Diosmin

Diosmin is a citrus flavonoid glycoside used for chronic venous insufficiency and hemorrhoids. Typically formulated as micronized purified flavonoid fraction (MPFF; Daflon) containing 90% diosmin and 10% hesperidin. Cochrane meta-analysis (56 RCTs, n=7690): Phlebotonics including diosmin reduced leg edema (RR 0.70) and ankle circumference (-4.27mm) vs placebo. Systematic review for hemorrhoids (22 RCTs, n=2335): MPFF improved post-hemorrhoidectomy outcomes, reduced bleeding rate, pain score, and edema. MPFF is the only venoactive drug recommended in CVD guidelines with Grade 1B evidence. Mechanism involves venous tone improvement, lymphatic drainage enhancement, and microcirculation protection.

Quick Answer

What it is

Diosmin is a citrus flavonoid glycoside used for chronic venous insufficiency and hemorrhoids. Typically formulated as micronized purified flavonoid fraction (MPFF; Daflon) containing 90% diosmin and 10% hesperidin.

Key findings

  • Grade A: Leg Edema Reduction (Chronic Venous Insufficiency)
  • Grade A: Chronic Venous Insufficiency Symptoms (Chronic Venous Insufficiency)
  • Grade A: Hemorrhoid Symptoms (Hemorrhoids)

Safety

  • Cochrane meta-analysis: Phlebotonics probably increase adverse events slightly vs placebo (RR 1.14, 95% CI 1.02-1.27).
ℹ️ Quick Facts: Diosmin

Quick Facts: Diosmin

  • Best Evidence:Grade A
  • Conditions Studied:3
  • Research Outcomes:6
  • Grade A Findings:3
  • Grade B Findings:3
  • Key Effect:Chronic Venous Insufficiency
Outcomes by grade:
A3
B3
C0
D0
3 conditions · 6 outcomes

Detailed Outcomes

|
A
Leg Edema Reduction
Cochrane meta-analysis (56 RCTs, n=7690, 2020): Phlebotonics including diosmin/MPFF reduced lower leg edema (RR 0.70, 95% CI 0.63-0.78) and ankle circumference (MD -4.27mm, 95% CI -5.61 to -2.93) vs placebo. Moderate-certainty evidence.
moderateImproves
A
Chronic Venous Insufficiency Symptoms
Systematic review and meta-analysis: MPFF (Daflon) highly effective in improving leg symptoms including pain, heaviness, fatigue, paresthesia. MPFF is the only venoactive drug with Grade 1B recommendation in international CVD guidelines.
moderateWorsens
B
Quality of Life in CVD
RCT for low-dose diosmin: Improved symptoms and quality of life in CVD patients. However, Cochrane meta-analysis found phlebotonics probably make little or no difference in QoL compared with placebo (moderate-certainty evidence).
smallImproves
B
Safety Profile
Cochrane meta-analysis: Phlebotonics probably increase adverse events slightly vs placebo (RR 1.14, 95% CI 1.02-1.27). GI disorders most common. Generally well-tolerated for short-term use. Long-term safety data limited.
moderateImproves
A
Hemorrhoid Symptoms
Meta-analysis (22 RCTs, n=2335): MPFF improved clinical efficacy post-hemorrhoidectomy, reduced bleeding rate (0.9% vs 6.1%, p=0.03), pain score, and edema score. Dose: 3000mg/day for 3 days then 1500mg/day for 4 days.
moderateImproves
B
Venous Ulcer Healing
Meta-analysis (5 trials): MPFF may hasten healing of venous leg ulcers. Effect demonstrated in ulcers 5-10cm² and present 6-12 months. Cochrane review: Low-certainty evidence for ulcer healing benefit.
smallImproves

Research Citations (10)

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