What is diosmin?

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).

Benefits and uses

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).

Side effects and precautions

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.

Dosage and how to take

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.

Overdose

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.

Interactions

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.

Storage and handling

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.

Pregnancy and breastfeeding

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.

Use in specific populations

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.

Alternatives

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. For best results, always follow your healthcare provider’s recommendations.