Drug Guide
Sodium Tetradecyl Sulfate
Classification
Therapeutic: Sclerotherapy agent
Pharmacological: Detergent sclerosant
FDA Approved Indications
- Treatment of varicose veins and spider veins via sclerotherapy
Mechanism of Action
Sodium tetradecyl sulfate causes endothelial damage to the targeted veins, leading to fibrosis and occlusion of the vessel, thereby reducing varicosities.
Dosage and Administration
Adult: Typically, 1-3 mL per session depending on size and number of veins, injected directly into the varicose or spider veins. Treatment is performed under ultrasound guidance when necessary.
Pediatric: Not generally indicated for pediatric use.
Geriatric: Adjust dosing based on patient response and tolerability.
Renal Impairment: No specific adjustment; however, caution is advised due to potential for increased adverse reactions.
Hepatic Impairment: Not specifically indicated; use with caution as systemic absorption may affect hepatic function in predisposed individuals.
Pharmacokinetics
Absorption: Locally administered; systemic absorption is minimal but can vary.
Distribution: Primarily localized at injection site.
Metabolism: Metabolized locally in tissues; systemic metabolism not well defined.
Excretion: Excreted primarily via lymphatic system and local tissue degradation.
Half Life: Unknown; systemic clearance not well characterized.
Contraindications
- Known allergy or hypersensitivity to sodium tetradecyl sulfate or other sclerosants.
- Active or infected vein sites.
- Pregnancy and lactation unless deemed necessary and benefits outweigh risks.
Precautions
- Use with caution in patients with compromised cardiopulmonary function, thrombosis history, or bleeding disorders.
Adverse Reactions - Common
- Pain or discomfort at injection site (Common)
- Bruising or ecchymosis (Common)
- Inflammation or phlebitis (Common)
Adverse Reactions - Serious
- Allergic reactions including anaphylaxis (Rare)
- Deep vein thrombosis or pulmonary embolism (Rare)
- Skin necrosis (Rare)
Drug-Drug Interactions
- None established specifically for sotradecol; caution with other injectables or agents affecting coagulation.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Evaluate the vein characteristics and patient’s medical history. Monitor for allergies, reactions, and vein responses.
Diagnoses:
- Risk for injury related to adverse local or systemic reactions.
- Impaired skin integrity related to injection site reactions.
Implementation: Ensure proper technique and dosages; counsel on post-procedure care and signs of adverse reactions.
Evaluation: Assess vein occlusion success; monitor for adverse reactions or complications.
Patient/Family Teaching
- Inform about possible local reactions like swelling, redness, or pain.
- Advise to report any severe pain, skin changes, or signs of allergic reaction immediately.
- Follow instructions regarding post-treatment activity and follow-up visits.
Special Considerations
Black Box Warnings:
- None specific.
Genetic Factors: None identified.
Lab Test Interference: Local tissue effects are not known to interfere with lab tests.
Overdose Management
Signs/Symptoms: Excessive pain, tissue necrosis, allergic reactions, systemic toxicity signs such as hypotension.
Treatment: Supportive care, symptomatic treatment, emergency measures for allergic reactions, and wound care for tissue damage.
Storage and Handling
Storage: Store at room temperature, protected from light.
Stability: Stable when stored properly, typically for 2-3 years depending on manufacturer recommendations.