From the Guidelines
Diosmin and hesperidin can be used for a duration of 2-6 months initially for the treatment of chronic venous insufficiency, with the option to continue long-term under medical supervision. The treatment duration may vary depending on the severity of symptoms and patient response. According to the available evidence, there is no specific recommendation for the duration of use of diosmin and hesperidin in the treatment of chronic venous insufficiency 1. However, based on general medical knowledge, the typical treatment duration for phlebotonics, including diosmin and hesperidin, can range from 2-6 months initially, with some patients continuing treatment for years under medical supervision.
Key Considerations
- The standard dosage of diosmin and hesperidin is typically 450-500 mg of diosmin combined with 50 mg of hesperidin taken twice daily.
- Patients often notice initial improvement within 2-4 weeks, but the full benefits may take 3-6 months to develop.
- For maintenance therapy after symptom improvement, some physicians recommend continuing with a lower dose or taking the medication intermittently.
- Side effects are generally mild and may include digestive discomfort.
- Regular follow-up with a healthcare provider is recommended to monitor effectiveness and adjust treatment as needed, especially for patients with other medical conditions or taking multiple medications.
Treatment Approach
- The decision to proceed with treatment and the choice of treatment are based on symptoms and patient preferences 1.
- Other considerations include cost, potential for complications, availability of resources, insurance reimbursement, and physician training.
- The presence or absence of deep venous insufficiency and the characteristics of the affected veins can also help guide treatment 1.
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. Many clinical trials have been conducted in adults with various manifestations of CVI to assess the efficacy of orally administered diosmin in doses ranging from 400 to 5,000 mg/day for up to a year.
The recommended duration of use for diosmin and hesperidin in the treatment of chronic venous insufficiency (CVI) is not explicitly stated for a specific time frame, but clinical trials have been conducted for up to a year [2] [3].
- For varicose/spider veins, edema, stasis dermatitis, results may not be seen for 4 to 8 weeks.
- For venous ulcers, results may not be seen for several months. It is recommended to follow the guidance of a physician for the treatment of CVI.
From the Research
Recommended Duration of Use for Diosmin and Hesperidin
The recommended duration of use for diosmin (Flavonoid) and hesperidin (Vitamin P) in the treatment of chronic venous insufficiency (CVI) can be inferred from several studies:
- A study published in 2008 4 found that administration of semisynthetic diosmin for 30 days resulted in significant improvement of clinical signs, quality of life, and CEAP stage of CVI.
- Another study from 2013 5 demonstrated that clinical administration of Venarus, whose basic components are diosmin and hesperidin, was effective in patients with lower limb chronic venous insufficiency, with a maximum positive effect observed within the first 4 weeks.
- A study from 2005 6 compared the efficacy of HR (0-[beta-hydroxyethyl]-rutosides) and D+H (diosmin+hesperidin) in patients with CVI, and found that both treatments were effective, but HR was more effective in improving microcirculatory parameters and signs/symptoms of CVI, over an 8-week treatment period.
- Additionally, a study from 2001 7 demonstrated the clinical benefits of Daflon 500 mg (450 mg diosmin plus 50 mg hesperidin) in the most severe stages of chronic venous insufficiency, but did not specify a particular duration of use.
- A study from 2015 8 discussed the therapeutic potential of micronized purified flavonoid fraction (MPFF) of diosmin and hesperidin, but did not provide information on the recommended duration of use.
Key Findings
Key findings from these studies include:
- Significant improvement in clinical signs, quality of life, and CEAP stage of CVI with diosmin treatment for 30 days 4
- Effective treatment of lower limb chronic venous insufficiency with Venarus (diosmin and hesperidin) over a 4-week period 5
- Comparative efficacy of HR and D+H (diosmin+hesperidin) in improving microcirculatory parameters and signs/symptoms of CVI over an 8-week treatment period 6
- Clinical benefits of Daflon 500 mg (diosmin and hesperidin) in severe stages of chronic venous insufficiency 7