What is the recommended dosage and treatment duration of Daflon 500 (diosmin) for a 70-year-old lady with internal hemorrhoids?

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Daflon 500 mg Dosage for Internal Hemorrhoids in a 70-Year-Old Woman

For a 70-year-old woman with internal hemorrhoids, the recommended dosage of Daflon 500 mg is 2 tablets twice daily (2000 mg total daily dose) for 4 weeks, followed by a maintenance dose of 2 tablets once daily if needed for long-term management.

Initial Treatment Phase

The optimal dosing regimen for Daflon 500 mg (micronized purified flavonoid fraction) in treating internal hemorrhoids follows a two-phase approach:

Acute Phase (First 4 weeks):

  • Dosage: 2 tablets (1000 mg) twice daily
  • Duration: 4 weeks
  • Total daily dose: 2000 mg

This intensive initial regimen has been shown to effectively reduce the frequency, duration, and intensity of hemorrhoidal symptoms in clinical studies 1, 2, 3.

Maintenance Phase (If needed):

  • Dosage: 2 tablets (1000 mg) once daily
  • Duration: As needed for symptom control
  • Total daily dose: 1000 mg

Efficacy and Mechanism of Action

Daflon 500 mg contains 90% micronized diosmin and 10% hesperidin, which work by:

  • Improving venous tone and lymphatic drainage
  • Reducing capillary hyperpermeability
  • Protecting microcirculation from inflammatory processes 1

Clinical studies have demonstrated that Daflon 500 mg significantly improves hemorrhoidal symptoms including:

  • Pain
  • Heaviness
  • Bleeding
  • Pruritus (itching)
  • Anal discharge 2, 3

The micronization of diosmin to particles <2 μm improves absorption and efficacy 1.

Considerations for Elderly Patients

For a 70-year-old patient, special attention should be paid to:

  • Tolerability: Daflon has a safety profile similar to placebo in clinical trials, making it appropriate for elderly patients 1
  • Potential drug interactions: Monitor for interactions with other medications commonly used by elderly patients
  • Renal function: No specific dose adjustment is typically required, but monitoring is prudent

Complementary Management Approaches

While taking Daflon 500 mg, the following additional measures should be implemented:

  • Dietary modifications: Increase fiber intake to 25-30g daily 4
  • Hydration: Ensure adequate fluid intake
  • Topical treatments: Consider low-potency topical corticosteroids (hydrocortisone 1%) for perianal irritation for up to 7 days if needed 4
  • Sitz baths: 2-3 times daily to relieve discomfort 4
  • Physical activity: Regular, gentle exercise to promote bowel regularity 4
  • Avoid prolonged sitting: Especially on the toilet, to reduce pressure on hemorrhoids 4

Treatment Duration and Follow-up

  • Initial evaluation: After 4 weeks of treatment
  • Long-term management: Consider maintenance therapy of 2 tablets daily for 60-83 days if symptoms persist or recur 1
  • Follow-up: Regular assessment to monitor symptom improvement and potential side effects

Potential Side Effects

The most common adverse events are mild and include:

  • Gastrointestinal symptoms (mild digestive discomfort)
  • Autonomic symptoms (rare)

These side effects are generally well-tolerated and rarely require discontinuation of treatment 1, 3.

When to Consider Alternative Treatments

If symptoms do not improve after 4 weeks of Daflon therapy, consider:

  • Rubber band ligation for grade I-II hemorrhoids 4
  • Surgical options for grade III-IV hemorrhoids if conservative measures fail 4
  • Referral to a specialist for further evaluation

By following this treatment protocol with Daflon 500 mg, most patients with internal hemorrhoids can expect significant symptom improvement within the 4-week initial treatment period.

References

Research

Daflon for haemorrhoids: a prospective, multi-centre observational study.

The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland, 2004

Research

Efficacy of Daflon in the treatment of hemorrhoids.

Saudi medical journal, 2002

Guideline

Management of Hemorrhoids

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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