From the Research
Sulodexide 250 LSU once daily may be a reasonable add-on therapy for your 65-year-old aunt with chronic venous insufficiency, but I strongly recommend consulting her physician before starting this medication, considering her existing hypertension and antiplatelet therapy with Plavix (clopidogrel). The most recent and highest quality study, published in 2020 1, suggests that sulodexide decreases the intensity of pain, cramps, heaviness, oedema, and total symptom score, and reduces inflammatory mediators in patients with chronic venous disease. However, it is crucial to weigh the benefits of sulodexide against potential risks, especially the increased bleeding risk associated with concomitant use of antiplatelet medications like Plavix.
For chronic venous insufficiency management, it is essential to encourage non-pharmacological approaches, such as:
- Elevating her legs regularly
- Wearing compression stockings during the day
- Maintaining a healthy weight
- Staying physically active with appropriate exercises like walking
These approaches are the cornerstone of treatment and can help alleviate symptoms like leg pain, swelling, and skin changes. Sulodexide works by improving vascular endothelial function and reducing inflammation in blood vessels, which may help alleviate symptoms of chronic venous insufficiency. However, its benefits should be carefully evaluated against potential risks, especially considering her existing medical conditions and medications.
It is also important to note that the evidence for sulodexide's efficacy and safety is mostly based on studies with patients who do not have concomitant antiplatelet therapy, and therefore, close monitoring and careful evaluation by her physician are necessary before starting sulodexide. The study published in 2020 1 found that sulodexide was associated with a low risk of adverse events, but the overall quality of evidence for adverse events is very low due to risk of bias and imprecision.
In conclusion, while sulodexide may be a beneficial add-on therapy for your aunt's chronic venous insufficiency, it is essential to consult her physician before starting this medication to carefully evaluate the potential benefits and risks, especially considering her existing hypertension and antiplatelet therapy.