Diosmin

Diosmin, semisynthetic phlebotropic drug, is a member of the flavonoid family.It is considered first-line therapy (with Hesperidin) to control internal hemorrhoidal (Piles) symptoms. It is an oral phlebotropic drug indicated in the treatment of venous disease, ie, chronic venous insufficiency (CVI) and all grades of hemorrhoidal disease (HD). Either in acute or chronic hemorrhoids, or as a valuable equivalent to rubber-band ligation in combination with fiber supplement), or as an adjuvant therapy to hemorrhoidectomy, in order to reduce secondary bleeding, it provides rapid and sutained relief.

Diosmin fight simultaneously all the pathophysiological aspects of venous disease, affecting the veins, lymphatics, and microcirculation. It prolongs the vasoconstrictor effect of noradrenaline 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).

This protective and reinforcing action on the venous and lymphatic system, associated with the vasculoprotective effect on the microcirculation, explains the restorative and protective efficacy of DIOSMIN WITH HESPERIDIN 500 mg in chronic venous insufficiency and hemorrhoidal disease, both of which are associated with perivascular inflammation and edema.

Razib Mahbubul Student of Pharmacy (B.Pharm) University of Dhaka. racynz007@yahoo.com