Daflon for Chronic Venous Insufficiency
Daflon (micronized purified flavonoid fraction: 450 mg diosmin + 50 mg hesperidin) is an effective and well-tolerated treatment for symptomatic chronic venous insufficiency at any stage of disease, with a recommended dose of 1000 mg daily (two 500 mg tablets). 1, 2, 3
Standard Dosing Regimen
- For chronic venous insufficiency with symptoms (leg heaviness, edema, varicose veins, skin changes): Take 1 tablet (500 mg) twice daily, or 2 tablets once daily 1, 2, 3
- Duration of therapy: Continue indefinitely, as chronic venous insufficiency is a progressive condition and symptoms typically recur upon discontinuation 4
- Time to clinical effect: Expect symptom improvement within 4-8 weeks for most manifestations; venous ulcers may require several months to show benefit 1, 5
Evidence for Efficacy
Symptom Relief & Edema Reduction:
- Daflon 500 mg twice daily significantly decreases ankle and calf circumference compared to placebo in randomized controlled trials 3, 5
- The medication improves leg heaviness, sensation of swelling, pain, and paresthesia by acting on venous wall tone and reducing red blood cell aggregation 2
- Plethysmographic parameters (venous tone and elasticity) show measurable improvement with treatment 3, 5
Venous Ulcer Healing:
- When added to standard compression therapy, Daflon 500 mg twice daily significantly accelerates healing of venous leg ulcers ≤10 cm in diameter over 2-6 months compared to compression alone 3, 5, 6
- The drug protects microcirculation from inflammatory processes, normalizes prostaglandin synthesis, decreases bradykinin-induced vascular leakage, and inhibits leukocyte activation 2, 6
Mechanism of Action
Daflon works through multiple complementary pathways 2, 6:
- Venous tone: Increases venous wall tone and elasticity, counteracting the deterioration that leads to valve dysfunction
- Lymphatic drainage: Improves lymph flow velocity, reducing edema formation 7
- Microcirculation protection: Reduces capillary hyperpermeability and protects against inflammatory damage to small vessels 2, 3
Safety Profile
- Daflon demonstrates a tolerability profile similar to placebo in clinical trials 3, 7
- The most common adverse events are mild gastrointestinal symptoms (nausea, dyspepsia) and autonomic effects, occurring in approximately 3-8% of patients 4, 3
- No substance-related alterations were found in toxicology studies evaluating acute, subacute, or chronic toxicity, mutagenicity, fertility, or embryotoxicity 7
Clinical Integration
First-line therapy indications:
- Daflon should be prescribed from the earliest stages of chronic venous insufficiency for relief of symptoms and edema 2, 3
- It serves as first-line treatment for any patient with symptomatic CVI, regardless of disease stage 2, 3
Combination therapy:
- In advanced disease stages (C4-C6), use Daflon in conjunction with compression therapy, sclerotherapy, or surgery as appropriate 2, 3, 6
- For venous ulcers, always combine Daflon with standard compression and local wound care 3, 6
- Daflon serves as an alternative when surgery or other interventions are not indicated or not feasible 2, 3
Common Pitfalls to Avoid
- Discontinuing therapy prematurely: Patients may stop treatment once symptoms improve, but chronic venous insufficiency requires ongoing management to prevent recurrence 4
- Expecting immediate results: Counsel patients that symptom relief typically requires 4-8 weeks, and ulcer healing may take several months 1
- Using as monotherapy for advanced disease: In patients with skin changes or ulceration (C4-C6), Daflon should supplement—not replace—compression therapy and appropriate wound care 3, 6
- Inadequate dosing: The evidence supports 1000 mg daily (500 mg twice daily); lower doses may be subtherapeutic 2, 3, 5