Interní Med. 2018; 20(5): 227-232 | DOI: 10.36290/int.2018.040

Pharmacotherapy of the symptoms of chronic venous insufficiency

doc. MUDr. Jana Hirmerová, Ph.D.

II. interní klinika LF UK a FN Plzeň

The main pathogenetic mechanisms of chronic venous insufficiency are increased venous pressure and impaired venous outflow.Objective signs of the disorder include varices, oedema, skin changes and, in the most advanced stage, leg ulcer. Subjectivesymptoms are represented by various complaints about discomfort in the legs, typically worsening after long standing orsitting, in hot weather or in the evening. The treatment should be complex and consists of regime measures and physiotherapy,compression therapy, surgical and endovascular methods, and pharmacotherapy. In this indication, medicinal productsfrom a heterogeneous group of venoactive drugs are being used. They are mainly of plant origin (flavonoids, saponins andother), some of them also semi-synthetic or synthetic (calcium dobesilate). Venoactive drugs act by increasing venous tone,improving capillary permeability, enhancing lymphatic drainage, they exert haemorheologic and antiinflammatory effectsas well. The guidelines for their use are based on the results of meta-analyses, systematic reviews and consensus statements.Most convincing data are available for the efficacy and safety of micronized purified flavonoid fraction. In the stage of venousulcer, sulodexid and pentoxiphyllin has proven benefit as well. Venoactive drugs are recommended for the management ofsymptomatic chronic venous insufficiency in all stages.

Keywords: chronic venous insufficiency, venoactive drugs, guidelines

Published: December 1, 2018  Show citation