SODIUM TETRADECYL SULFATE
Clinical safety rating: caution
Comprehensive clinical and safety monograph for SODIUM TETRADECYL SULFATE (SODIUM TETRADECYL SULFATE).
Sodium tetradecyl sulfate is a synthetic anionic surfactant that acts as a sclerosing agent. It works by causing endothelial damage and inflammation of the venous wall, leading to fibrosis and occlusion of the injected vein.
| Metabolism | Not extensively metabolized; primarily eliminated unchanged by the kidneys. |
| Excretion | Primarily renal; approximately 95% of the dose is excreted unchanged in urine within 24 hours. Minor biliary/fecal elimination (<5%). |
| Half-life | Approximately 2.5 hours (range 1.5–4 hours) in patients with normal renal function. Clinical context: prolonged in renal impairment, requiring dose adjustment. |
| Protein binding | Approximately 50% bound to plasma proteins (albumin and globulins). |
| Volume of Distribution | 0.2–0.3 L/kg, indicating distribution primarily within extracellular fluid and plasma volume. |
| Bioavailability | Intravenous: 100% (direct intravascular administration). Oral: negligible due to extensive degradation and poor absorption. |
| Onset of Action | Sclerotherapy: immediate thrombotic effect upon injection; clinical sclerosis occurs within 1–2 minutes. |
| Duration of Action | Duration varies with vein diameter and concentration; typically 2–4 weeks for sufficient fibrosis. Repeat treatments often needed at 2–4 week intervals. |
1% to 3% solution, 0.1-0.5 mL per injection, intravenous, as needed for sclerotherapy; maximum 10 mL per session.
| Dosage form | INJECTABLE |
| Renal impairment | No dose adjustment required for renal impairment. |
| Liver impairment | Use with caution in Child-Pugh class C; no specific dose adjustment defined. |
| Pediatric use | 0.1-0.3 mL of 1% solution per injection, repeated as needed; maximum 5 mL per session. |
| Geriatric use | No specific adjustment; use lowest effective dose due to potential increased sensitivity. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for SODIUM TETRADECYL SULFATE (SODIUM TETRADECYL SULFATE).
| Breastfeeding | No data on excretion into human milk. M/P ratio unknown. Due to local administration and rapid metabolism, systemic exposure is minimal. Caution advised; consider discontinuing breastfeeding or avoiding use in lactating women. |
| Teratogenic Risk | Sodium tetradecyl sulfate (STS) is a sclerosing agent with no known teratogenic effects in humans. Animal studies are limited. Use is generally avoided during pregnancy due to lack of safety data, especially in the first trimester. Theoretical risk of placental transfer is low due to high molecular weight and local administration. No reported fetal anomalies. |
■ FDA Black Box Warning
None.
| Serious Effects |
["Known hypersensitivity to sodium tetradecyl sulfate or any component of the formulation","Acute thromboembolic disease","Severe peripheral arterial disease","Valvular incompetence of the deep venous system","Uncontrolled systemic disease (e.g., diabetes, thyroid disorders)","Local infection or inflammation at the injection site"]
| Precautions | ["Anaphylactic shock and severe allergic reactions have been reported.","Intra-arterial injection can cause severe necrosis or ischemia.","Extravasation may cause pain and tissue necrosis.","Use caution in patients with underlying arterial disease or hypercoagulable states.","Thromboembolic events including deep vein thrombosis and pulmonary embolism have been reported."] |
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| Fetal Monitoring | No specific fetal monitoring required. Monitor maternal injection sites for extravasation, allergic reactions, and thromboembolic events. Assess for signs of anaphylaxis or pulmonary embolism. |
| Fertility Effects | No known effects on fertility in animal studies. Human data lacking. Unlikely to impact reproductive function due to local administration. |