Micronized purified flavonoid fraction, «venoactive» agent
ATC code: C05CA53 (Diosmin, combinations (with hesperidin))
Brand names
Venosmine, Diosminol
Micronized purified flavonoid fraction: 90% diosmin and 10% hesperidin. Claimed in vitro effects: raised venous tone via adrenergic receptors, reduced capillary permeability, antioxidant and anti-inflammatory activity. Diosmin bioavailability in humans is low (gut microbiota metabolize it to active diosmetin). Evidence for hard clinical outcomes (ulcer healing, disease progression) is limited.
Adjunct
In hemorrhoidal flares, used short-term to reduce pain, bleeding, and edema. The Alonso-Coello 2006 meta-analysis of flavonoids in hemorrhoids showed relative risk of no response of 0.42 (95% CI 0.28–0.61). Acute dose: 6 tablets per day for 4 days, then 4 tablets per day for 3 days. Foundation therapy is stool optimization (fiber, hydration), topical care, and minimally invasive procedures for severe symptoms.
Sources
Adjunct
Used symptomatically for leg heaviness, edema, and pain in chronic venous insufficiency CEAP classes C0s–C3. Evidence is modest: the 2020 Cochrane meta-analysis of flavonoids showed moderate effect on pain and edema with low certainty. No effect has been described on hard outcomes (disease progression, venous ulcer healing) apart from a small effect on venous ulcer healing alongside compression. ESVS 2022 foundation therapy is compression and lifestyle change; diosmin/hesperidin does not replace them.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Avoid in T1 where possible due to limited data. Short courses in T2 and T3 are acceptable when indicated. For pregnancy venous symptoms, class 2 graduated compression stockings are first-line.
Limited data on milk excretion. Lactation use is not recommended without clear indication.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Diosmin/hesperidin is evaluated for the following indications with varying evidence strength: Hemorrhoidal disease (evidence tier C), Chronic venous insufficiency (evidence tier D). See the full indication matrix with dosing and citations above on this page.
Common side effects of Diosmin/hesperidin (≥ 1 in 100): Nausea, Epigastric pain, Diarrhea, Headache, Skin rash (rare). See the Safety section for uncommon and serious reactions.
FDA category C. Avoid in T1 where possible due to limited data. Short courses in T2 and T3 are acceptable when indicated. For pregnancy venous symptoms, class 2 graduated compression stockings are first-line.
Limited data on milk excretion. Lactation use is not recommended without clear indication.
Diosmin/hesperidin is contraindicated in: Hypersensitivity to diosmin, hesperidin, or excipients; Pregnancy in T1 (limited data). Full list in the Safety section.