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Sodium Tetradecyl Sulfate for Sclerotherapy Treatment of Veins: Is Compounding Pharmacy Solution Safe?

OBJECTIVE The objective was to determine the composition of three available solutions of sodium tetradecyl sulfate from compounding pharmacies in comparison to pharmaceutical-grade sodium tetradecyl sulfate, Fibrovein (STD Pharmaceuticals, Ltd.). METHODS Solutions of 3% sodium tetradecyl sulfate were obtained from three compounding pharmacies. An analysis of their composition was performed. RESULTS All samples of 3% sodium tetradecyl sulfate obtained had a different concentration of sodium tetradecyl sulfate than that stated on the bottle (range, 2.59%–3.39%). Significant concentrations of the contaminant carbitol were present in samples from all three sources (0.33%–4.18%). CONCLUSION The production of 3% sodium tetradecyl sulfate by these three compounding pharmacies appears to occur by simple dilution of a 27% industrial detergent solution that is not manufactured for use in humans. Physicians need to be aware that the stated concentration may not be correct and that along with sodium tetradecyl sulfate, potentially harmful contaminants may be present in the solution.