Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

Overview

Hesperidin is a plant chemical that is classified as a “bioflavonoid.” It is most commonly found in citrus fruits. People use it as medicine.

Hesperidin, alone or in combination with other citrus bioflavonoids (such as diosmin), is most commonly used for blood vessel conditions such as hemorrhoids, varicose veins, and poor circulation (venous stasis).

Hesperidin may help blood vessels function better. It may also reduce inflammation.

Uses & Effectiveness ?

Possibly Effective for

• Poor circulation that can cause the legs to swell (chronic venous insufficiency or CVI). Taking a particular product containing hesperidin methyl chalcone, butcher’s broom, and vitamin C by mouth seems to relieve the symptoms of poor circulation in the legs. Also, taking a different product containing hesperidin and diosmin by mouth for 2-6 months seems to improve CVI symptoms, although taking the drug Venoruton might be more effective for treating this condition.
• Hemorrhoids. Some research suggests that taking hesperidin and diosmin improves symptoms of anal hemorrhoids. It may also prevent hemorrhoids from coming back after they have healed and may help in an emergency worsening of hemorrhoids.
• Leg sores caused by weak blood circulation (venous leg ulcer). Taking a specific product containing hesperidin and diosmin by mouth for 2 months seems to improve the healing of small venous stasis ulcers when used along with compression dressings.

Possibly Ineffective for

• High cholesterol. Most research shows that taking hesperidin doesn’t improve cholesterol levels.
• Obesity. Some research shows that taking glucosyl hesperidin for 12 weeks doesn’t reduce body weight in people that are slightly overweight.

Side Effects

When taken by mouth: Hesperidin is POSSIBLY SAFE for most people when taken by mouth for up to 6 months. There isn’t enough information to know if hesperidin is safe when taken for longer than 6 months. Side effects include stomach pain and upset, diarrhea, and headache.

Special Precautions and Warnings

When taken by mouth: Hesperidin is POSSIBLY SAFE for most people when taken by mouth for up to 6 months. There isn’t enough information to know if hesperidin is safe when taken for longer than 6 months. Side effects include stomach pain and upset, diarrhea, and headache. Pregnancy and breast-feeding: Hesperidin is POSSIBLY SAFE for pregnant or breast-feeding women when taken by mouth with diosmin.

Bleeding disorder: Hesperidin might slow blood clotting and increase the risk of bleeding. In theory, hesperidin might make bleeding disorders worse.

Low blood pressure: Hesperidin might lower blood pressure. In theory, taking hesperidin might make blood pressure become too low in people who already have low blood pressure.

Surgery: Hesperidin might prolong bleeding. There is concern that hesperidin might increase the risk of bleeding during and after surgical procedures. Stop taking hesperidin at least 2 weeks before a scheduled surgery.

Interactions ?

Moderate Interaction

Be cautious with this combination

• Hesperidin may reduce how much celiprolol the body absorbs. This might decrease how well celiprolol works. Do not take hesperidin with celiprolol.

• Hesperidin may reduce how much diltiazem the body absorbs. This might decrease how well diltiazem works. Do not take diltiazem with hesperidin.

• Hesperidin might decrease blood pressure. Taking hesperidin along with medications used to lower high blood pressure might cause your blood pressure to go too low.

  Some medications for high blood pressure include nifedipine (Adalat, Procardia), verapamil (Calan, Isoptin, Verelan), diltiazem (Cardizem), isradipine (DynaCirc), felodipine (Plendil), amlodipine (Norvasc), and others.

• Some medications are moved by pumps in cells. Hesperidin might make these pumps less active and increase the amount of some medications that get absorbed by the body. This might increase the amount of some medications in the body, which could lead to more side effects. But there is not enough information to know if this is a big concern.

  Some medications that are moved by these pumps include etoposide, paclitaxel, vinblastine, vincristine, vindesine, ketoconazole, itraconazole, amprenavir, indinavir, nelfinavir, saquinavir, cimetidine, ranitidine, diltiazem, verapamil, corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.

• Hesperidin might slow blood clotting. Taking hesperidin along with medications that also slow blood clotting might increase the risk of bruising and bleeding and others.

• Hesperidin might cause sleepiness and drowsiness. Medications that cause sleepiness are called sedatives. Taking hesperidin along with sedative medications might cause too much sleepiness. Taking hesperidin along with sedative medications used in surgery might cause prolonged sedation.

  Some sedative medications include pentobarbital (Nembutal), phenobarbital (Luminal), secobarbital (Seconal), thiopental (Pentothal), fentanyl (Duragesic, Sublimaze), morphine, propofol (Diprivan), and others.

• Hesperidin may increase how much verapamil the body absorbs. This might increase the effects and side effects of verapamil. Do not take verapamil with hesperidin.

Dosing

The following doses have been studied in scientific research:

ADULTS

BY MOUTH:

• For poor circulation that can cause the legs to swell (chronic venous insufficiency or CVI): A specific combination product containing hesperidin methyl chalcone 150 mg, butcher’s broom root extract 150 mg, and ascorbic acid 100 mg has been used. Also, a combination of 100-150 mg of hesperidin with 900-1350 mg of diosmin taken daily for 2-6 months has been used.
• For hemorrhoids: A combination of 150 mg of hesperidin plus 1350 mg of diosmin twice daily for 4 days, followed by 100 mg of hesperidin and 900 mg of diosmin twice daily for 3 days has been used. Also, a combination of 50 mg of hesperidin plus 450 mg of diosmin twice daily for 3 months has been used to prevent the return of hemorrhoids.
• For sores caused by weak blood circulation (venous leg ulcer): A combination of 100 mg of hesperidin and 900 mg of diosmin daily for up to 2 months has been used.

View References

CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version.
© Therapeutic Research Faculty 2020.

Benefits, Dosage, Side Effects, and More

Diosmin is a flavonoid most commonly found in citrus fruits. Flavonoids are plant compounds that have antioxidant properties, which protect your body from inflammation and unstable molecules called free radicals (1, 2).

Diosmin was first isolated from the figwort plant (Scrophularia nodosa L.) in 1925 and has been used since 1969 as a natural therapy to treat various conditions, such as hemorrhoids, varicose veins, venous insufficiency, leg ulcers, and other circulatory issues (2).

It’s believed to help reduce inflammation and restore normal blood flow in people with venous insufficiency, a condition in which blood flow is impaired (2).

Today, diosmin is widely derived from another flavonoid called hesperidin, which is also found in citrus fruits — especially orange rinds (2).

Diosmin is often combined with micronized purified flavonoid fraction (MPFF), a group of flavonoids that includes disomentin, hesperidin, linarin, and isorhoifolin (3).

Most diosmin supplements contain 90% diosmin with 10% hesperidin and are labeled MPFF. In most cases, the terms “diosmin” and “MPFF” are used interchangeably (3).

This supplement is available over the counter in the United States, Canada, and some European countries. Depending on your location, it may be called Diovenor, Daflon, Barosmin, citrus flavonoids, Flebosten, Litosmil, or Venosmine (4, 5).

Diosmin is most widely used to treat blood vessel disorders, such as hemorrhoids and chronic venous insufficiency (CVI). Hemorrhoids are swollen veins located near the anus, while CVI refers to swollen, blocked veins in the legs (6, 7).

People may also take diosmin for other blood vessel disorders, including varicose veins, blood clots, retinal hemorrhage (bleeding in the retina of the eye), venous leg ulcers, and venous stasis (slow blood flow in the legs) (8, 9).

Research suggests that this compound may reduce inflammation in the veins and thus improve blood flow (2).

Hemorrhoids

Numerous studies suggest that diosmin helps treat internal and external hemorrhoids.

In a review of 24 studies in over 2,300 people, plant flavonoids like diosmin decreased hemorrhoid-related itchiness, bleeding, discharge, and other hemorrhoid symptoms (10).

Other studies reveal similar improvements in hemorrhoid symptoms. Additionally, diosmin has been shown to reduce recovery time following a hemorrhoidectomy, or surgical removal of hemorrhoids (3, 11, 12, 13).

Though these results are promising, most improvements are seen in people in the early stages of hemorrhoid disease. Overall, diosmin may not be as effective as other hemorrhoid treatments (11, 12, 14, 15).

Chronic venous disease

Chronic venous disease (CVD) is an umbrella term for conditions related to weak or diseased veins. These include CVI, varicose veins, spider veins, leg ulcers, and phlebitis — a condition in which the leg veins become swollen (16).

A 2012 review of 10 studies concluded that moderate evidence supports the use of MPFF (diosmin) to improve CVD symptoms, such as leg ulcers, edema, varicose veins, tingling sensation, general quality of life, and subjective pain ratings (16).

A 2016 review and 2018 meta-analysis supported these findings. Furthermore, they showed diosmin reduced leg heaviness, swelling, cramps, and restless leg syndrome (17, 18).

Diosmin treats CVD by reducing inflammation, improving the health of veins, and increasing blood and lymphatic circulation (3, 19, 20, 21).

Still, a 2017 study in 1,051 people noted that diosmin wasn’t as effective at treating CVD symptoms as other medications, such as Venoruton (Novartis) and Pycnogenol (pine bark extract). Other studies report similar findings (22, 23, 24).

Though diosmin may reduce symptoms of CVD, it’s best to speak to a healthcare professional before supplementing with it.

Back pain

In one study, 300 people reported minor improvements in back pain after taking 900 mg of diosmin 3 times daily for 2 weeks, followed by the same dose twice daily for 2 weeks, then a maintenance dose of 450 mg twice daily for 1 month (25).

However, compared with a control group taking mannitol and dexamethasone, diosmin was not more effective at reducing subjective back pain (25).

More research is needed to understand if diosmin aids back pain compared with more established treatments.

Other conditions

Some people take diosmin for other conditions, including lymphedema (swelling of the lymphatic system), varicocele (pain and enlargement of veins in the scrotum), minor bleeding, pelvic pain, and rosacea.

Diosmin is a known anti-inflammatory compound and may work to treat some of these inflammatory and circulation disorders.

Although small studies have shown some positive results for treating symptoms of lymphedema, varicocele, minor nasal bleeds, and pelvic pain, larger studies are needed before widespread recommendations can be made (26, 27, 28, 29).

Diosmin is generally recognized as a safe over-the-counter supplement.

Though rare, side effects of diosmin include stomach pain, diarrhea, headaches, dizziness, skin rash, hives, muscle pain, and — in severe cases — irregular heartbeat (30, 31).

If you experience any side effects after taking diosmin, discontinue use and speak with your healthcare provider. If you experience severe pain, severe diarrhea (10 or more loose stools in 24 hours), or an irregular heartbeat, seek medical attention immediately.

Diosmin is available over the counter in the United States, Canada, and certain European countries. It’s typically sold as micronized purified flavonoid fraction (MPFF), which usually contains 90% diosmin and 10% hesperidin.

The most common and well-researched supplement is Daflon 500 (450 mg diosmin, 50 mg hesperidin). It’s also known as Detralex in some regions. However, many other diosmin products are likely available in your local pharmacy and online.

Most diosmin products recommend taking one 500-mg supplement with food once in the morning and again in the evening for a total of 1,000 mg per day.

Under the guidance of a health professional, these dosage guidelines have been shown to be safe and effective for various conditions (16, 32, 33):

• Chronic venous disease: 1,000 mg per day for 3–6 months
• Hemorrhoids: 1,000–2,000 mg per day for 4 days, followed by 1,000 mg per day for 3 days
• Varicose veins: 1,000–2,000 mg per day for up to 6 months

Do not take diosmin for more than 3 months — or take more than the recommended dose on the label — unless instructed by your healthcare provider.

To date, there are no known cases of diosmin overdose or reports of toxicity.

Nonetheless, you should always follow the instructions on the label and speak to a healthcare professional to make sure it’s right for you.

Diosmin may interact with the following medications (34, 35, 36):

• anticoagulants (such as Warfarin)
• anticonvulsants (such as Carbamazepine and Phenytoin/Dilantin)
• antihistamines (such as Allegra)
• muscle relaxants (such as Chlorzoxazone)
• non-steroidal anti-inflammatory drugs (such as Voltaren, Motrin, Advil, and Aleve)
• acetaminophen (such as Tylenol)

Diosmin may inhibit various liver enzymes responsible for metabolizing the above medications. This can result in your medications working less effectively and may be dangerous for those with bleeding disorders by preventing proper blood clotting (34, 35, 36).

Diosmin may also interact with certain herbal supplements, including fenugreek, feverfew, garlic, ginger, ginkgo, ginseng, and turmeric, due to their involvement in blood thinning (34).

If you take any of these medications or supplements, be sure to speak to your healthcare provider before trying diosmin.

Be sure to store diosmin in a cool, dry environment, such as a medicine cabinet. Always read the label and avoid taking any supplements past their expiration date.

Due to a lack of safety research, women who are pregnant or breastfeeding should avoid taking diosmin.

Always speak with your healthcare provider before taking any supplements or medications.

Diosmin may worsen bleeding people with bleeding disorders. If you have any bleeding disorders, avoid this supplement unless instructed otherwise by your healthcare provider (30, 31).

Children and teenagers should avoid taking diosmin, as there is no available safety research in these age groups.

If you have any underlying conditions, such as diabetes, heart disease, and inflammatory bowel disease (IBD), it’s important to speak with a healthcare professional before taking diosmin.

Depending on your condition, a variety of other products or treatments may work as a suitable alternative to diosmin (7, 21, 37, 38):

• Hemorrhoids: high fiber diets, topical creams and suppositories, over-the-counter pain relievers (Advil, Motrin, Tylenol), prescription medications, injections, and surgical procedures like hemorrhoid removal or hemorrhoid stapling
• CVD (including varicose veins): over-the-counter pain relievers (Advil, Motrin, Tylenol), compression socks, exercise, Antistax (red vine leaf extract) or other supplements, prescription medications, sclerotherapy, laser or radiofrequency ablation, and surgical procedures like vein ligation

Though diosmin has been shown to aid these conditions, your healthcare provider may recommend a combination of treatments.