Diosmin
Encyclopedia
Diosmin is a semisynthetic
phlebotropic drug
(modified hesperidin
), a member of the flavonoid
family. It is an oral phlebotropic drug used in the treatment of venous disease, i.e., chronic venous insufficiency
(CVI) and hemorrhoidal disease (HD), in acute or chronic hemorrhoids, in place of rubber-band ligation, in combination with fiber supplement, or as an adjuvant therapy to hemorrhoidectomy, in order to reduce secondary bleeding. To control internal symptoms of hemorrhoids (piles), it is used with hesperidin
.
Clinical studies have been inconclusive and no review articles on its use in vascular disease have been published.
Diosmin is currently a prescription medication in some European countries, and is sold as a nutritional supplement in the United States and the rest of Europe.
Diosmin aglycone is diosmetin
.
Diosmin has been found to be effective in mitigating hyperglycemia in diabetic rats. It is also speculated that diosmin might have potential in the treatment of neurodegenerative diseases, such as alzheimer's disease
, and its anti-inflammatory and anti-apoptotic activity has been demonstrated in neuronal cells, in vitro.
on the vein wall, increasing venous tone, and therefore reducing venous capacitance, distensibility, and stasis
. This increases the venous return and reduces venous hyperpressure present in patients suffering from CVI.
Diosmin improves lymphatic drainage by increasing the frequency and intensity of lymphatic contractions, and by increasing the total number of functional lymphatic capillaries. Furthermore, diosmin with hesperidine decreases the diameter of lymphatic capillaries and the intralymphatic pressure.
At the microcirculation level, diosmin reduces capillary hyperpermeability and increases capillary resistance by protecting the microcirculation from damaging processes.
Diosmin reduces the expression of endothelial adhesion molecules (ICAM1, VCAM1), and inhibits the adhesion, migration, and activation of leukocytes at the capillary level. This leads to a reduction in the release of inflammatory mediators, principally oxygen free radicals and prostaglandins (PGE2, PGF2a).
One company that markets diosmin supplements, Nutratech, has responded that diosmin can reasonably be expected to be safe on the basis of clinical trials, and has a long history of use in Europe. In the U.S., dietary supplements are regulated under Dietary Supplement Health and Education Act of 1994, which does not require proof of efficacy so long as no specific health claims are made.
Semisynthetic
"Semisynthesis" or partial chemical synthesis is a type of chemical synthesis that uses compounds isolated from natural sources as starting materials. These natural biomolecules are usually large and complex molecules...
phlebotropic drug
Drug
A drug, broadly speaking, is any substance that, when absorbed into the body of a living organism, alters normal bodily function. There is no single, precise definition, as there are different meanings in drug control law, government regulations, medicine, and colloquial usage.In pharmacology, a...
(modified hesperidin
Hesperidin
Hesperidin is a flavanone glycoside found abundantly in citrus fruits. Its aglycone form is called hesperetin. Its name is derived from the Hesperides nymphs of Greek mythology. Hesperidin is believed to play a role in plant defense. It acts as an antioxidant according to in vitro studies...
), a member of the flavonoid
Flavonoid
Flavonoids , are a class of plant secondary metabolites....
family. It is an oral phlebotropic drug used in the treatment of venous disease, i.e., chronic venous insufficiency
Chronic venous insufficiency
Chronic venous insufficiency or CVI is a medical condition where the veins cannot pump enough oxygen-poor blood back to the heart. It is sometimes referred to as an "impaired musculovenous pump", this is due to damaged or "incompetent" valves as may occur after deep vein thrombosis or phlebitis...
(CVI) and hemorrhoidal disease (HD), in acute or chronic hemorrhoids, in place of rubber-band ligation, in combination with fiber supplement, or as an adjuvant therapy to hemorrhoidectomy, in order to reduce secondary bleeding. To control internal symptoms of hemorrhoids (piles), it is used with hesperidin
Hesperidin
Hesperidin is a flavanone glycoside found abundantly in citrus fruits. Its aglycone form is called hesperetin. Its name is derived from the Hesperides nymphs of Greek mythology. Hesperidin is believed to play a role in plant defense. It acts as an antioxidant according to in vitro studies...
.
Clinical studies have been inconclusive and no review articles on its use in vascular disease have been published.
Diosmin is currently a prescription medication in some European countries, and is sold as a nutritional supplement in the United States and the rest of Europe.
Diosmin aglycone is diosmetin
Diosmetin
Diosmetin is an O-methylated flavone, a chemical compound that can be found in the Caucasian vetch...
.
Diosmin has been found to be effective in mitigating hyperglycemia in diabetic rats. It is also speculated that diosmin might have potential in the treatment of neurodegenerative diseases, such as alzheimer's disease
Alzheimer's disease
Alzheimer's disease also known in medical literature as Alzheimer disease is the most common form of dementia. There is no cure for the disease, which worsens as it progresses, and eventually leads to death...
, and its anti-inflammatory and anti-apoptotic activity has been demonstrated in neuronal cells, in vitro.
Mechanisms
Diosmin prolongs the vasoconstrictor effect of norepinephrineNorepinephrine
Norepinephrine is the US name for noradrenaline , a catecholamine with multiple roles including as a hormone and a neurotransmitter...
on the vein wall, increasing venous tone, and therefore reducing venous capacitance, distensibility, and stasis
Stasis
The term stasis may refer to* A state of stability, in which all forces are equal and opposing, therefore they cancel out each other....
. This increases the venous return and reduces venous hyperpressure present in patients suffering from CVI.
Diosmin improves lymphatic drainage by increasing the frequency and intensity of lymphatic contractions, and by increasing the total number of functional lymphatic capillaries. Furthermore, diosmin with hesperidine decreases the diameter of lymphatic capillaries and the intralymphatic pressure.
At the microcirculation level, diosmin reduces capillary hyperpermeability and increases capillary resistance by protecting the microcirculation from damaging processes.
Diosmin reduces the expression of endothelial adhesion molecules (ICAM1, VCAM1), and inhibits the adhesion, migration, and activation of leukocytes at the capillary level. This leads to a reduction in the release of inflammatory mediators, principally oxygen free radicals and prostaglandins (PGE2, PGF2a).
Regulatory status
Diosmin is distributed in the U.S. as a dietary supplement. The FDA concluded that there was inadequate evidence on which to base an expectation of safety.One company that markets diosmin supplements, Nutratech, has responded that diosmin can reasonably be expected to be safe on the basis of clinical trials, and has a long history of use in Europe. In the U.S., dietary supplements are regulated under Dietary Supplement Health and Education Act of 1994, which does not require proof of efficacy so long as no specific health claims are made.
External links
- Diosmin, Alternative Medicine Review, Sept 2004