Phlebofa, tablets 600 mg 30 pcs

Pharmacotherapeutic group: Angioprotective agent.

TATX code: C05SA03

Pharmacological properties

Pharmacodynamics

. Diosmin belongs to the group of bioflavonoids and has phlebotonic properties (it reduces stretching of veins, increases venous tone (dose-dependent effect), reduces venous congestion), improves lymphatic drainage (it increases tone and frequency of contraction of lymphatic capillaries, increases their functional density, It reduces the lymphatic pressure), improves microcirculation (it increases capillary resistance (dose-dependent effect) and decreases their permeability), reduces leucocyte adhesion to the venous wall and their migration into the paravenous tissue, improves oxygen diffusion and perfusion in the skin tissue and has an anti-inflammatory effect. It enhances the vasoconstrictor effect of adrenaline and noradrenaline, blocks the production of free radicals, the synthesis of prostaglandins and thromboxane.

Pharmacokinetics

Diosmin is rapidly absorbed from the gastrointestinal tract. It is detected in blood plasma 2 hours after intake. The bioavailability of the drug after oral administration is approximately 40 – 57.9%. Part of the drug is metabolized by cecum bacteria to form hippuric and benzoic acids. Maximum concentration in blood plasma is reached 5 hours after intake. The drug accumulates in all layers of the wall of the hollow veins and subcutaneous veins of the lower limbs, to a lesser extent in the kidneys, liver and lungs and other tissues. Distribution volume of the drug is 62.1 l. The maximum selective accumulation of diosmin and/or its metabolites in the wall of the venous vessels is noted 9 hours after administration and persists for 96 hours.

Diosmin is rapidly metabolized in the liver. The main metabolite is hydroxyphenylpropionic acid. Metabolites of diosmin excreted mainly by the kidneys in the form of conjugates with glucuronic acid. 79% of ingested diosmin is excreted by the kidneys, 11% – the intestines, 2.4% – with the bile. Enterohepatic circulation of the drug is noted. After taking diosmin labeled with radioactive isotope about 86% of the drug is excreted by the kidneys and intestines within 48 hours.

Indications

Active ingredient

Composition

1 tablet contains:

Active substance:

diosmin 600 mg;

Auxiliary substances:

gelatin 50 mg,

sodium carboxymethyl starch 40 mg,

magnesium stearate 10 mg,

microcrystalline cellulose up to 1000 mg.

How to take, the dosage

The drug is intended to be taken orally.

In varicose veins of the lower extremities and chronic lymphovenous insufficiency. The drug is prescribed 1 tablet a day in the morning on an empty stomach. The therapy duration is usually 2 months.

In severe forms of chronic lymphovenous insufficiency (edemas, pain, cramps, etc.) the treatment may be longer (total duration of continuous therapy should not exceed three to four months). Courses of treatment with the drug are repeated in 2-3 months.

For the treatment of chronic lymphovenous insufficiency during the second and the third trimester of pregnancy the drug is prescribed 1 tablet once a day. It is necessary to stop taking the drug 2-3 weeks before delivery.

In case of exacerbation of hemorrhoids. The drug is prescribed 2-3 tablets a day with meals for 7 days. If necessary the drug can be continued in 1 tablet once a day for 1 -2 months.

In case of 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, the drug should be used as usual and in the usual dose.

Interaction

Clinically significant interactions of diosmin with other drugs have not been described.

Special Instructions

The treatment of acute hemorrhoids is combined with other medications. In the absence of rapid clinical effect it is recommended to consult a proctologist, and if necessary, to conduct additional examination and adjust the current therapy.

In patients with venous circulatory disorders (varicose veins of the lower extremities, chronic lymphovenous insufficiency of the lower extremities) the maximum effect of therapy is achieved by the combination of therapy and lifestyle changes: it is advisable to avoid long periods of standing in an upright position and to reduce excessive body weight. In some cases improving blood circulation helps to wear special stockings (compression stockings).

There is insufficient experience with diosmin in children under 18 years of age. If there is no reduction or if the symptoms become more severe, consult a doctor! Do not exceed the maximum periods and recommended doses of the drug without consulting your doctor!

Impact on driving and operating ability

The drug has no effect on driving and operating ability.

Contraindications

Side effects

The frequency of adverse effects is defined according to the WHO classification of adverse drug reactions by frequency of occurrence: very common – more than 1/10, common – more than 1/100 and less than 1/10, infrequent – more than 1/1000 and less than 1/100, rare – more than 1/10000 and less than 1/1000, very rare – less than 1/10000, including isolated cases; unknown frequency (it is impossible to determine the incidence of adverse reactions on the available data).

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

The central nervous system: rarely – headache, dizziness.

Skin and subcutaneous fatty tissue, rarely – skin rash, itching;

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

General disorders: rarely – malaise.

If any of the side effects listed in the instructions worsen, or if you notice any other side effects not listed in the instructions, tell your doctor.

Overdose

In cases of overdose have not been described. Given the wide therapeutic range of diosmin, the risk of intoxication in overdose seems insignificant. A specific antidote is unknown. If you overdose on the drug, seek medical attention immediately!

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