Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Diosmin is a naturally occurring flavonoid glycoside, primarily found in citrus fruits, and is widely used as a venotonic agent. Its main traditional and clinical application is in the management of chronic venous insufficiency (CVI), varicose veins, hemorrhoids, and other circulatory disorders involving the veins. Multiple randomized controlled trials and meta-analyses have demonstrated that diosmin (often in combination with hesperidin) can reduce symptoms such as leg swelling (edema), pain, and heaviness associated with CVI. Diosmin is thought to work by increasing venous tone, reducing venous distensibility and stasis, and improving lymphatic drainage. It also exhibits anti-inflammatory and antioxidant effects that may further benefit vein health.

The Cochrane Database of Systematic Reviews (2014) concluded that micronized purified flavonoid fraction (which contains diosmin) is more effective than placebo for symptom improvement in CVI. The European Medicines Agency (EMA) recognizes diosmin as a traditional herbal medicinal product for relief of symptoms of CVI and hemorrhoids. Side effects are generally mild and include gastrointestinal discomfort and headache. While more high-quality, long-term studies would be valuable, the existing evidence base, including decades of use in Europe, supports the use of diosmin for venous disorders, justifying a high evidence rating.

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