Daflon Maintenance Dosage for Chronic Venous Insufficiency
For maintenance therapy of chronic venous insufficiency, the recommended dosage is Daflon 500 mg (diosmin 450 mg + hesperidin 50 mg) one tablet daily. 1
Standard Maintenance Dosing
The FDA-approved maintenance dose for chronic venous insufficiency (CVI) is 600 mg daily (one tablet of Daflon 500 mg per day) for ongoing management of varicose veins, edema, stasis dermatitis, and venous ulcers 1
Initial results may not be apparent for 4-8 weeks, and for venous ulcers specifically, improvement may require several months of continuous therapy 1
Acute vs. Maintenance Dosing Distinction
For acute treatment phases (active symptoms or ulcers), the dosage is 1000 mg daily (two tablets of Daflon 500 mg per day) for 2-6 months, which has been validated in multiple randomized controlled trials 2, 3, 4
After resolution of acute symptoms or ulcer healing, the dose should be reduced to the maintenance regimen of 600 mg daily (one tablet) to prevent recurrence and manage chronic symptoms 1
Special Dosing for Hemorrhoidal Disease
For acute hemorrhoidal flares, the initial dose is dramatically higher: 3 tablets (1500 mg) twice daily for 4 days, followed by 2 tablets (1000 mg) twice daily for 9 days 1, 2
Following resolution of acute hemorrhoidal symptoms, maintenance therapy is 600 mg daily (one tablet) to prevent recurrent flares 1
Evidence Quality and Clinical Efficacy
The maintenance dosing recommendation comes directly from FDA-approved prescribing information for diosmin products, representing the highest quality evidence available 1
Multiple double-blind, randomized controlled trials demonstrated that 1000 mg daily (two tablets) significantly improved venous tone, reduced edema, and accelerated ulcer healing compared to placebo, with improvements in plethysmographic parameters including venous capacitance and emptying time 5, 2, 3
The micronized formulation (Daflon 500 mg) shows superior pharmacodynamic and clinical activity compared to non-micronized diosmin at equivalent doses, with 95% patient satisfaction versus 80% for non-micronized formulations 6
Duration of Maintenance Therapy
Maintenance therapy should continue indefinitely for chronic venous insufficiency, as the condition is progressive and symptoms typically recur upon discontinuation 1, 3
For patients with healed venous ulcers, continuing maintenance therapy reduces the risk of ulcer recurrence 2, 3
Safety and Tolerability
Daflon has an excellent safety profile similar to placebo, with the most common adverse events being mild gastrointestinal symptoms (nausea, gastric pain) occurring in approximately 3-8% of patients 2, 7
In clinical trials, treatment withdrawal due to adverse effects occurred in only 3 patients out of 183 treated 5
Common Pitfalls to Avoid
Do not discontinue maintenance therapy once acute symptoms resolve, as this leads to symptom recurrence and disease progression 1, 3
Do not use non-micronized diosmin formulations, as they have inferior absorption and clinical efficacy compared to micronized preparations like Daflon 500 mg 6
Do not expect immediate results—counsel patients that symptom improvement requires 4-8 weeks minimum, and ulcer healing may take several months 1
Maintenance dosing (600 mg daily) is distinct from acute treatment dosing (1000 mg daily)—using acute dosing long-term is unnecessary and increases cost without additional benefit 1, 2