Dosing of Daflon for Bleeding Hemorrhoids
For acute bleeding hemorrhoids, administer Daflon 500 mg at 3 tablets twice daily (total 6 tablets/day) for the first 4 days, then reduce to 2 tablets twice daily (total 4 tablets/day) for the following 3 days. This 7-day intensive regimen provides rapid symptom control for acute hemorrhoidal episodes 1.
Acute Hemorrhoidal Crisis Dosing
- Days 1-4: Take 3 tablets of Daflon 500 mg twice daily (morning and evening), totaling 3000 mg per day 1.
- Days 5-7: Reduce to 2 tablets of Daflon 500 mg twice daily, totaling 2000 mg per day 1.
- This intensive 7-day regimen significantly reduces bleeding, pain, anal discomfort, and anal discharge compared to placebo, with benefits evident as early as day 2 1.
Chronic or Recurrent Hemorrhoidal Bleeding
- For ongoing symptoms: Continue with 2 tablets of Daflon 500 mg daily (1000 mg/day) for 60-83 days to reduce the frequency, duration, and severity of recurrent hemorrhoidal symptoms 2.
- This maintenance dosing significantly improves overall signs and symptoms of chronic hemorrhoids compared to placebo 2, 3.
Mandatory Adjunctive Measures
Daflon must never be used as monotherapy—it requires concurrent dietary and lifestyle modifications to achieve therapeutic benefit 4.
- Increase dietary fiber to 25-30 grams daily (approximately 5-6 teaspoons of psyllium husk mixed with 600 mL water) to soften stool and reduce straining 4, 5.
- Ensure adequate daily water intake to complement fiber supplementation and minimize anorectal pressure during defecation 4, 5.
- Take regular warm sitz baths to reduce inflammation and provide symptomatic relief 4.
Topical Adjuncts for Symptom Control
- For thrombosed external hemorrhoids: Apply topical 0.3% nifedipine with 1.5% lidocaine ointment every 12 hours for two weeks, which achieves a 92% resolution rate 4, 5.
- For perianal inflammation: Short-term topical corticosteroids may be used for ≤7 days maximum to avoid mucosal thinning and increased injury risk 4, 5.
Evidence Supporting This Regimen
The intensive 7-day regimen (3 tablets BID × 4 days, then 2 tablets BID × 3 days) demonstrated statistically significant improvements in bleeding control, with greater overall symptom relief than placebo from day 2 through day 7 1. A separate trial showed that 2 tablets daily for 60 days reduced the frequency, duration, and severity of acute hemorrhoidal symptoms in chronic disease 2.
Critical Limitations and Red Flags
- Symptom recurrence reaches 80% within 3-6 months after cessation of flavonoid therapy, indicating that Daflon provides temporary relief rather than definitive cure 4, 5.
- Never attribute anemia to hemorrhoids without colonoscopy to exclude inflammatory bowel disease, colorectal cancer, or other proximal colonic pathology 4, 5.
- Severe anorectal pain is not typical of uncomplicated internal hemorrhoids and should prompt immediate assessment for thrombosed external hemorrhoids, anal fissure, abscess, or strangulated prolapse 5.
When Daflon Is Insufficient
- If bleeding persists or worsens after 1-2 weeks of treatment, reassessment is necessary 4.
- For grade III-IV hemorrhoids with active bleeding and anemia, surgical hemorrhoidectomy provides definitive treatment with 90-98% success rates and only 2-10% recurrence 4.
- Rubber band ligation is the most effective office-based procedure for persistent grade I-III internal hemorrhoids, with success rates of 70.5-89% 4.