Venixxa: Micronized Purified Flavonoid Fraction for Post-Thrombotic Syndrome
Venixxa is a micronized purified flavonoid fraction (MPFF) medication used to treat post-thrombotic syndrome (PTS), a chronic condition that develops in up to 50% of patients following deep vein thrombosis. 1
Mechanism of Action and Composition
Venixxa contains micronized purified flavonoid fraction, which belongs to the class of venoactive drugs. These medications work by:
- Improving venous tone
- Reducing venous inflammation
- Decreasing capillary permeability
- Improving lymphatic drainage
Clinical Application
Indications
- Post-thrombotic syndrome (PTS) characterized by:
- Leg heaviness
- Cramps
- Pain
- Edema
- Villalta score ≥5 1
Dosing
- Standard dosage: 1000 mg daily 1
- Duration: Typically administered for at least 6 months
Efficacy
- Used as an adjunctive therapy to standard PTS treatments (such as compression stockings)
- Primary outcome measure is improvement in Villalta score, defined as:
- Decrease of at least 30% in Villalta score, OR
- Achievement of Villalta score <5 in the affected leg 1
Important Considerations
Drug Interactions
Unlike direct oral anticoagulants (DOACs) such as rivaroxaban, apixaban, or edoxaban, Venixxa is not known to have significant interactions with CYP3A4 inhibitors or inducers that would require dose adjustments.
Contraindications
- The available evidence does not specifically mention contraindications for Venixxa
- Standard precautions for venoactive medications should be observed
Safety Profile
- Generally well-tolerated
- Does not appear to have the bleeding risks associated with anticoagulants
- No specific impact on immune defense has been documented
Clinical Pearls
- Venixxa should be considered as an adjunctive therapy to compression stockings in patients with symptomatic PTS
- Unlike anticoagulants (such as rivaroxaban, apixaban, or edoxaban), Venixxa is not used for the prevention or treatment of acute venous thromboembolism
- Venixxa addresses the chronic inflammatory and vascular changes that occur after DVT rather than preventing new clot formation
- Patient quality of life is an important secondary outcome measure when using this medication 1
Common Pitfalls
- Do not confuse Venixxa (micronized purified flavonoid fraction) with Venclexta/venetoclax (a BCL-2 inhibitor used in hematologic malignancies) 2
- Venixxa is not an anticoagulant and should not be used as a substitute for appropriate anticoagulation therapy when indicated
- Treatment of PTS requires a comprehensive approach, with Venixxa being one component alongside compression therapy and other supportive measures