heparinoid: clinical use

Prescribing considerations

• Confirm that suspected superficial thrombophlebitis does not require investigation or systemic management for venous thromboembolism.
• Restrict use to intact, localised skin and explain the serious fire risk from residue on fabrics.
• Review persistent or worsening symptoms and reconsider the diagnosis.

Contraindications and cautions

• Hypersensitivity to heparinoid or any formulation component
• Broken skin, large skin areas, sensitive sites or mucous membranes
• Children under 5 years

Monitoring

• No routine laboratory monitoring is specified for topical use.
• Assess symptom progression, local skin tolerability and features suggesting deep-vein thrombosis or pulmonary embolism.

Clinical pharmacology

Mucopolysaccharide polysulphate has weak anti-inflammatory, anticoagulant, urokinase-potentiating thrombolytic and hyaluronidase-inhibiting anti-exudative activity. Systemic absorption through the skin is low and below the threshold considered physiologically relevant to coagulation.

Formulation and product differences

• Cream is massaged into the skin and contains lanolin, cetostearyl alcohol and paraben preservatives that may cause local or delayed reactions.
• Gel is a colourless, alcohol-based preparation containing propylene glycol and may be preferable when a cooling formulation is wanted.