Daflon: Dosing

Availability: 

• Davmorid, Diosmin 450mg + Hesperidin 50mg

Mechanism of Action

• Diosmin seems to work by improving venous tone, reducing stasis, restoring normal capillary permeability, and improving lymphatic drainage.
• Diosmin might improve venous tone and reduce stasis by improving vasculature response to adrenergic stimulation.
• Diosmin's anti-inflammatory effects seem to help restore normal capillary permeability.
• Diosmin inhibits phosphodiesterase and increases intracellular cyclic adenosine monophosphate (cAMP), which causes decreased production of inflammatory prostaglandins E2 and F2 and thromboxane B2

Dosing (adults)
Haemorrhoids / Acute attack:

• 6 tablets daily in 2 divided doses 4 days followed by 4 tablets daily (in 2 divided doses) for the next 3 days than 2 tablets daily

Chronic haemorrhoids:

• 2 tablets daily.

Chronic venous disease

• 2 tablets daily.

Other dosing regimen:

• For treating lymphedema following surgery for breast cancer, the combination of 900 mg diosmin and 100 mg hesperidin daily has been used for up to 6 months
• For the treatment of venous stasis ulcers, the combination of 900 mg diosmin and 100 mg hesperidin daily has been used for up to 2 months

Evidences:

• combination of diosmin 1350 mg plus hesperidin 150 mg twice daily for 4 days followed by diosmin 900 mg and hesperidin 100 mg twice daily for 3 days seems to significantly improve signs and symptoms of internal hemorrhoids. The combination can stop acute bleeding in up to 92% of patients after 4 days of treatment.
• It can also reduce symptoms such as anal discomfort, pain, discharge, and local lesions. Subjective symptoms can be relieved within 2 days of treatment.
• The combination also seems to reduce the duration and intensity of hemorrhoidal flare-ups
• Some clinicians use diosmin in lower doses and in combination with bulk laxatives instead of hesperidin. Diosmin 600 mg three times daily for 4 days, then 300 mg twice daily for 10 more days plus the bulk laxative psyllium 11 grams daily does seem to slightly help after 4 days of treatment
• However, this combination does not seem to be as effective as the higher dose of diosmin plus hesperidin combination.
• Maintenance use of diosmin 450 mg plus hesperidin 50 mg twice daily for 3 months in patients following acute treatment for internal hemorrhoids seems to significantly decrease the relapse rate

References:

1. http://naturaldatabase.therapeuticresearch.com/nd/PrintVersion.aspx?id=1030
2. http://online1.mimsgateway.com.my
3. Drug Information Leaflet