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== Diosmiplex ==
== Diosmiplex ==
Micronized purified flavonoid fraction (generic name diosmiplex, commercial name Vasculera)<ref name="CVDUS2017" /> is a 2nd generation diosmin classified as a [[medical food]] by the FDA in the United States for the potential treatment of [[chronic venous insufficiency]].<ref>{{cite web |title=DailyMed - VASCULERA- diosmiplex tablet |url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=563d3d34-a547-471e-aecd-f4a4a57cbf1d |website=dailymed.nlm.nih.gov |publisher=National Institutes of Health |accessdate=8 November 2019 |date=26 April 2012}}</ref><ref name="vasc">{{cite web |title=Vasculera |url=https://www.drugs.com/mtm/vasculera.html |publisher=Drugs.com |accessdate=7 November 2019 |date=3 December 2018}}</ref> Diosmiplex is the only phlebotonic, {{asof|2017|lc=y}}, sold as a medical food product purported for the management of [[chronic venous insufficiency]].<ref name="CVDUS2017">{{cite journal |last1=Bush |first1=R |last2=Comerota |first2=A |last3=Meissner |first3=M |last4=Raffetto |first4=JD |last5=Hahn |first5=SR |last6=Freeman |first6=K |title=Recommendations for the medical management of chronic venous disease: The role of Micronized Purified Flavanoid Fraction (MPFF): Recommendations from the Working Group in Chronic Venous Disease (CVD) 2016 |journal=Phlebology |date=April 2017 |volume=32 |issue=1_suppl |pages=3-19 |doi=10.1177/0268355517692221 |pmid=28211296 |url=https://journals.sagepub.com/doi/abs/10.1177/0268355517692221 |type=Professional society guidelines |quote=Only recently has a standardized formulation MPFF been available in the United States (Vasculera—Primus Pharmaceuticals, Inc.).}}</ref> Diosmiplex is recommended by the American Working Group in Chronic Venous Disease as a medical therapy, alone or combined with compressive therapy, for chronic venous disease and venous ulcers, having "beneficial outcomes without serious adverse events", concurring with the previous guidance of the International European Society for Vascular Surgery.<ref name="CVDUS2017" />
Micronized purified flavonoid fraction (generic name diosmiplex, commercial name Vasculera)<ref name="CVDUS2017">{{cite journal |last1=Bush |first1=R |last2=Comerota |first2=A |last3=Meissner |first3=M |last4=Raffetto |first4=JD |last5=Hahn |first5=SR |last6=Freeman |first6=K |title=Recommendations for the medical management of chronic venous disease: The role of Micronized Purified Flavanoid Fraction (MPFF): Recommendations from the Working Group in Chronic Venous Disease (CVD) 2016 |journal=Phlebology |date=April 2017 |volume=32 |issue=1_suppl |pages=3-19 |doi=10.1177/0268355517692221 |pmid=28211296 |url=https://journals.sagepub.com/doi/abs/10.1177/0268355517692221 |type=Professional society guidelines |quote=Only recently has a standardized formulation MPFF been available in the United States (Vasculera—Primus Pharmaceuticals, Inc.).}}</ref> is a 2nd generation diosmin classified as a [[medical food]] by the FDA in the United States for the potential treatment of [[chronic venous insufficiency]].<ref name="dailymed-diosmiplex">{{cite web |title=DailyMed - VASCULERA- diosmiplex tablet |url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=563d3d34-a547-471e-aecd-f4a4a57cbf1d |website=dailymed.nlm.nih.gov |publisher=National Institutes of Health |accessdate=8 November 2019 |date=26 April 2012}}</ref><ref name="vasc">{{cite web |title=Vasculera |url=https://www.drugs.com/mtm/vasculera.html |publisher=Drugs.com |accessdate=7 November 2019 |date=3 December 2018}}</ref> Diosmiplex is the only phlebotonic, {{asof|2017|lc=y}}, sold as a medical food product purported for the management of [[chronic venous insufficiency]].<ref name="CVDUS2017" /> Diosmiplex is recommended by the American Working Group in Chronic Venous Disease as a medical therapy, alone or combined with compressive therapy, for chronic venous disease and venous ulcers, having "beneficial outcomes without serious adverse events", concurring with the previous guidance of the International European Society for Vascular Surgery.<ref name="CVDUS2017" />


== See also ==
== See also ==

Revision as of 04:01, 8 November 2019

Diosmin
Clinical data
AHFS/Drugs.comInternational Drug Names
Routes of
administration		oral
ATC code
Identifiers
  • 5-Hydroxy-2-(3-hydroxy-4-methoxyphenyl)- 7-[(2S,3R,4S,5S,6R)-3,4,5-trihydroxy -6-[[(2R,3R,4R,5R,6S) -3,4,5-trihydroxy-6-methyloxan-2-yl]oxymethyl]oxan-2-yl]oxychromen-4-one
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.007.537 Edit this at Wikidata
Chemical and physical data
FormulaC28H32O15
Molar mass608.545 g/mol g·mol−1
3D model (JSmol)
  • O=C\4c5c(O)cc(O[C@@H]2O[C@H](CO[C@@H]1O[C@H]([C@H](O)[C@@H](O)[C@H]1O)C)[C@@H](O)[C@H](O)[C@H]2O)cc5O/C(c3ccc(OC)c(O)c3)=C/4
  • InChI=1S/C28H32O15/c1-10-21(32)23(34)25(36)27(40-10)39-9-19-22(33)24(35)26(37)28(43-19)41-12-6-14(30)20-15(31)8-17(42-18(20)7-12)11-3-4-16(38-2)13(29)5-11/h3-8,10,19,21-30,32-37H,9H2,1-2H3/t10-,19+,21-,22+,23+,24-,25+,26+,27+,28+/m0/s1 checkY
  • Key:GZSOSUNBTXMUFQ-YFAPSIMESA-N checkY
 ☒NcheckY (what is this?)  (verify)

Diosmin (diosmetin 7-O-rutinoside), a flavone glycoside of diosmetin, is manufactured from citrus fruit peels as a non-prescription dietary supplement used to aid treatment of hemorrhoids or chronic venous diseases, mainly of the legs.[1]

Uses

Diosmin is a dietary supplement used to aid treatment of hemorrhoids and venous diseases, i.e., chronic venous insufficiency including spider and varicose veins, leg swelling (edema), stasis dermatitis and venous ulcers.[1] A 2016 Cochrane review found only moderate-quality evidence that diosmin or other compounds called phlebotonics improved leg and ankle swelling and lower leg pain.[2]

Its mechanism of action is undefined,[1] and clinical evidence of benefit is limited.[1] Diosmin is not recommended for treating the rectal mucosa, skin irritations, or wounds, and should not be used to treat dermatitis, eczema, or urticaria.[1] Diosmin is not recommended for use in children or women during pregnancy.[1]

Adverse effects

In some 10% of users, diosmin causes mild gastrointestinal disorders or skin irritations (hives, itching), stomach pain, nausea, heart arrhythmias, or anemia.[1] Preliminary research indicates there is no indication of toxicity.[1] The US Food and Drug Administration (FDA) concluded in 2001 that there was inadequate evidence on which to base an expectation of safety.[3] As of 2013, the FDA did not revise this position.[4]

Regulatory status

Diosmin is distributed in the U.S. as a dietary supplement called Daflon.[1] Diosmin is not approved as a prescription drug in the United States or Europe.[1]

Diosmiplex

Micronized purified flavonoid fraction (generic name diosmiplex, commercial name Vasculera)[5] is a 2nd generation diosmin classified as a medical food by the FDA in the United States for the potential treatment of chronic venous insufficiency.[6][7] Diosmiplex is the only phlebotonic, as of 2017, sold as a medical food product purported for the management of chronic venous insufficiency.[5] Diosmiplex is recommended by the American Working Group in Chronic Venous Disease as a medical therapy, alone or combined with compressive therapy, for chronic venous disease and venous ulcers, having "beneficial outcomes without serious adverse events", concurring with the previous guidance of the International European Society for Vascular Surgery.[5]

See also

References

  1. ^ a b c d e f g h i j "Diosmin". Drugs.com. 1 January 2019. Retrieved 7 November 2019.
  2. ^ Martinez-Zapata, Maria José; Vernooij, Robin WM; Uriona Tuma, Sonia Maria; Stein, Airton T; Moreno, Rosa M; Vargas, Emilio; Capellà, Dolors; Bonfill Cosp, Xavier (6 April 2016). "Phlebotonics for venous insufficiency". Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD003229.pub3. PMID 27048768.
  3. ^ New Dietary Ingredients in Dietary Supplements, U. S. Food and Drug Administration Center for Food Safety and Applied Nutrition Office of Nutritional Products, Labeling, and Dietary Supplements February 2001 (Updated September 10, 2001) [1], Memorandum [2]
  4. ^ Garg, Nitin; Gloviczki, Peter (2013). "55 - Chronic Venous Insufficiency". Vascular Medicine: A Companion to Braunwald's Heart Disease (Second Edition). Elsevier Health Sciences. pp. 652–666. ISBN 9781437729306.
  5. ^ a b c Bush, R; Comerota, A; Meissner, M; Raffetto, JD; Hahn, SR; Freeman, K (April 2017). "Recommendations for the medical management of chronic venous disease: The role of Micronized Purified Flavanoid Fraction (MPFF): Recommendations from the Working Group in Chronic Venous Disease (CVD) 2016". Phlebology (Professional society guidelines). 32 (1_suppl): 3–19. doi:10.1177/0268355517692221. PMID 28211296. Only recently has a standardized formulation MPFF been available in the United States (Vasculera—Primus Pharmaceuticals, Inc.).
  6. ^ "DailyMed - VASCULERA- diosmiplex tablet". dailymed.nlm.nih.gov. National Institutes of Health. 26 April 2012. Retrieved 8 November 2019.
  7. ^ "Vasculera". Drugs.com. 3 December 2018. Retrieved 7 November 2019.
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