DIOSMIN: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

Overview

Diosmin is a chemical in some plants. It's found mainly in citrus fruits.

Diosmin is most often used for hemorrhoids and leg sores caused by poor blood flow. It's also used for other conditions, but there's no strong evidence to support these uses.

Diosmin is often taken with hesperidin. Hesperidin is another plant chemical.

How does it work ?

Diosmin might work by reducing swelling (inflammation) and restoring normal vein function. Diosmin also seems to have antioxidant effects.

Uses & Effectiveness

Possibly Effective for

Hemorrhoids. Taking diosmin in high doses along with hesperidin seems to reduce symptoms of hemorrhoids. Taking diosmin in lower doses along with hesperidin plus troxerutin also seems to help. Taking diosmin in lower doses along with hesperidin seems to help prevent hemorrhoids from coming back.
Leg sore caused by weak blood circulation (venous leg ulcer). Taking diosmin with hesperidin and using compression dressing seems to help heal leg ulcers caused by poor circulation.

Insufficient Evidence for

Back pain. Early research shows that taking diosmin for at least 8 weeks decreases pain and might reduce the need to use rescue pain medicine similarly to receiving the standard medications mannitol and dexamethasone.
Poor circulation that can cause the legs to swell (chronic venous insufficiency or CVI). Some research shows that taking diosmin may help to reduce pain by a small amount in people with CVI. But not all research agrees.
Swelling in the arms or legs caused by damage to the lymph system (lymphedema). Taking diosmin with hesperidin might not reduce swelling of the arms following surgery for breast cancer.
Minor bleeding.
Bleeding gums.
Bleeding (hemorrhage) in the eye.
Preventing damage to the liver.
Varicose veins.
Other conditions.

More evidence is needed to rate the effectiveness of diosmin for these uses.

Side Effects

When taken by mouth: Diosmin is POSSIBLY SAFE for most people when used by mouth short-term. It can cause some side effects such as stomach pain, diarrhea, dizziness, headache, skin redness and hives, muscle pain, blood problems, and altered heart rate.

Special Precautions and Warnings

Pregnancy and breast-feeding: Not enough is known about the use of diosmin during pregnancy and breast-feeding. Stay on the safe side and avoid use.

Bleeding disorders: Diosmin might make bleeding disorders worse. If you have a bleeding disorder, don't use diosmin.

Interactions

Moderate Interaction

Be cautious with this combination

Chlorzoxazone (Parafon Forte, Paraflex) interacts with DIOSMIN
The body breaks down chlorzoxazone (Parafon Forte, Paraflex) to get rid of it. Diosmin might decrease how quickly the body breaks down chlorzoxazone (Parafon Forte, Paraflex). Taking diosmin along with chlorzoxazone (Parafon Forte, Paraflex) might increase the effects and side effects of chlorzoxazone (Parafon Forte, Paraflex).
Diclofenac (Voltaren, others) interacts with DIOSMIN
The body breaks down diclofenac (Voltaren, others) to get rid of it. Diosmin might decrease how quickly the body breaks down diclofenac (Voltaren, others). Taking diosmin along with diclofenac (Voltaren, others) might increase the effects and side effects of diclofenac (Voltaren, others).
Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates) interacts with DIOSMIN
Some medications are changed and broken down by the liver. Diosmin might decrease how quickly the liver breaks down some medications. Taking diosmin along with some medications that are broken down by the liver might increase the effects and side effects of these medications. Before taking diosmin, talk to your healthcare provider if you take any medications that are changed by the liver.
Some medications that are changed by the liver include celecoxib (Celebrex), diclofenac (Voltaren), fluvastatin (Lescol), glipizide (Glucotrol), ibuprofen (Advil, Motrin), irbesartan (Avapro), losartan (Cozaar), phenytoin (Dilantin), piroxicam (Feldene), tamoxifen (Nolvadex), tolbutamide (Tolinase), torsemide (Demadex), warfarin (Coumadin), and others.
Medications changed by the liver (Cytochrome P450 2E1 (CYP2E1) substrates) interacts with DIOSMIN
Some medications are changed and broken down by the liver. Diosmin might decrease how quickly the liver breaks down some medications. Taking diosmin along with some medications that are broken down by the liver may increase the effects and side effects of these medications.
Some medications changed by the liver include acetaminophen, chlorzoxazone (Parafon Forte), ethanol, theophylline, and anesthetics such as enflurane (Ethrane), halothane (Fluothane), isoflurane (Forane), and methoxyflurane (Penthrane).
Medications moved by pumps in cells (P-Glycoprotein Substrates) interacts with DIOSMIN
Some medications are moved by pumps in cells. Diosmin might make these pumps less active and increase the amount of some medications that get absorbed by the body. This might increase the amount of some medications in the body, which could lead to more side effects.
Some medications that are moved by these pumps include some chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), protease inhibitors (amprenavir, indinavir, nelfinavir, saquinavir), H2 antagonists (cimetidine, ranitidine), some calcium channel blockers (diltiazem, verapamil), corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with DIOSMIN
Diosmin might slow blood clotting. Taking diosmin along with medications that also slow blood clotting might increase the chances of bruising and bleeding. Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.
Carbamazepine (Tegretol) interacts with DIOSMIN
The body breaks down carbamazepine (Tegretol) to get rid of it. Diosmin might decrease how quickly the body breaks down carbamazepine (Tegretol). Taking diosmin along with carbamazepine (Tegretol) might increase the effects and side effects of carbamazepine (Tegretol).
Fexofenadine (Allegra) interacts with DIOSMIN
Some medications including fexofenadine (Allegra) are moved by pumps in cells. Diosmin might make these pumps less active and increase how much of some medications get absorbed by the body. This might cause more side effects from some medications.
Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) interacts with DIOSMIN
Some medications are changed and broken down by the liver. Diosmin may decrease how quickly the liver breaks down some medications. Taking diosmin along with some medications may increase the effects and side effects of these medications. Before taking diosmin, talk to your health care provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), clarithromycin (Biaxin), erythromycin, cyclosporine (Neoral, Sandimmune), amlodipine (Norvasc), verapamil (Calan, Isoptin), diltiazem (Cardizem), estrogens, indinavir (Crixivan), fexofenadine (Allegra), triazolam (Halcion), alprazolam (Xanax), and many others.

Dosing

Diosmin is often taken in combination with hesperidin.

The following doses have been studied in scientific research:

ADULTS

BY MOUTH:

For hemorrhoids: For treating hemorrhoids, 1350 mg of diosmin plus 150 mg of hesperidin twice daily for 4 days followed by 900 mg of diosmin and 100 mg of hesperidin twice daily for 3 days has been used. Also, 300 mg of diosmin, 300 mg of troxerutin, and 300 mg of hesperidin three times daily for 3 days, followed by two times daily for 2 days, and then once daily for 7 days has been used. Thereafter, 300 mg of diosmin, 300 mg of troxerutin, and 100 mg of hesperidin has been used daily for one month. Some researchers also try 600 mg of diosmin three times daily for 4 days, followed by 300 mg twice daily for 10 days, in combination with 11 grams of psyllium daily. However, this lower diosmin dose does not seem to be as effective.
For leg ulcers caused by poor circulation (venous stasis ulcers): 900 mg of diosmin plus 100 mg of hesperidin daily has been used for up to 2 months.

View References

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DIOSMIN - Uses, Side Effects, and More

Overview

How does it work ?

Uses & Effectiveness

Possibly Effective for

Insufficient Evidence for

Side Effects

Special Precautions and Warnings

Interactions

Moderate Interaction

Chlorzoxazone (Parafon Forte, Paraflex) interacts with DIOSMIN

Diclofenac (Voltaren, others) interacts with DIOSMIN

Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates) interacts with DIOSMIN

Medications changed by the liver (Cytochrome P450 2E1 (CYP2E1) substrates) interacts with DIOSMIN

Medications moved by pumps in cells (P-Glycoprotein Substrates) interacts with DIOSMIN

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with DIOSMIN

Carbamazepine (Tegretol) interacts with DIOSMIN

Fexofenadine (Allegra) interacts with DIOSMIN

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) interacts with DIOSMIN

Dosing