Diosmin, 600 mg 30 pcs.

Pharmacodynamics

Diosmin is a benzpyron derivative. It belongs to the group of bioflavonoids. It has phlebotonic action (decreases venous distensibility, increases venous tone (dose-dependent effect), decreases venous congestion), improves lymphatic drainage (increases tone and frequency of contraction of lymph capillaries, increases their functional density, reduces lymphatic pressure), It improves microcirculation (increases capillary resistance (dose-dependent effect), decreases their permeability), reduces leukocyte adhesion to the venous wall and their migration into the paravenous tissue, improves oxygen diffusion and perfusion in the skin tissue, has anti-inflammatory effect.

It enhances vasoconstrictor effect of adrenaline and noradrenaline, blocks production of free radicals, synthesis of prostaglandins and thromboxane. It was shown that diosmin decreases plasma levels of enzymes responsible for metabolism of mucopolysaccharides in the venous wall.

In clinical trials diosmin decreased venous bed capacity and venous stasis volume (according to plethysmography), decreased average pressure in deep and superficial leg veins (according to ultrasound Dopplerography) and increased systolic and diastolic blood pressure in patients with postoperative orthostatic hypotension. Pharmacokinetics Absorption Rapidly absorbed from the gastrointestinal tract, detected in plasma 2 hours after administration. Bioavailability of diosmin after oral administration is approximately 40-57.9%.

Diosmin is transformed by intestinal microflora into diosmetin, hippuric acid and benzoic acid. Distribution Maximum concentration in plasma is reached 5 hours after intake. Diosmin is evenly distributed and accumulated in all layers of the wall of hollow veins and subcutaneous veins of lower limbs, to a lesser extent – in kidneys, liver, lungs and other tissues.

Distribution volume is 62.1 liters. Selective accumulation of diosmin and/or its metabolites in the venous vessels reaches a maximum by the ninth hour after administration and persists for 96 hours. Metabolism Diosmin is metabolized in the liver. The main metabolite is hydroxyphenylpropionic acid.

Metabolites of diosmin are excreted mainly by the kidneys in the form of conjugates with glucuronic acid.

Excretion 79% of ingested diosmin is excreted by kidneys, through the intestine – 11%, in the bile – 2.4%. Enterohepatic circulation of diosmin is observed. After intake of diosmin labeled with a radioactive isotope, about 86% is excreted by the kidneys and intestines within 48 hours.

Indications

Hemorrhoids, trophic ulcers, vascular eye disease, varicose veins in the complex therapy: to eliminate the symptoms of varicose veins of the lower limbs, to eliminate the symptoms of chronic lymphovenous insufficiency of the lower limbs: a feeling of heaviness or fatigue in the legs, pain, in violation of microcirculation to eliminate the symptoms of acute hemorrhoids.

Active ingredient

Diosmin

Directions for use

Use the drug only according to the indications, the route of administration and the doses given in the instructions. Before using the drug you should consult with your doctor.

The drug Diosmin is intended for oral administration. In varicose veins of the lower limbs and chronic lymphovenous insufficiency 1 tablet a day in the morning on an empty stomach is prescribed.

The therapy duration is usually 2 months. Under severe forms of chronic lymphovenous insufficiency (edemas, pain, cramps and so on) treatment may be longer (total duration of continuous therapy should not exceed 3-4 months). The courses of Diosmin treatment should be repeated in 2-3 months.

For chronic lymphovenous insufficiency during the II and III trimester of pregnancy the preparation is used 1 tablet once a day. The therapy duration is not more than 30 days.

It is necessary to stop taking the preparation 2-3 weeks before childbirth. If hemorrhoids worsen the drug is prescribed 2 to 3 tablets a day with food for 7 days. Further, if necessary, the drug may be continued on 1 tablet once a day for 1-2 months. In patients with microcirculatory disorders

The drug is prescribed 1 tablet a day in the morning on an empty stomach. The duration of therapy is usually 1-2 months. If one or more doses of the drug are missed, it is necessary to continue using the drug as usual and in the usual dose.

Special Instructions

Treatment of acute hemorrhoids is carried out in conjunction with other drugs. In case of absence of rapid clinical effect it is necessary to perform additional examination and adjust the therapy.

In case of venous circulation disorders (varicose veins of the lower extremities, chronic lymphovenous insufficiency of the lower extremities) the maximum effect of treatment is achieved by combination of therapy with lifestyle changes: it is advisable to avoid long standing upright positions, reduce excessive body weight.

In some cases wearing special stockings (compression stockings) improves blood circulation. If there is no reduction or if the symptoms of the disease become worse, consult a doctor.

Do not exceed the maximum periods and recommended doses of the drug without medical advice.

Contraindications

Hypersensitivity to the drug components; I trimester of pregnancy and breast-feeding (experience of use is limited); age under 18 years.

Side effects

Classification of side effect frequency according to the World Health Organization (WHO) recommendations: very common ≥ 1/10; common from ≥ 1/100 to < 1/10; infrequent from ≥ 1/1000 to < 1/100; rare from ≥ 1/10000 to < 1/1000; very rare < 1/10000, including individual reports; frequency is unknown – according to available data it is impossible to determine the incidence.

Gastrointestinal tract: frequently – nausea, vomiting, diarrhea, dyspeptic disorders, heartburn, constipation; infrequently – colitis.

Central nervous system: rarely – headache, malaise, dizziness.

Skin and subcutaneous fat: rare – skin rash, itching.

Allergic reactions: rare – urticaria, the frequency is unknown – isolated edema of the face, lips, eyelids, in exceptional cases – angioedema (Quincke’s edema).

If any of the side effects mentioned in the instructions are aggravated, or if you notice any other side effects not specified in the instructions, inform the doctor.

Overdose

Symptoms Symptoms of overdose are not described.

Given the wide therapeutic range of diosmin, the risk of intoxication in overdose seems insignificant.

Treatment A specific antidote is unknown.

Pregnancy use

Pregnancy So far in clinical practice, there have been no reports of any side effects when using the drug in pregnant women. Nevertheless, it is not recommended to apply the drug during the first trimester of pregnancy for safety reasons.

The drug can be used during pregnancy in the II and III trimesters only by prescription in cases when the expected benefits to the mother exceed the potential risk to the fetus.

Teratogenic effect of diosmin on fetus has not been found in experimental studies.

Breast-feeding During breast-feeding it is not recommended to take the drug, because there is no data on penetration of diosmin into the breast milk.

Similarities

Phlebodia 600, Venolek, Phlebofa