*2.2.3.2. Indications*

Several clinical studies have demonstrated the efficacy of sulodexide in the treatment or prevention of vascular diseases associated with increased thrombotic risk, such as peripheral arterial occlusive diseases, post-myocardial infarction, recurrent DVT, and postthrombotic syndrome [42]. Other clinical applications are treatment of venous ulcers, cerebrovascular disorders, diabetic nephropathy, and other diabetic complications (nephropathy and macular edema).

### *2.2.3.3. Pharmacokinetics*

Sulodexide is available for both intravenous and intramuscular administration, but it can be taken also orally. By the oral route, Sulodexide is absorbed within 1–2 hours and behaves as a mono-compound, reaching the time to peak in about 4 hours with a dose of 50–100 mg. Similar concentrations are maintained at least up to 18 hours. The distribution volume is very large, due to a higher affinity of sulodexide for the extensive surface area of the endothelium rather than for plasma proteins. Metabolism is liver dependent and based on N-desulfation, while excretion is mostly kidney dependent [40, 43].
