Sulodexide and its antithrombotic effect - the use in a clinical practice, and combined treatment with other drugs affecting hemostasis
Abstract
Sulodexide is a glycosaminoglycan with pleiotropic effect - antithrombotic, endotelprotective, rheologic, and lipolytic. The use of sulodexide might be beneficial for the patients with periphery artery disease, chronic venous disease including leg ulcer (sulodexide is approved for the treatment of posttrombotic syndrome), vascular complications of diabetes; it looks promising also in the secondary prophylaxis of venous thrombosis.
The influence on and modulation of haemostasis consists of several mechanisms - inhibition of factor Xa, profibrinolytic effect, reduction of excessive fibrinogen level. However, no changes in global coagulation tests were mentioned after oral administration of sulodexide.
Caution is recommended for combining sulodexide with other drugs influencing haemostasis. Nevertheless, bleeding complications in clinical studies with sulodexide were not documented as frequent (haematoma in the injection site 1/10 000-1/1 000, stomach bleeding less than 1/10 000).
Several case reports from angiologic practice are mentioned demonstrating concomitant use of sulodexide with antiplatelets or anticoagulants without haemorrhagic events. Sulodexide seems to be an agent with excellent safety profile and low bleeding risk.