Phlebotonic drugs

The first type of drugs that we present to you are phlebotonic drugs  which are able to increase the tone of the walls of the veins, reducing swelling and the sense of fatigue in the legs and ankles.

In the pharmacy you can find the following products which we will describe to you shortly. They can be bought without a prescription as they are products

Arvenum®

Let’s begin by examining one of the first drugs of this type, namely Arvenum®, a medicine produced by the pharmaceutical company Istituto Farmaco Biologico Stroder Srl which is used to counteract the symptoms and problems caused by capillary fragility and venous insufficiency, including  hemorrhoids .

This ailment is quite widespread and is treated with Arvenum® 500 mg , which contains two flavonoids, namely hesperidin and  diosmin , which act by restoring venous tone, bringing relief.

The active ingredients exert a beneficial action on the health of the veins and capillaries, reducing the distensibility of the blood vessels and venous stagnation and reinforcing the capillary walls, avoiding their breakage and tissue blood spillage and the consequent appearance of bruises.

It is a SOP, i.e. a drug that does not require a prescription to be purchased: however, taking it in case of hemorrhoids requires a visit to the general practitioner.

Arvenum® is not loanable, therefore the cost is entirely borne by the patient. A pack of 30 tablets costs around 15 euros, or 27 euros for a pack of 60.

As far as contraindications are concerned, these are linked to individual hypersensitivity to the various active ingredients present in the formulation, or to the onset of allergies to one or more of the excipients.

However, possible interactions of the drug with the development of the fetus are not known, and it is advisable not to take it during pregnancy. The same goes for breastfeeding, as there are no certain data on the possible excretion of the drug in breast milk, with consequent ingestion by the child.

Daflon®

Daflon® contains the same flavonoids as the previous drug, and is used to counteract varicose veins, capillary fragility, phlebitic complications and in acute episodes of hemorrhoids.

This medicine combines two actions, as at the venous level it decreases distensibility and stasis, while at the microcirculation level it normalizes permeability, increasing capillary resistance.

Also in this case it is possible to buy the product without the need for a prescription, but it is always advisable to go to the doctor to assess the severity of the problem.

How is it taken? It depends on the problem we have to treat: if the disorder is capillary fragility, then you need to take 2 tablets a day with the main meals, while if the problem is hemorrhoids in the acute phase, you need to take 6 tablets a day. In any case, these tablets are also used as a preventive treatment for those who are subject to these episodes.

As regards pregnancy and breastfeeding, also in this case it is not recommended to take it, since the certain absence of risks for the child has not yet been fully demonstrated. Instead, no particular drug interactions have been declared.

However, if you are certain that you are hypersensitive to the active ingredients contained, it is advisable to avoid taking the product.

Instead, the side effects can be diarrhea, vomiting and nausea or digestive difficulties, but also skin rashes and itching.

You can buy it in pharmacies at a price of 14.28 euros for a pack of 30 tablets and 27 euros for a pack of 60 tablets.

Venoruton®

This drug is a vasoprotector and contains oxerutin, which is indicated for those with venous insufficiency due to varicose veins in the legs.

We find different formats in the pharmacy that we can buy:

• Venoruton® sachets 1000 mg granules for oral solution;
• Venoruton® film-coated tablets 500 mg;
• Venoluton® gel 2%;
• Venoruton® effervescent tablets 1000 mg and 500 mg.

Obviously it is assumed differently depending on the product purchased: the 1000 mg granulated sachets provide for the intake of up to 2-3 sachets a day. The gel is a product that can assist oral therapy with sachets or tablets, and should be applied to the affected area.

Instead, you must take 2-3 tablets a day, swallowed whole, while effervescent tablets require you to take 2 tablets a day.

Taking this product can cause side effects in some people, such as flatulence, abdominal cramps, diarrhea, nausea, itching and skin problems and rashes. Rarely, headaches, flushing and dizziness or tiredness may also appear.

Furthermore, it is not recommended to take it during pregnancy and while breastfeeding, while no interactions with other drugs or particular foods have been found, but for any doubt it is always better to ask your doctor.

The use of the product is recommended only for short periods of treatment, perhaps taking it in cycles during the year, always according to medical indications.

Flebinec®

This is a food supplement produced by the pharmaceutical company Biofutura Pharma SpA, and is also suitable for combating the problems of varicose veins, as it compensates for the lack of diosmin, troxerutin and hesperidin and therefore promotes circulation and lymphatic drainage.

In addition to these flavonoids, it also contains L-carnitine and sucralose.

The recommended dosage is one sachet a day to be taken on a full stomach, dissolved in a large glass of water.

It must be taken cyclically, for limited periods of time. If you want to take the product in larger doses and for prolonged periods, as always you need to consult and ask for the opinion of your doctor, above all to try to place the administration of Flebinec® in the context of a planned therapy.

As for contraindications, being a natural supplement, the side effects of this product are few if any.

However, it is inadvisable to take the sachets during pregnancy and breastfeeding, unless advised by the doctor. A pack of Flebinec® of 14 sachets costs 17 euros and you can buy it in pharmacies without a prescription.

Profibrinolytic drugs

Profibrinolytic drugs work by dissolving accumulations of fibrin, a plasma protein that participates in the formation of blood clots, accumulations that have formed due to vascular lesions such as varicose veins.

Streptase®

Streptase® contains streptokinase, active ingredients that are part of the profibrinolytic drugs we are talking about.

They enhance the fibrinolytic activity, acting on the clinical profile of the patient suffering from varicose vein disorder.

This drug is taken as a slow intravenous infusion: 250,000 units over 30 minutes, followed by 100,000 units every hour for 12 to 72 hours, depending on the severity of the disorder.

Obviously this infusion must be followed up by the doctor, who can check that there are no undesirable effects and who can suspend the treatment in case of contraindications.

Side effects that may arise are chills, fever or generalized exanthema, but also headaches, back pain, myalgia, gastrointestinal disturbances and vomiting. More rarely, problems of arterial hypotension and allergic reactions have been reported.

Sclerotherapy

Sclerotherapy is a type of therapeutic intervention which involves the injection of a substance into a pathological vein which destroys the injured vessel, facilitating the reabsorption of the fibrosis.

We can distinguish between:

• Simple sclerotherapy : also known as the “sight mode”. It involves the injection, through a very fine needle, of a liquid into the pathological vessel;
• Sclerotherapy with augmented reality: specific tools are used to increase the visibility of veins and capillaries that would not be seen under normal visual control;
• Echosclerosis : this therapy instead involves the use of an ultrasound, and thus guarantees more effectiveness in the sclerotherapy treatment of veins that are not directly accessible from the skin but which are located deep in the tissues.

Let’s see what drugs are administered.

sodium tetradecyl sulfate

This drug is administered, as anticipated, by injection, a slow infusion into an empty and isolated segment of a vein. The recommended dose can vary from 0.1 to 1 ml of solution up to 0.2%, depending on the condition of the varicose vein and its location.

Ethanolamine oleate

This drug is also administered by slow injection into a small portion of a vein, and the methods of administration vary according to the evaluation of the expert doctor on the severity of the clinical picture of the vein itself.

Laureth-9 

This drug is also to be used for slow intravenous injection, usually to treat varicose veins of the diameter:

• less than or equal to 1 mm. In this case the dosage usually recommended is 0.5%;
• between 1 and 3 mm: it is recommended to use the drug at 1%;

Finally, 0.1-0.3 mL per injection should be injected, and no more than 10 mL per session.

So let’s move on to anticoagulants.

Anticoagulants

These medicines are used to promote circulation in the presence of varicose veins, although there are some scholars who have doubts about it. In this group of drugs we find the heparinodes, which are used against varicose veins for their anticoagulant action. Here are two examples of drugs.

Sulfopolyglycano (es. Hirudoid®)

This is a drug available in cream or gel form, and is therefore applied topically, directly to the affected area.

In fact, it is used for:

• inflammation of a vein, to counteract superficial phlebitis, or a blood clot causing the inflammation (thrombophlebitis);
• inflammation caused by varicosis (widening of a vein);
• the hematomas.

There are no known interactions with other medicines or foods and no particular onset of side effects have been found, however it is not recommended to take it both during pregnancy and while breastfeeding, and also if you were taking other coagulants.

For the rest, 3-5 cm of cream must be applied 1-2 times a day for not too extensive inflammations, while the recommended dose is 25 cm of cream a day for 3-4 days, in case of larger inflammations.

Eparan sulphate (es. Clarema®)

Also in this case, since it is an anticoagulant, it is advisable not to take it in conjunction with other anticoagulants, unless under close observation by the doctor, whose advice is essential even if the patient is pregnant or breastfeeding, although no particular criticalities in these stages of life by taking this drug.

You need to take one tablet a day away from meals, or apply it to the skin if you use the product for topical use.

Possible side effects are nausea and various gastro-intestinal disorders and skin rashes. Its composition is as follows:

Natural medicines against varicose veins

If you want to prevent vein problems, or want to support drug treatments, then you can also resort to natural remedies.

Phytotherapy has been offering us a hand for the treatment of many ailments for years. If you have vein problems you can take advantage of the benefits of natural products such as:

• the horse chestnut;
• gotu kola;
• butcher’s broom;
• Red grapevine;
• Blackberry.

These plants exert a strong protective activity on the capillaries and also have a decongestant action. They are therefore effective in counteracting episodes of peripheral venous insufficiency and varicose veins.

It is obvious that these are preventive or adjuvant remedies, and are not intended as a substitute for a therapy established by the doctor, especially if the patient is affected by varicose veins in a more advanced stage.

Neglecting the problem could mean having to undergo surgery, in which the diseased venous portion is removed.

We must therefore not neglect every symptom and prevention, which is essential to keep the risks associated with this problem under control.

The doctor is, as always, the first ally for our health.