Tetradecyl hydrogen sulfate (ester)



Tetradecyl hydrogen sulfate (ester) is an anionic surfactant used to treat small uncomplicated varicose veins.

Brand Names
Generic Name
Tetradecyl hydrogen sulfate (ester)
DrugBank Accession Number

Sodium tetradecyl sulfate is an anionic surface-active agent which is used for its wetting properties in the industry and is also used in medicine as a blood vessel irritant and sclerosing agent for hemorrhoids and varicose veins 2.

Sodium tetradecyl sulfate has been widely used since the 1950s, and in 1978 the first successful report of injecting a 1% solution into spider angiomas in 144 patients was made. Also noted was an unspecified number of episodes of epidermal necrosis without significant long-term effects and a 30% incidence of post-sclerosis pigmentation that resolved within a few months 3.

Small Molecule
Average: 294.45
Monoisotopic: 294.18648062
Chemical Formula
  • 7-Ethyl-2-methyl-4-undecanol sulfate
  • Tetradecyl hydrogen sulfate



Sotradecol (sodium tetradecyl sulfate injection) is indicated in the treatment of small, uncomplicated varicose veins of the legs showing simple dilation, with competent valves 1.

Sodium tetradecyl sulfate has been designated as an orphan drug by the FDA for the treatment of gastrointestinal bleeding due to esophageal varices 8.

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Associated Conditions
Indication TypeIndicationCombined Product DetailsApproval LevelAge GroupPatient CharacteristicsDose Form
Treatment ofGastrointestinal bleeding••••••••••••
Treatment ofUncomplicated competent valves, simple dilation varicose veins of legs••••••••••••
Contraindications & Blackbox Warnings
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Telangiectasias or varicose veins occur in about 33% of adult women and about 15% of adult men. Sclerotherapy with sotradecol is widely used in the treatment of varicose veins 7.

Sotradecol (sodium tetradecyl sulfate injection) is a sclerosing agent. Intravenous (IV) injection of this agent causes blood vessel intima inflammation and thrombus formation. This normally occludes the injected vein, leading to a series of events. Subsequent formation of fibrous tissue results in partial or complete vein obliteration that may be temporary or permanent 1.

Mechanism of action

When injected directly into a vein, sodium tetradecyl sulfate causes intimal inflammation and venous thrombus formation, which then results in occlusion of the vein. Following this sequence of events, fibrous tissue forms and causes partial to complete obliteration of the vein, which may be temporary or permanent. An important role of this drug, as well as other sclerosing agents, is to control active hemorrhage and encourage hemostasis. This may be due to the esophageal and vascular smooth muscle spasm induced by the sclerosing agent 5.

During acute and active bleeding, the sodium tetradecyl sulfate injected directly into the esophageal varices may dissipate rapidly, as the varices have a much higher blood volume/flow rate and no functioning valves 5.

The mechanical compression effect of submucosal edema, created by the injection of sclerosing agents, may also be responsible for acute hemostasis 5.

AEndothelial protein C receptor

Not Available

Volume of distribution

In humans, a large proportion (75%) of an injected dose of radiolabelled 3% sodium tetradecyl sulfate rapidly disappeared from the empty varicose vein injection site into communicating blood vessels with rapid entry into the deep veins of the calf 9.

In rats, at 72 hours after intravenous dosing of radiolabelled sodium tetradecyl sulfate, tissue levels of radiolabelled matter found in sample tissues (liver, kidney, lipid and skeletal muscle) were measured as very low. Although there was some evidence of radiolabel associated with the injection site, the levels were negligible 9.

Protein binding

Not Available

Not Available
Route of elimination

After an intravenously administered radiolabelled dose, 70% of the drug was recovered in the urine of rats within 24 hours post-dosing 9.

At the end of the 72 hour post-dose period, 73.5% of the radiolabel had been recovered from the urine and 18.2% recovered from the faeces 9.


Not Available


Not Available

Adverse Effects
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The intravenous LD50 of sodium tetradecyl sulfate in mice is 90 ± 5 mg/kg 1.

In the rat, the acute intravenous LD50 of sodium tetradecyl sulfate is estimated at 72 mg/kg and 108 mg/kg 1.

Adverse events are below:

Deep venous thrombosis

Because of the risk of deep vein thrombosis, patients must be evaluated for valvular competency and deep venous patency before treatment is initiated and slow injections of a small volume (< 2 mL) should be injected. It is recommended that patients be monitored post-treatment for both deep vein thrombosis and pulmonary embolism 12.

Air embolism

Stroke, transient ischemic attack, myocardial infarction, and impaired cardiac function have been associated with tetradecyl sulfate administration. Such sequelae may be caused by air embolism 5.

Local reaction

Local reactions including pain, itching or ulceration at the site of injection with permanent discoloration may remain along the path of the treated/sclerosed vein segment. Sloughing and/or necrosis of surrounding tissue may occur following extravasation from the injection site 1.

Allergic reactions

Hives, asthma, hay fever and anaphylactic shock have been reported with use of this drug 1.

*Mild systemic reactions *

Headache, nausea and vomiting 1.

Death A minimum of 6 deaths have reported with the use of Sotradecol. Four incidences of anaphylactic shock resulting in death have been reported in patients who received this drug 1.

One death has been reported in a patient who received Sotradecol while receiving an anti-ovulatory agent 1

Another death (from lethal pulmonary embolism) has been reported in a 36-year-old female treated with sodium tetradecyl acetate and was not taking oral contraceptive therapy 1

Not Available
Pharmacogenomic Effects/ADRs
Not Available


Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
AbacavirAbacavir may decrease the excretion rate of Tetradecyl hydrogen sulfate (ester) which could result in a higher serum level.
AceclofenacAceclofenac may decrease the excretion rate of Tetradecyl hydrogen sulfate (ester) which could result in a higher serum level.
AcemetacinAcemetacin may decrease the excretion rate of Tetradecyl hydrogen sulfate (ester) which could result in a higher serum level.
AcetaminophenAcetaminophen may decrease the excretion rate of Tetradecyl hydrogen sulfate (ester) which could result in a higher serum level.
AcetazolamideAcetazolamide may increase the excretion rate of Tetradecyl hydrogen sulfate (ester) which could result in a lower serum level and potentially a reduction in efficacy.
Food Interactions
No interactions found.


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International/Other Brands
Fibro-vein (Australasian Medical and Scientific Limited) / Fibro-Vein 3% (STD) / Fibrovein (Craveri) / Veinfibro (STD Pharmaceutical Products)
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
(sotradecol) Sodium Tetradecyl SulfateInjection, solution30 mg/1mLIntravenousHF Acquisition Co LLC, DBA HealthFirst2021-06-25Not applicableUS flag
Sodium Tetradecyl SulfateInjection, solution10 mg/1mLIntravenousHF Acquisition Co LLC, DBA HealthFirst2021-07-18Not applicableUS flag
SotradecolInjection, solution10 mg/1mLIntravenousAngiodynamics2004-12-012015-09-30US flag
SotradecolInjection, solution10 mg/1mLIntravenousMylan Institutional LLC2013-04-29Not applicableUS flag
SotradecolInjection, solution30 mg/1mLIntravenousMylan Institutional LLC2013-04-29Not applicableUS flag


Drug Categories
Not classified
Affected organisms
  • Humans and other mammals

Chemical Identifiers

CAS number
InChI Key
[(7-ethyl-2-methylundecan-4-yl)oxy]sulfonic acid


General References
  1. SOTRADECOL- tetradecyl hydrogen sulfate (ester) injection, solution [Link]
  2. Sotradecol, PubChem [Link]
  3. Sodium tetradecyl sulfate [Link]
  4. Sodium Tetradecyl Sulfate [Link]
  5. PDR Sotradecol [Link]
  6. Evaluation of sodium tetradecyl sulfate and polidocanol as sclerosants for leg telangiectasia based on histological evaluation with clinical correlation [Link]
  7. Anaphylactoid Reaction After the Use of Sodium Tetradecyl Sulfate: A Case Report [Link]
  8. Drug Approval Package [Link]
  9. NZ Drug Safe Fibrovein [Link]
  10. Intralesional 3% Sodium Tetradecyl Sulfate for Treatment of Cutaneous Kaposi's Sarcoma [Link]
  11. Sodium tetradecyl sulfate actions [Link]
  12. Sotradecol [Link]
Download (253 KB)

Clinical Trials

Clinical Trials
Clinical Trial & Rare Diseases Add-on Data Package
Explore 4,000+ rare diseases, orphan drugs & condition pairs, clinical trial why stopped data, & more. Preview package
PhaseStatusPurposeConditionsCountStart DateWhy Stopped100+ additional columns
4Active Not RecruitingTreatmentVenous Malformations1somestatusstop reasonjust information to hide
4CompletedTreatmentVaricosities of the great saphenous vein1somestatusstop reasonjust information to hide
4WithdrawnTreatmentSuperficial Venous Insufficiency, Varicose Veins1somestatusstop reasonjust information to hide


Not Available
Not Available
Dosage Forms
Injection, solutionIntravenous10 mg/1mL
Injection, solutionIntravenous30 mg/1mL
Injection, solutionParenteral0.2 %
Injection, solutionParenteral0.5 %
Injection, solutionParenteral1 %
Injection, solutionParenteral3 %
Not Available
Not Available


Not Available
Experimental Properties
melting point (°C)199MSDS
Predicted Properties
Water Solubility0.0104 mg/mLALOGPS
pKa (Strongest Acidic)-1.1Chemaxon
Physiological Charge-1Chemaxon
Hydrogen Acceptor Count3Chemaxon
Hydrogen Donor Count1Chemaxon
Polar Surface Area63.6 Å2Chemaxon
Rotatable Bond Count11Chemaxon
Refractivity77.77 m3·mol-1Chemaxon
Polarizability33.53 Å3Chemaxon
Number of Rings0Chemaxon
Rule of FiveNoChemaxon
Ghose FilterYesChemaxon
Veber's RuleNoChemaxon
MDDR-like RuleNoChemaxon
Predicted ADMET Features
Not Available


Mass Spec (NIST)
Not Available
SpectrumSpectrum TypeSplash Key
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSsplash10-0002-4930000000-40ee004ed0ce1c09d253
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSsplash10-0006-1090000000-2147066aeb5646debe1b
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSsplash10-0007-8090000000-4ce90d21cf3823810d67
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSsplash10-001d-9710000000-3ff81197b983f0b17d3d
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSsplash10-0002-9200000000-c0f097338ddb277602c3
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSsplash10-053s-9000000000-56b158c6df785e5701e4
Predicted 1H NMR Spectrum1D NMRNot Applicable
Predicted 13C NMR Spectrum1D NMRNot Applicable
Chromatographic Properties
Collision Cross Sections (CCS)
Not Available


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Pharmacological action
General Function
Receptor activity
Specific Function
Binds activated protein C. Enhances protein C activation by the thrombin-thrombomodulin complex; plays a role in the protein C pathway controlling blood coagulation.
Gene Name
Uniprot ID
Uniprot Name
Endothelial protein C receptor
Molecular Weight
26671.245 Da
  1. Sodium tetradecyl sulfate actions [Link]

Drug created at December 03, 2015 16:52 / Updated at February 13, 2021 10:52