Asclera: Q&A
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Is Asclera (polidoconal) a Safer Sclerosant Than Sodium Tetradecyl Sulfate?
I had an anaphylactic reaction to scerosing agent sodium tetradecyl and now need more treatment. I possibly reacted to the preservative benzyl alcohol. Is polidoconal safer?
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14 Doctor Answers |
Asked by
jamiphx
in New York
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Spider vein injections with Asclera and Polidocanol - Comparison with STS
There is evidence that the risk profile of Asclera is less than that of STS, but both solutions are safely used to eliminate unwanted spider veins. Choosing the appropriate sized veins to treat, and patient selection are important in reducing complications and improving results.
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Polidocanol is safer than sodium tetradechyl
Although it is generally safer and less allergenic, the fact that you had a life-threatening reaction suggests that you should not have either agent - ever.
A good choice for you might be laser treatment of the feeding reticular veins - more painful and more treatments than with Polidocanol - or hyper tonic salt solution injected directly into the visible and offending spider veins. This will back fill the reticular vein feeders. I did this alone for years before I got and then abandoned...
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Bay Area General Surgeon
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Asclera (Polidocanol) Sclerotherapy Drug Reaction Allergy, Which Medication is Safe?
If you had a true anaphylactic allergic reaction to Sodium Tetradecyl (Sotradecol), I would suggest that you avoid Asclera as well . . . although they are different drugs they work through a similar mechanism. Since your body has demonstrated that it does not like this type of medication in your system, I would consider you to be at too much of a risk to try the Asclera. Asclera is typically very safe, with an estimated 1 in 10,000 chance of an anaphylactic reaction. But...
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Allergic reaction to STS or Asclera
Vein specialists (phlebologists) use both STS and Asclera and if you had a life threatening reaction to one, avoid the other. Find a vein specialist or dermatlogist (an old timer) who has experience using 21% saline and have him/her use that. There are potential risks of skin necrosis if the injector is inexperienced using this formula but saline (sodium chloride) is part of our system physiologicaly and you will not have an allergic reaction to sodium chloride.
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Anaphylaxis possible with Polidocanol
I would recommend against either agent for you. Hypertonic saline slolution (sterile salt water) is the only sclerosant not associated with anaphylaxis to my knowledge. Although this is an off-label use, it is well known to be very efective. I would still recommend a small test dose.
Lasers are generally less effective, cost more, hurt more and are generally not preferred over sclerotherapy.
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Polidocanol is safest and best
I have been using polidocanol for more than eight years. I have not had not even one case of adverse reaction in over a 1000 of patients that I have treated. This product is safe and effective. The average cost is aout $400 to treat the spider veins.
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Safe use of sclerotherapy agents, Polidocanol and Sodium Tetradecyl Sulfate
Polidocanol and sodium tetradecyl sulfate are in the same class of sclerosing agents. While there is a good chance that Polidocanol would pose no problem for you, there is some risk of a similar allergic reaction. Therefore, a small test dose should be administered first, wait a week, and then proceed with treatment if no problem arises. Polidocanol (Asclera--BioForm Medical, USA; Aethoxysclerol--Europe) has been used with great success and excellent safety profile for many years...
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Polidocanol potentially safer but approach with some caution
Polidocanol (Asclera) and sodium tetradecyl sulfate (Sotradecol) are similar in structure so there is a potential for a similar reaction, although the chance may be small. It will be important to inform the treating physician of your history of anaphylaxis, and you may consider trying a test dose first, at a low concentration. Foaming the agent also always a lower concentration of the agent to be used while at the same time increasing the efficacy of treatment. If you...
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Asclera safer
Asclera (polidconol) is a safe alternative to sotradecol. I usually perform a test dose. lasers may be a safer alternative for you if you are allergic to the test dose.
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Polidocanol is safe
Asclera (polidocanol) is a very safe sclerosant and in your case I would say would be a better choice than STS for sure! There is a risk of anaphylaxis after polidocanol and anyone injecting this for leg veins should have epinephrine close by. Risks with sclerosants is dose-dependent and in your case using foaming techniques and limiting initial dosing would be important.
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Polidocanol may have a lower allergic reaction risk than sodium tetradecyl sulfate
Polidocanol and sodium tetradecyl sulfate are in the same class of sclerosing agents. While there is a good chance that Polidocanol would pose no problem for you, there is some risk of a similar allergic reaction. Therefore, a small test dose should be administered first, wait a week, and then proceed with treatment if no problem arises.
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Allergic Reaction to Sclerotherapy
Polidocanol does have a lower incidence of allergic sensitivity than Sotradecol. However, both are in the same class of chemical and you could be allergic to Polidocanol as well. It would be best to use a small test dose before proceeding with a treatment session. There are a number of lasers that could be used if your vessels are of the proper size.
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Polidocanol safer than STS?
If you've had an allergic reaction with STS, there is a possibility you may react with Polidocanol as well. The provider would need to proceed with caution. Other methods of spider vein reduction may be safer for you, such as Yag or VBeam laser. Please let us know if you have any further questions.
Sincerely,
Moradi MD
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