A topical combination product containing Benzyl Nicotinate, a vasodilator and counter-irritant, and Heparin, an anticoagulant and anti-inflammatory agent. It is primarily used in the Indian market for the symptomatic relief of superficial thrombophlebitis, hematoma, and traumatic swelling. The combination aims to reduce inflammation, improve local blood flow, and prevent clot extension.
Adult: Apply a thin layer of gel/cream to the affected area, 3 to 4 times daily. Gently rub in until absorbed. The area of application should not exceed 5-10 cm in diameter per gram of product.
Note: For external use only. Wash hands before and after application. Apply to clean, dry, intact skin. Do not apply on mucous membranes, eyes, or open wounds. Do not cover with occlusive dressings unless advised by a doctor. A mild, transient warming and reddening of the skin is normal.
The combination works via two complementary mechanisms. Benzyl Nicotinate is hydrolyzed on the skin to release nicotinic acid, which acts as a direct vasodilator on cutaneous capillaries and arterioles, increasing local blood flow (hyperemia). This helps resolve edema and improves tissue oxygenation. Heparin, a mucopolysaccharide, exerts potent local anti-inflammatory and anti-exudative effects by binding to antithrombin III (inhibiting thrombin and factor Xa), neutralizing inflammatory mediators (like bradykinin and histamine), and reducing capillary permeability. It also helps prevent the extension of microthrombi in superficial vessels.
Pregnancy: Category C (US FDA). No well-controlled studies in pregnant women. Use only if clearly needed and potential benefit justifies potential risk to the fetus. Systemic absorption is minimal.
Driving: No effect on driving ability. The medication is for topical use only.
| Oral Anticoagulants (Warfarin, Acenocoumarol) | Potential increased risk of bleeding if applied to large areas or broken skin. Monitor INR. | Moderate |
| Direct Oral Anticoagulants (Dabigatran, Rivaroxaban, Apixaban) | Theoretical additive risk of bleeding. Caution advised. | Moderate |
| Anti-platelet drugs (Aspirin, Clopidogrel) | Possible increased risk of local bruising or bleeding. | Mild |
| Topical Corticosteroids | May alter skin integrity and increase systemic absorption. Sequential use not recommended without gap. | Mild |
| Nicotinic Acid (systemic) | Additive vasodilatory effects possible. | Mild |
Same composition (Benzyl Nicotinate (2.0mg) + Heparin (50IU)), different brands: