FDA pregnancy category C. It is not known whether laureth-9 will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while receiving this medicine.

It is not known whether laureth-9 passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using laureth-9.

How is laureth-9 given?

Laureth-9 is injected with a small needle directly into a varicose or spider vein. You will receive this injection in a clinic or hospital setting.

The number of injections you receive will depend on the number of spider or varicose veins being treated.

Laureth-9 must be injected slowly into the vein. Your caregivers will apply slight pressure to the vein during an injection.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when laureth-9 is injected. You will be watched closely after your injection, to make sure this medication is not causing harmful effects.

After the needle is removed from the vein, a compression bandage or stocking will be placed on the leg to prevent blood clots from forming.

When your treatment session is finished, your caregivers may want you to walk around for 15 or 20 minutes. Your doctor may instruct you to take daily walks for a few days after your treatment with laureth-9.

You may need to wear compression stockings for several days or weeks after your treatment. Carefully follow your doctor's instructions about caring for yourself after receiving this medication.

You may need additional treatment sessions with laureth-9 to best treat the varicose vein. At least 1 week should pass between treatment sessions.

What happens if I miss a dose?

Because you will receive laureth-9 in a clinical setting, you are not likely to miss a dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose may cause severe skin reaction such as burning, discoloration or tissue damage where an injection was given.

What should I avoid after receiving laureth-9?

Avoid heavy or strenuous exercise for 2 or 3 days after your treatment. Also avoid sitting for long periods of time, such as long-distance travel in a car or on an airplane.

Also avoid exposure to sunlight, tanning beds, hot tubs, or saunas for 2 or 3 days after your treatment.

Do not use ice or a heating pad on your treated leg without your doctor's advice.

Laureth-9 side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; sneezing, runny nose, difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers at once if you have a serious side effect such as:

  • severe pain, burning, or other irritation in your leg;

  • discoloration or skin changes where an injection was given;

  • sudden severe headache, confusion, problems with vision, speech, or balance;

  • pain, swelling, warmth, or redness in one or both legs;

  • severe numbness that does not go away;

  • trouble breathing, pounding heartbeats or fluttering in your chest; or

  • confusion, feeling like you might pass out.

Common side effects may include:

  • mild numbness or tingling;

  • mild headache, dizziness;

  • increased hair growth on the treated leg; or

  • mild pain or warmth, mild itching, or slight bruising where an injection was given.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Side Effects (complete list)

Laureth-9 dosing information

Usual Adult Dose for Varicose Vein:

-The strength of the solution and the volume injected depend on the size and extent of the varicose veins. Extensive varicosities may require multiple treatment sessions.
-Spider veins (varicose veins 1 mm or less in diameter): Use 0.5% solution
Reticular veins (varicose veins 1 to 3 mm in diameter): Use 1% solution
-Use 0.1 to 0.3 mL for each injection into each varicose vein. The maximum recommended volume per treatment session is 10 mL.

-For IV use only.
-Be prepared to treat anaphylaxis.
-Do not inject intra-arterially.
-Do not inject intra-perivascularly.
-Use a syringe (glass or plastic) with a fine needle (typically, 26- or 30-gauge). Insert the needle tangentially into the vein and inject the solution slowly while the needle is still in the vein.
-Apply gentle pressure during injection to prevent vein rupture.
-After the needle has been removed and the injection site has been covered, apply compression in the form of a stocking or bandage.
-After the treatment session, encourage the patient to walk for 15 to 20 minutes.
-Keep the patient under observation to detect any anaphylactic or allergic reaction.
-Maintain compression for 2 to 3 days after treatment of spider veins and for 5 to 7 days for reticular veins.
-For extensive varicosities, longer compression treatment with compression bandages or a gradient compression stocking of a higher compression class is recommended. Posttreatment compression is necessary to reduce the risk of deep vein thrombosis.
-Repeat treatments may be necessary if the extent of the varicose veins requires more than 10 mL. These treatments should be separated by 1 to 2 weeks.
-Small intravaricose blood clots (thrombi) that develop may be removed by stab incision and thrombus expression (microthrombectomy).

Use: The solution is used to sclerose uncomplicated spider veins (varicose veins 1 mm in diameter or less) and uncomplicated reticular veins (varicose veins 1 to 3 mm in diameter) in the lower extremity

Use up to 5 mL per injection and no more than 15 mL per session. Inject freshly generated injectable foam slowly (approximately 1 mL/second in the great saphenous vein (GSV) and 0.5 mL/second in accessory veins or varicosities) while monitoring using ultrasound. Confirm venospasm of the treated vein using ultrasound. When treating the proximal GSV, stop the injection when this drug is 3 to 5 cm distal to the saphenofemoral junction (SFJ).

-The injectable foam should be administered within 75 seconds of extraction from the canister to maintain injectable foam properties.
-This drug is intended for IV injection using ultrasound guidance, administered via a single cannula into the lumen of the target incompetent trunk veins or by direct injection into varicosities.
-Be prepared to treat anaphylaxis.
-Do not inject intra-arterially.
-Do not inject intra-perivascularly.
-Physicians administering this drug must be experienced with venous procedures, possess a detailed working knowledge of the use of the duplex ultrasound in venous disease, and be trained in the administration of this drug.
-A local anesthetic may be administered prior to cannula insertion but neither tumescent anesthesia nor patient sedation is required.
-Apply compression bandaging and stockings and have the patient walk for at least 10 minutes, while being monitored.
-Maintain compression for 2 weeks after treatment.
-Repeat treatment may be necessary if the size and extent of the veins to be treated require the use of more than 15 mL.
-Separate treatment sessions by a minimum of 5 days.
-Retained coagulum may be removed by aspiration (microthrombectomy) to improve comfort and reduce skin staining.

Use: The injectable foam is a sclerosing agent used for the treatment of incompetent great saphenous veins, accessory saphenous veins, and visible varicosities of the great saphenous vein (GSV) system above and below the knee. This drug improves the symptoms of superficial venous incompetence and the appearance of visible varicosities.

What other drugs will affect laureth-9?

It is not likely that other drugs you take orally or inject will have an effect on laureth-9 used to treat varicose veins. But many drugs can interact with each other. Tell your doctor about all medicines you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about laureth-9.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.02.

Date modified: December 03, 2017
Last reviewed: October 27, 2014