Sulodexide

Sulodexide, traded as Aterina, is a highly purified mixture of glycosaminoglycans composed of low molecular weight heparin (80%) and dermatan sulfate (20%).

Sulodexide
Clinical data
AHFS/Drugs.comInternational Drug Names
Routes of
administration		Oral, Subcutaneous, Intravenous, Intramuscular
ATC code
Identifiers
IUPAC name
  • Glucurono-2-amino-2-deoxyglucoglucan sulfate
CAS Number
DrugBank
UNII
KEGG
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Pharmacology

The low molecular weight of both sulodexide fractions allows for extensive oral absorption compared to unfractionated heparin. The pharmacological effects of sulodexide differ substantially from other glycosaminoglycans and are mainly characterized by a prolonged half-life and reduced effect on global coagulation and bleeding parameters.[1] Due to the presence of both glycosaminoglycan fractions, sulodexide potentiates the antiprotease activities of both antithrombin III and heparin cofactor II simultaneously.[2]

Uses

Clinically, sulodexide is used for the prophylaxis and treatment of thromboembolic diseases; however, recent research has also demonstrated the beneficial effects of sulodexide in animal models of reperfusion injury[3] and the treatment of diabetic nephropathy.[4][5][6] In combination with melatonin, sulodexide has been shown to be a viable treatment option for patients suffering from central or sensorineural tinnitus.[7][8] There have also been positive results in treating tinnitus using sulodexide as a monotherapy.[9] Soludexide has also been effectively used in the treatment of chronic venous disease.[10]

References
  1. Lauver DA, Lucchesi BR (2006). "Sulodexide: a renewed interest in this glycosaminoglycan" (PDF). Cardiovascular Drug Reviews. 24 (3–4): 214–26. doi:10.1111/j.1527-3466.2006.00214.x. PMID 17214598.
  2. Harenberg J (1998). "Review of pharmacodynamics, pharmacokinetics, and therapeutic properties of sulodexide". Med Res Rev. 18 (1): 1–20. doi:10.1002/(SICI)1098-1128(199801)18:1<1::AID-MED1>3.0.CO;2-4. PMID 9436179.
  3. Lauver DA, Booth EA, White AJ, Poradosu E, Lucchesi BR (2005). "Sulodexide attenuates myocardial ischemia/reperfusion injury and the deposition of C-reactive protein in areas of infarction without affecting hemostasis". J Pharmacol Exp Ther. 312 (2): 794–800. doi:10.1124/jpet.104.075283. PMID 15365091.
  4. Achour A, Kacem M, Dibej K, Skhiri H, Bouraoui S, El May M (2005). "One year course of oral sulodexide in the management of diabetic nephropathy". J Nephrol. 18 (5): 568–574. PMID 16299683.
  5. Gambaro G, Venturini AP, Noonan DM, et al. (1994). "Treatment with a glycosaminoglycan formulation ameliorates experimental diabetic nephropathy". Kidney Int. 46 (3): 797–806. doi:10.1038/ki.1994.335. PMID 7527876.
  6. Škrha J, Perušičová J, Pont'uch P, Okša A, et al. (1997). "Treatment with a glycosaminoglycan formulation ameliorates experimental diabetic nephropathy". Diabetes Res Clin Practice. 38 (1): 25–31. doi:10.1016/S0168-8227(97)00076-4. PMID 9347243.
  7. Neri G, Baffa C, De Stefano A, et al. (2009). "Management of tinnitus: oral treatment with melatonin and sulodexide". J. Biol. Regul. Homeost. Agents. 23 (2): 103–10. PMID 19589291.
  8. Neri G. De Stefano A. Baffa C. Kulamarva G. Di Giovanni P. Petrucci G. Poliandri A. Dispenza F. Citraro L. Croce A. ,"Treatment of central and sensorineural tinnitus with orally administered Melatonin and Sulodexide: personal experience from a randomized controlled study." Acta Otorhinolaryngologica Italica. 29(2):86-91, 2009 Apr.
  9. El Beaino, Marc; McCaskey, Meghan K.; Eter, Elie (1 May 2018). "Sulodexide Monotherapy in Chronic Idiopathic Subjective Tinnitus: A Randomized Controlled Trial". Otolaryngology–Head and Neck Surgery. SAGE Publications. 158 (6): 1107–1112. doi:10.1177/0194599818767618. ISSN 0194-5998.
  10. Andreozzi, Giuseppe Maria (April 2012). "Sulodexide in the Treatment of Chronic Venous Disease:". American Journal Cardiovascular Drugs. 12 (2): 73–81. doi:10.2165/11599360-000000000-00000. ISSN 1175-3277.
  • sulodexide at the US National Library of Medicine Medical Subject Headings (MeSH)


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