Table 4.

Summary of commonly used agents

Agent	Mechanism of action	Standard dose	Adverse effects
Ethanol	Endothelial denudation and thrombosis	1 mL/kg, most studies have max of 10–20 mL	Skin necrosis, tachycardia, DVT, PE, pain
Bleomycin	DNA damage. Lipid peroxidation, non-specific inflammatory reaction	1 mg/kg up to 15 mg	Skin pigmentation, fever, mucositis, pulmonary toxicity (rare)
Sodium tetradecyl sulfate	Detergent resulting in lipid damage in vessel wall, inflammatory reaction	0.5–2 mL of 3% solution	Pain, edema, ecchymosis, nerve injury
Ethanolamine oleate	Fatty acid emulsion inducing endothelial damage and thrombosis	2 mL of 50 mg/mL solution	Skin ulceration and necrosis
Pingyangmycin	DNA damage. Lipid peroxidation, non-specific inflammatory reaction	8 mg in a 2 mg/mL solution	Atrophy of subcutaneous tissues, fever, swelling, anaphylactic shock
OK-432	Natural killer cell activator resulting in inflammation and endothelial permeability	0.1 mg dried cocci in 10 mL of normal saline	Fever, pain, edema, inflammation
Doxycycline	Inhibition of matrix metalloproteins and VEGF > decreased angiogenesis	10–20 mg/kg	Severe pain on injection

DVT, deep vein thrombosis; PE, pulmonary embolism; VEGF, vascular endothelial growth factor.