Polidocanol Injection (Asclera)
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Polidocanol Injection (Asclera)

Asclera
(polidocanol) Injection, for Intravenous use

DRUG DESCRIPTION

Asclera (polidocanol injection) is a sterile, nonpyrogenic, and colorless to faintly greenish-yellow solution of polidocanol for intravenous use as a sclerosing agent.

The active ingredient, polidocanol is a non-ionic detergent, consisting of two components, a polar hydrophilic (dodecyl alcohol) and an apolar hydrophobic (polyethylene oxide) chain. Polidocanol has the following structural formula:

Asclera (polidocanol) Structural Formula Illustration

C12H25(OCH2CH2)nOH      Polyethylene glycol monododecyl ether

Mean extent of polymerization (n) : Approximately 9
Mean molecular weight : Approximately 600

Each mL contains 5 mg (0.5%) or 10 mg (1.0%) polidocanol in water for injection with 5% (v/v) ethanol at pH 6.5-8.0; disodium hydrogen phosphate dihydrate, potassium dihydrogen phosphate are added for pH adjustment.

What are the possible side effects of laureth-9 (Asclera)?

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;
  • severe numbness that does not go away;
  • pain, swelling, warmth, or redness in one or both...

Read All Potential Side Effects and See Pictures of Asclera »

Last reviewed on RxList: 4/16/2010
This monograph has been modified to include the generic and brand name in many instances.

INDICATIONS

Asclera™ (polidocanol) is indicated to sclerose uncomplicated spider veins (varicose veins ≤ 1 mm in diameter) and uncomplicated reticular veins (varicose veins 1 to 3 mm in diameter) in the lower extremity. Asclera (polidocanol injection) has not been studied in varicose veins more than 3 mm in diameter.

DOSAGE AND ADMINISTRATION

For intravenous use only. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Do not use if particulate matter is seen or if the contents of the vial are discolored or if the vial is damaged in any way.

For spider veins (varicose veins ≤ 1 mm in diameter), use Asclera (polidocanol injection) 0.5%. For reticular veins (varicose veins 1 to 3 mm in diameter), use Asclera (polidocanol injection) 1%. Use 0.1 to 0.3 mL per injection and no more than 10 mL per session.

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 only 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 (see WARNINGS AND PRECAUTIONS).

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. Post-treatment 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).

HOW SUPPLIED

Dosage Forms And Strengths

Asclera (polidocanol injection) is available as a 0.5% and 1% solution in 2 mL glass ampules.

Storage And Handling

Asclera (polidocanol injection) is supplied in single-use, preservative free ampules in the following packages:

NDC XXXXX-XXX-XX Five 0.5% ampules (2 mL)
NDC XXXXX-XXX-XX Five 1.0% ampules (2 mL)

Each ampule is intended for immediate use in a single patient. Each unopened ampule is stable up to three years.

Store at 15-30°C; (59-86°F).

Distributed by: BioForm Medical, Inc. 4133 Courtney Road, Suite #10, Franksville, WI 53126. Manufactured by: Chemische Fabrik Kreussler & Co. GmbH 65203 Wiesbaden GERMANY.

Last reviewed on RxList: 4/16/2010
This monograph has been modified to include the generic and brand name in many instances.

SIDE EFFECTS

Clinical Study Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

In 5 controlled randomized clinical trials, Asclera (polidocanol injection) has been administered to 401 patients with small or very small varicose veins (reticular and spider veins) and compared with another sclerosing agent and with placebo. Patients were 18 to 70 years old. The patient population was predominately female and consisted of Caucasian and Asian patients.

Table 1 shows adverse events more common with Asclera (polidocanol injection) or sodium tetradecyl sulfate (STS) 1% than with placebo by at least 3% in the placebo- controlled EASI study (see Clinical Studies). All of these were injection site reactions and most were mild.

Table 1: Adverse Reactions in EASI-study

  ASCLERA
(180 patients)
STS 1%
(105 patients)
Placebo
(53 patients)
Injection site haematoma 42% 65% 19%
Injection site irritation 41% 73% 30%
Injection site discoloration 38% 74% 4%
Injection site pain 24% 31% 9%
Injection site pruritus 19% 27% 4%
Injection site warmth 16% 21% 6%
Neovascularisation 8% 20% 4%
Injection site thrombosis 6% 1% 0%

Ultrasound examinations at one week (±3 days) and 12 weeks (±2 weeks) after treatment did not reveal deep vein thrombosis in any treatment group.

Post-marketing Safety Experience

The following adverse reactions have been reported during use of polidocanol in world-wide experience; in some of these cases these adverse events have been serious or troublesome. Because these reactions are reported voluntarily from a population of uncertain size and without a control group, it is not possible to estimate their frequency reliably or to establish a causal relationship to drug exposure.

Immune system disorders: Anaphylactic shock, angioedema, urticaria generalized, asthma

Nervous system disorders: Cerebrovascular accident, migraine, paresthesia (local), loss of consciousness, confusional state, dizziness

Cardiac disorders: Cardiac arrest, palpitations

Vascular disorders. Deep vein thrombosis, pulmonary embolism, syncope vasovagal, circulatory collapse, vasculitis

Respiratory, thoracic and mediastinal disorders: Dyspnea

Skin and subcutaneous tissue disorders: Skin hyperpigmentation, dermatitis allergic, hypertrichosis (in the area of sclerotherapy)

General disorders and injection site conditions: Injection site necrosis, pyrexia, hot flush

Injury, poisoning and procedural complications: Nerve injury

Read the Asclera (polidocanol injection) Side Effects Center for a complete guide to possible side effects »

DRUG INTERACTIONS

No drug-drug interactions have been studied with Asclera (polidocanol injection) .

Last reviewed on RxList: 4/16/2010
This monograph has been modified to include the generic and brand name in many instances.

WARNINGS

Included as part of the PRECAUTIONS section.

PRECAUTIONS

Anaphylaxis

Severe allergic reactions have been reported following polidocanol use, including anaphylactic reactions, some of them fatal. Severe reactions are more frequent with use of larger volumes ( > 3 mL). The dose of polidocanol should therefore be minimized. Be prepared to treat anaphylaxis appropriately.

Severe adverse local effects, including tissue necrosis, may occur following extravasation; therefore, care should be taken in intravenous needle placement and the smallest effective volume at each injection site should be used.

After the injection session is completed, apply compression with a stocking or bandage, and have the patient walk for 15-20 minutes. Keep the patient under supervision during this period to treat any anaphylactic or allergic reaction (see DOSAGE AND ADMINISTRATION).

Accidental Intra-arterial Injection

Intra-arterial injection can cause severe necrosis, ischemia or gangrene. If this occurs consult a vascular surgeon immediately.

Inadvertent Perivascular Injection

Inadvertent perivascular injection of Asclera (polidocanol injection) can cause pain. If pain is severe, a local anesthetic (without adrenaline) may be injected.

Nonclinical Toxicology

Carcinogenesis, Mutagenesis, Impairment of Fertility

Long-term studies to evaluate carcinogenic potential have not been conducted with polidocanol. Polidocanol was negative in bacterial reverse mutation assays in Salmonella and E. coli, and in a micronucleus assay conducted in mice. Polidocanol induced numerical chromosomal aberrations in cultured newborn Chinese hamster lung fibroblasts in the absence of metabolic activation.

Polidocanol did not affect reproductive performance (fertility) of rats when administered intermittently at dosages up to 10 mg/kg (approximately equal to the maximum human dose on the basis of body surface area).

Use In Specific Populations

Pregnancy

Pregnancy Category C

Polidocanol has been shown to have an embryocidal effect in rabbits when given in doses approximately equal (on the basis of body surface area) to the human dose. This effect may have been secondary to maternal toxicity. There are no adequate and well-controlled studies in pregnant women. Asclera (polidocanol injection) should not be used during pregnancy.

Animal Studies

Developmental reproductive toxicity testing was performed in rats and rabbits with intravenous administration. Polidocanol induced maternal and fetal toxicity in rabbits, including reduced mean fetal weight and reduced fetal survival, when administered during gestation days 6-20 at doses of 4 and 10 mg/kg, but it did not cause skeletal or visceral abnormalities. No adverse maternal or fetal effects were observed in rabbits at a dose of 2 mg/kg. No evidence of teratogenicity or fetal toxicity was observed in rats dosed during gestation days 6-17 with doses up to 10 mg/kg. Polidocanol did not affect the ability of rats to deliver and rear pups when administered intermittently by intravenous injection from gestation day 17 to post-partum day 21 at doses up to 10 mg/kg.

Human Studies

There are no adequate and well-controlled studies on the use of Asclera (polidocanol injection) in pregnant women.

Labor and Delivery

The effects of Asclera (polidocanol injection) on labor and delivery in pregnant women are unknown.

Nursing Mothers

It is not known whether polidocanol is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants, avoid administering to a nursing woman.

Pediatric Use

The safety and effectiveness of Asclera (polidocanol injection) in pediatric patients have not been established.

Geriatric Use

Clinical studies of Asclera (polidocanol injection) did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.

Last reviewed on RxList: 4/19/2010
This monograph has been modified to include the generic and brand name in many instances.

OVERDOSE

Overdose may result in a higher incidence of localized reactions such as necrosis.

CONTRAINDICATIONS

Asclera (polidocanol injection) is contraindicated for patients with known allergy (anaphylaxis) to polidocanol and patients with acute thromboembolic diseases.

Last reviewed on RxList: 4/16/2010
This monograph has been modified to include the generic and brand name in many instances.

CLINICAL PHARMACOLOGY

Mechanism of Action

The active ingredient of Asclera is polidocanol.

Polidocanol is a sclerosing agent that locally damages the endothelium of blood vessels. When injected intravenously, polidocanol induces endothelial damage. Platelets then aggregate at the site of damage and attach to the venous wall. Eventually, a dense network of platelets, cellular debris, and fibrin occludes the vessel. Finally, the occluded vein is replaced with connective fibrous tissue.

Pharmacodynamics

Polidocanol has a concentration- and volume-dependent damaging effect on the endothelium of blood vessels.

Pharmacokinetics

During the major effectiveness study (EASI-trial), scheduled blood samples were taken from a sub-group of 22 patients to measure plasma levels of polidocanol after Asclera (polidocanol injection) treatment of spider and reticular veins. Low systemic blood levels of polidocanol were seen in some patients.

The mean t½ of polidocanol in 4 patients with evaluable data receiving 4.5 -18.0 mg was 1.5 h.

Clinical Studies

Asclera (polidocanol injection) was evaluated in a multicenter, randomized, double-blind, placebo- and comparator-controlled trial (EASI-study) in patients with spider or reticular varicose veins. A total of 338 patients were treated with Asclera (polidocanol injection) [0.5% for spider veins (N=94), 1% for reticular veins (N=86)], sodium tetradecyl sulfate (STS) 1% (N=105), or placebo (0.9% isotonic saline solution) (N=53) for either spider or reticular veins. Patients were predominately female, ranging in age from 19 to 70 years. All of them received an intravenous injection in the first treatment session; repeat injections were given three and six weeks later if the previous injection was evaluated as unsuccessful (defined as 1, 2 or 3 on a 5-point scale, see below). Patients returned at 12 and 26 weeks after the last injection for final assessments.

The primary effectiveness endpoint was improvement of veins judged by a blinded panel. Digital images of the selected treatment area were taken prior to injection, compared with those taken at 12 weeks post-treatment, and rated on a 5-point scale (1 = worse than before, 2 = same as before, 3 = moderate improvement, 4 = good improvement, 5 = complete treatment success); results are shown in Table 2.

Table 2 : Improvement of veins in digital photographs after 12 weeks and 26 weeks

Treatment Group Polidocanol (N=155) STS (N=105) Placebo (N=53)
Digital Photograph Scores at 12 weeks
Mean ± SD (N) 4.5* 4. 2.2  
Digital Photograph Scores at 26 weeks
Mean ± SD (N) 4.5* 4. 2.2  
*p < 0.0001 compared to placebo (Wilcoxon-Mann-Whitney test)

The secondary efficacy criterion was the rate of treatment success, pre-defined as a score of 4 or 5 with patients scoring 1, 2, or 3 considered treatment failures; results are shown in Table 3.

Table 3 : Treatment success rates at 12 weeks and 26 weeks

Treatment success?* Polidocanol (N=155) STS (N=105) Placebo (N=53)
At 12 weeks (Visit 4)
Yes 95%** 92%** 8%
No 5% 8% 92%
Missing 0.6% 0% 0%
At 26 weeks (Visit 5)
Yes 95%** 91%** 6%
No 5% 9% 94%
*Treatment success: Yes= Grade 4 to 5, No= Grade 1 to 3; derived from median of evaluation; **p < 0.0001 compared to placebo.

At 12 and 26 weeks, patients' judgment of the results was assessed by showing them the digital images of their treatment area taken at baseline and asking them to rate their satisfaction with their treatment using a verbal rating scale (1 = very unsatisfied; 2 = somewhat unsatisfied; 3 = slightly satisfied; 4 = satisfied and 5 = very satisfied); results are shown in Table 4.

Table 4 : Patient satisfaction after 12 weeks and 26 weeks

  Polidocanol (N=155) STS (N=105) Placebo (N=53)
Patient satisfaction with treatment after 12weeks (Visit 4)
Satisfied or very satisfied 87%* 64% 14%
Patient satisfaction with treatment after 26weeks (Visit 5)
Satisfied or very satisfied 84%* 63% 16%
*p < 0.0001 compared to STS and placebo

Last reviewed on RxList: 4/16/2010
This monograph has been modified to include the generic and brand name in many instances.

PATIENT INFORMATION

Advise the patient to wear compression stockings or support hose on the treated legs continuously for 2 to 3 days and for 2 to 3 weeks during the daytime. Compression stockings or support hose should be thigh or knee high depending upon the area treated in order to provide adequate coverage.

Advise the patient to walk for 15 to 20 minutes immediately after the procedure and daily for the next few days.

For two to three days following treatment, advise the patient to avoid heavy exercise, sunbathing, long plane flights, and hot baths or sauna.

Last reviewed on RxList: 4/16/2010
This monograph has been modified to include the generic and brand name in many instances.

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PATIENT INFORMATION

Advise the patient to wear compression stockings or support hose on the treated legs continuously for 2 to 3 days and for 2 to 3 weeks during the daytime. Compression stockings or support hose should be thigh or knee high depending upon the area treated in order to provide adequate coverage.

Advise the patient to walk for 15 to 20 minutes immediately after the procedure and daily for the next few days.

For two to three days following treatment, advise the patient to avoid heavy exercise, sunbathing, long plane flights, and hot baths or sauna.

Last reviewed on RxList: 4/16/2010
This monograph has been modified to include the generic and brand name in many instances.

Asclera
(polidocanol) Injection, for Intravenous use

DRUG DESCRIPTION

Asclera (polidocanol injection) is a sterile, nonpyrogenic, and colorless to faintly greenish-yellow solution of polidocanol for intravenous use as a sclerosing agent.

The active ingredient, polidocanol is a non-ionic detergent, consisting of two components, a polar hydrophilic (dodecyl alcohol) and an apolar hydrophobic (polyethylene oxide) chain. Polidocanol has the following structural formula:

Asclera (polidocanol) Structural Formula Illustration

C12H25(OCH2CH2)nOH      Polyethylene glycol monododecyl ether

Mean extent of polymerization (n) : Approximately 9
Mean molecular weight : Approximately 600

Each mL contains 5 mg (0.5%) or 10 mg (1.0%) polidocanol in water for injection with 5% (v/v) ethanol at pH 6.5-8.0; disodium hydrogen phosphate dihydrate, potassium dihydrogen phosphate are added for pH adjustment.

Last reviewed on RxList: 4/16/2010
This monograph has been modified to include the generic and brand name in many instances.

Asclera
(polidocanol) Injection, for Intravenous use

DRUG DESCRIPTION

Asclera (polidocanol injection) is a sterile, nonpyrogenic, and colorless to faintly greenish-yellow solution of polidocanol for intravenous use as a sclerosing agent.

The active ingredient, polidocanol is a non-ionic detergent, consisting of two components, a polar hydrophilic (dodecyl alcohol) and an apolar hydrophobic (polyethylene oxide) chain. Polidocanol has the following structural formula:

Asclera (polidocanol) Structural Formula Illustration

C12H25(OCH2CH2)nOH      Polyethylene glycol monododecyl ether

Mean extent of polymerization (n) : Approximately 9
Mean molecular weight : Approximately 600

Each mL contains 5 mg (0.5%) or 10 mg (1.0%) polidocanol in water for injection with 5% (v/v) ethanol at pH 6.5-8.0; disodium hydrogen phosphate dihydrate, potassium dihydrogen phosphate are added for pH adjustment.

Last reviewed on RxList: 4/16/2010
This monograph has been modified to include the generic and brand name in many instances.

Asclera
(polidocanol) Injection, for Intravenous use

DRUG DESCRIPTION

Asclera (polidocanol injection) is a sterile, nonpyrogenic, and colorless to faintly greenish-yellow solution of polidocanol for intravenous use as a sclerosing agent.

The active ingredient, polidocanol is a non-ionic detergent, consisting of two components, a polar hydrophilic (dodecyl alcohol) and an apolar hydrophobic (polyethylene oxide) chain. Polidocanol has the following structural formula:

Asclera (polidocanol) Structural Formula Illustration

C12H25(OCH2CH2)nOH      Polyethylene glycol monododecyl ether

Mean extent of polymerization (n) : Approximately 9
Mean molecular weight : Approximately 600

Each mL contains 5 mg (0.5%) or 10 mg (1.0%) polidocanol in water for injection with 5% (v/v) ethanol at pH 6.5-8.0; disodium hydrogen phosphate dihydrate, potassium dihydrogen phosphate are added for pH adjustment.

Last reviewed on RxList: 4/16/2010
This monograph has been modified to include the generic and brand name in many instances.

Asclera Patient Information Including Side Effects

Brand Names: Asclera

Generic Name: laureth-9 (polidocanol) (Pronunciation: LAWR eth-9 (pol i DOE ka nol))

What is laureth-9 (Asclera)?

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 are the possible side effects of laureth-9 (Asclera)?

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;
  • severe numbness that does not go away;
  • pain, swelling, warmth, or redness in one or both legs;
  • trouble breathing, pounding heartbeats or fluttering in your chest; or
  • confusion, feeling like you might pass out.

Less serious 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.

Read the Asclera (polidocanol injection) Side Effects Center for a complete guide to possible side effects »

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

You should not receive this medication 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), swelling of a vein caused by a blood clot, or Buerger's disease.

Before you receive laureth-9, tell your doctor about all of your medical conditions or allergies.

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.

Carefully follow your doctor's instructions about caring for yourself after receiving this medication.

For 2 or 3 days after your treatment: Avoid exposure to sunlight, tanning beds, hot tubs, or saunas. Do not use ice or a heating pad on your treated leg without your doctor's advice.

Also avoid heavy or strenuous exercise, or sitting for long periods of time, such as long-distance travel in a car or on an airplane.

Side Effects Centers

Asclera Patient Information including How Should I Take

What should I discuss with my healthcare provider before taking laureth-9 (Asclera)?

You should not receive this medication 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 you can safely receive laureth-9, 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 medication..

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 (Asclera)?

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.

Side Effects Centers

Asclera Patient Information including If I Miss a Dose

What happens if I miss a dose (Asclera)?

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

What happens if I overdose (Asclera)?

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 (Asclera)?

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.

What other drugs will affect laureth-9 (Asclera)?

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.

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.

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