Supplement
Diosmin is a citrus-derived flavonoid that helps veins keep their tone and may calm inflammation and leakage in small vessels. People mostly look at it for vein problems, and the evidence is strongest for chronic venous insufficiency, where trials found less leg swelling and eased pain, heaviness and fatigue. Much of that work tested flavonoid blends containing diosmin, and a large review found little difference in quality of life.
- Updated
- How we grade
- 8 studies cited
- Best evidence
- Grade A
- Conditions studied
- 3
- Outcomes
- 6
- Graded outcomes
- 3300
Evidence by condition
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| 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. | Improves (the measure goes up) | Moderate effect | ||||
| 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. | Improves (the measure goes down) | Moderate effect | ||||
| 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). | Improves (the measure goes up) | Small effect | ||||
| 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. | Improves (the measure goes up) | Moderate effect |
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| 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. | Improves (the measure goes down) | Moderate effect |
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| 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. | Improves (the measure goes up) | Small effect |
Key findings
- Leg Edema ReductionImproves (the measure goes up)
- Chronic Venous Insufficiency SymptomsImproves (the measure goes down)
- Hemorrhoid SymptomsImproves (the measure goes down)
Safety notes in the studies
- Cochrane meta-analysis: Phlebotonics probably increase adverse events slightly vs placebo (RR 1.14, 95% CI 1.02-1.27).
Studies cited
8 studies from PubMed
- Phlebotonics for venous insufficiency
- Efficacy of micronized purified flavonoid fraction (Daflon) on improving individual symptoms, signs and quality of life in patients with chronic venous disease: a systematic review and meta-analysis of randomized double-blind placebo-controlled trials
- Recommendations for the medical management of chronic venous disease: The role of Micronized Purified Flavanoid Fraction (MPFF)
- Therapeutic potential of micronized purified flavonoid fraction (MPFF) of diosmin and hesperidin in treatment chronic venous disorder
- Flavonoids for treating venous leg ulcers
- Micronised purified flavonoid fraction: a review of its use in chronic venous insufficiency, venous ulcers and haemorrhoids
- From symptoms to leg edema: efficacy of Daflon 500 mg
- Clinical benefits of Daflon 500 mg in the most severe stages of chronic venous insufficiency