From the Guidelines
The recommended dosage for DIOSMIN PLUS (diosmin and hesperidin) is 500-1000 mg taken twice daily for chronic venous insufficiency, or 1000 mg taken three times daily for acute hemorrhoid episodes, as suggested by recent guidelines 1. For chronic venous insufficiency, treatment usually continues for 2-3 months initially, with maintenance therapy potentially extending longer based on symptom improvement. For acute hemorrhoid flare-ups, higher doses are typically used for 4-7 days, followed by a reduced maintenance dose for 2-3 months to prevent recurrence. Some key points to consider when using DIOSMIN PLUS include:
- Taking the medication with meals to improve absorption and reduce gastrointestinal discomfort
- Diosmin and hesperidin work by strengthening vein walls, improving venous tone, and reducing inflammation and capillary permeability, which helps alleviate symptoms like pain, swelling, and heaviness in the legs or hemorrhoidal discomfort
- Results typically begin within 1-2 weeks, but optimal benefits may require consistent use for 4-8 weeks
- Patients should consult their healthcare provider before starting treatment, especially if they have existing medical conditions or take other medications. The use of flavonoids, such as diosmin and hesperidin, is supported by moderate quality evidence, suggesting a beneficial effect in relieving symptoms of complicated hemorrhoids 1. Additionally, non-operative management, including dietary and lifestyle changes, is recommended as first-line therapy for complicated hemorrhoids 1. It is essential to note that the definition of "symptomatic" hemorrhoids used in these studies is unclear, making it challenging to determine whether the symptoms are acute or chronic 1. However, the available evidence suggests that DIOSMIN PLUS can be an effective treatment option for patients with venous insufficiency or hemorrhoids, and its use should be considered in conjunction with other non-operative management strategies.
From the FDA Drug Label
The recommended intake of VASCULERA (diosmiplex) is 1 tablet per day for the dietary management of Chronic Venous Insufficiency (CVI), manifested as: varicose/spider veins, edema, stasis dermatitis and or venous ulcers. Results may not be seen for 4 to 8 weeks. For venous ulcers, results may not be seen for several months. For CVI manifested as hemorrhoidal disease, the recommended initial intake is 1 tablet 3 times daily for 4 days followed by 1 tablet twice daily for 9 days, or as directed by a physician. For hemorrhoidal discomfort persisting after resolution of the acute flare or for recurrent hemorrhoidal flares irrespective of persisting discomfort, a maintenance intake of 600 mg of Vasculera daily is recommended.
The recommended dosage and treatment duration for DIOSMIN PLUS (diosmin and hesperidin) in patients with venous insufficiency or hemorrhoids are as follows:
- Chronic Venous Insufficiency (CVI): 1 tablet per day, with results expected in 4 to 8 weeks.
- Venous Ulcers: 1 tablet per day, with results expected in several months.
- Hemorrhoidal Disease:
- Initial treatment: 1 tablet 3 times daily for 4 days, followed by 1 tablet twice daily for 9 days.
- Maintenance treatment: 600 mg of Vasculera daily for hemorrhoidal discomfort persisting after resolution of the acute flare or for recurrent hemorrhoidal flares. 2
From the Research
Recommended Dosage and Treatment Duration for DIOSMIN PLUS
The recommended dosage and treatment duration for DIOSMIN PLUS (diosmin and hesperidin) in patients with venous insufficiency or hemorrhoids vary depending on the specific condition being treated.
- For chronic venous insufficiency, the recommended dosage is 500 mg of micronised purified flavonoid fraction (MPFF) twice daily, containing 90% diosmin and 10% hesperidin 3.
- For acute internal hemorrhoids, the recommended dosage is 3 tablets of MPFF 500 mg twice daily for 4 days, then 2 tablets of MPFF 500 mg twice daily for 3 days 3.
- For chronic (recurrent) hemorrhoids, the recommended dosage is 2 tablets of MPFF 500 mg daily for 60 or 83 days 3.
- In another study, purified diosmin was given at a dose of two 450 mg tablets bid for the first 7 days, then at 1 tablet bid for up to 2 months, in patients suffering from primitive hemorrhoids of grade 1-4 4.
Treatment Duration
The treatment duration for DIOSMIN PLUS also varies depending on the specific condition being treated.
- For chronic venous insufficiency, treatment duration can range from 2-6 months 3, 5.
- For acute internal hemorrhoids, treatment duration is typically 7 days 3.
- For chronic (recurrent) hemorrhoids, treatment duration can range from 60 to 83 days 3.
- In another study, the treatment duration for purified diosmin in patients with hemorrhoids was up to 2 months 4.
Adverse Effects
While DIOSMIN PLUS is generally well-tolerated, there have been reports of adverse effects, including gastrointestinal and autonomic events 3, 6.
- In rare cases, diosmin therapy has been associated with increased levels of serum creatine phosphokinase and lactic dehydrogenase 6.