Background: Polidocanol is approved for its competence in the treatment of varicose
veins and spider veins; however, unfortunately, many of its off-label uses are still underappreciated.
Objective: Lack of an appropriate comprehensive review for off-label uses of this medication troubles
physicians about making evidence-based decisions on prescribing it for its various outstanding
off-label uses. This article attempts to provide physicians with the latest information concerning
successful and unsuccessful use of polidocanol as an alternative treatment for esophageal and gastric
varices, tendinopathy and epicondylitis, vascular malformations, varicocele, hydrocele and
spermatocele, aneurysmal bone cysts, itching, management of gastrointestinal bleeding, simple
renal cysts, reducing the incidence and severity of radio-induced dermatitis and hemorrhoids.
Method: The two databases of MEDLINE and Cochrane Library were searched for all human English
studies, published in January 2006 to November 2017, which contained the keyword of “polidocanol”
or its alternative MeSH terms.
Results: Our search identified a total number of 597 articles. Those articles that were only discussing
the approved uses of polidocanol were excluded and the remaining 116 articles were reviewed.
Eleven major and 30 minor off-label uses were found within included studies.
Conclusion: Numerous successful administrations of this drug in a variety of clinical conditions
lead to promising perspectives toward it. Sclerotherapy with polidocanol as a minimal-invasive
method (having similar outcomes like the prevalent surgeries) may reduce the rate of complications.
Furthermore, for determining the most appropriate method and dosage, randomized clinical trials
are needed, confirming and providing more clear instructions for different conditions.