Sclerosants

Name: Sulfonamide-derived drugs (non-antibacterial)
Creator: Jason Cafer, MD

Agents injected into a vein to destroy its endothelium so it thromboses, occludes and fibroses — treatment of varicose, reticular and spider veins
Polidocanol is the one FDA-approved member in the library: a non-ionic detergent whose hydrophobic tail disrupts the endothelial lipid membrane
Anaphylaxis; severe necrosis, ischemia or gangrene with intra-arterial injection or extravasation; venous thrombosis — monitor after treatment
Deactivated on contact with blood, which keeps the action local and leaves no systemic drug interactions to check

Class at a glance

Agents injected into a vein to destroy its endothelium so it thromboses, occludes and fibroses — treatment of varicose, reticular and spider veins
Polidocanol is the one FDA-approved member in the library: a non-ionic detergent whose hydrophobic tail disrupts the endothelial lipid membrane

Anaphylaxis; severe necrosis, ischemia or gangrene with intra-arterial injection or extravasation; venous thrombosis — monitor after treatment
Deactivated on contact with blood, which keeps the action local and leaves no systemic drug interactions to check

How does a detergent sclerosant close a vein?
Its hydrophobic end lodges in the endothelial membrane and destroys the endothelium; the exposed wall is thrombogenic, the vein occludes and is replaced by fibrous tissue.