Diosmin Side Effects
Diosmin is generally well-tolerated with mild side effects that primarily include gastrointestinal disturbances and headaches. 1
Common Side Effects
Diosmin has been extensively studied in clinical trials at doses ranging from 400 to 5,000 mg/day for up to one year, with the following common side effects reported:
Gastrointestinal effects:
- Dyspepsia/mild stomach upset (up to 7% of patients, approximately twice the frequency seen in placebo groups) 1
- Abdominal pain
- Diarrhea
Other common side effects:
Rare Side Effects
Some rare adverse events that have been reported include:
- Inguinal pain
- Cystitis
- Asthenia (weakness)
- Metrorrhagia and menometrorrhagia (abnormal uterine bleeding) 1
- Phlebitis (approximately 2% of patients) 1
- Venous thrombosis (approximately 4% of patients) 1
- Skin changes around existing ulcers (1.6% of patients) 1
- Swelling of extremities (1.6% of patients) 1
Unusual Biochemical Effects
There have been rare case reports of unusual biochemical abnormalities:
- Elevated creatine phosphokinase (CPK) levels - suggesting possible muscle damage 2
- Increased serum lactic dehydrogenase (LDH) levels 2
These rare effects may be related to exaggerated adrenergic activity on microcirculation, potentially leading to excessive peripheral vasoconstriction and subsequent ischemic damage in susceptible individuals 2.
Special Populations
- Elderly patients: No significant differences in adverse event profiles have been observed in elderly populations (≥70 years of age) compared to younger populations 1
- Patients with comorbidities: Adverse events are not higher in patients with concomitant hypertension, atherosclerosis, diabetes, neurologic/psychiatric disease, or alcoholism 1
Monitoring Considerations
While routine laboratory monitoring is not generally required during diosmin therapy, patients should be advised to report:
- Persistent gastrointestinal symptoms
- Muscle pain or weakness (which could potentially indicate rare muscle effects)
- Any new or worsening symptoms during treatment
Potential Drug Interactions
Diosmin has been shown to exhibit inhibitory effects on different metabolic enzymes, which may lead to potential drug interactions 3. Careful consideration should be given when combining diosmin with other medications, particularly those with narrow therapeutic indices.
Beneficial Effects
Despite these potential side effects, diosmin has demonstrated several beneficial pharmacological properties in various studies, including:
- Anti-inflammatory effects
- Antioxidant properties
- Antidiabetic effects
- Antihyperlipidemic properties
- Antifibrotic effects 3
These properties may contribute to its therapeutic value in certain conditions, particularly chronic venous insufficiency and hemorrhoids, despite the potential for mild side effects.