Cece's quote wrote:
Flavonoids such as micronized purified flavonoid fraction, containing 90% diosmin and 10% hesperidin, may also protect the vein wall from hypoxia and inhibit the expression of adhesion molecules on endothelium and leucocyte [6,17,67,68].
Cece, the last sentence of your last quote describes Daflon which you might remember we've discussed before.
DAFLON 500 mg is an oral phlebotropic drug indicated in the treatment of venous disease, i.e, chronic venous insufficiency (CVI) and haemorrhoidal disease (HD).
Origin and composition of DAFLON 500 mg
DAFLON 500 mg, micronized, purified flavonoid fraction (MPFF), is a semisynthetic phlebotropic drug whose active ingredients are micronized diosmin (90%) and hesperidin (10%). Hesperidin is extracted from a species of Rutaceae aurantieae of the citrus genus, a type of immature small orange harvested and dried in Spain, North Africa, and China. Diosmin, a member of the flavonoid family, is synthesized starting from this raw material.(1,2)
Why is the micronized form of DAFLON 500 mg important?
Micronization means that the active ingredient of DAFLON 500 mg undergoes a high-tech grinding process with a jet of air at supersonic velocities, reducing the size of standard particles from more than 20 µm to less than 2 µm. Thanks to its micronized form, DAFLON 500 mg has better and faster absorption, and thus an increased bioavailability, which leads to faster and more powerful clinical efficacy in venous disease.(3-7)
How does DAFLON 500 mg act?
DAFLON 500 mg has a comprehensive and rigorously demonstrated mode of action, which enables it to fight simultaneously all the pathophysiological aspects of venous disease, affecting the veins, lymphatics, and microcirculation.
DAFLON 500 mg prolongs the vasoconstrictor effect of noradrenaline on the vein wall,(8) even under warm and acidotic conditions, 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.
DAFLON 500 mg improves lymphatic drainage by increasing the frequency and intensity of lymphatic contractions, and by increasing the total number of functional lymphatic capillaries. Furthermore, DAFLON 500 mg decreases the diameter of lymphatic capillaries and the intralymphatic pressure (9,10)
At the microcirculation level, DAFLON 500 mg reduces capillary hyperpermeability and increases capillary resistance by protecting the microcirculation from damaging processes. DAFLON 500 mg reduces the expression of endothelial adhesion molecules (ICAM1, VCAM1),(11) 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, PGF2).(12-18)
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 DAFLON 500 mg in chronic venous insufficiency and haemorrhoidal disease, both of which are associated with perivascular inflammation and edema.
Has DAFLON 500 mg demonstrated its clinical efficacy in chronic venous insufficiency?
In patients suffering from CVI, DAFLON 500 mg provides significant relief by improving disabling symptoms, (18-20) such as pain, heavy legs, cramps, and sensation of swelling. Moreover, DAFLON 500 mg also significantly improves clinical signs, such as leg edema,(20,21) skin disorders,(22) and venous leg ulcer.(23,24) This improvement of signs and symptoms contributes to a significant increase in patients' quality of life, as assessed with a validated international scale specific to CVI: the CIVIQ questionnaire.(19)
Can DAFLON 500 mg be useful in treating complications of chronic venous insufficiency?
*Venous leg ulcer
In venous leg ulcer, the combination of DAFLON 500 mg and conventional compression therapy has been proven not only to accelerate the healing rate, but also to increase the total number of completely healed leg ulcers.(23,24) A recent study confirmed the same and also showed that addition of Daflon 500 reduces healing time by 1 month (25) and improves cost – effectiveness ratio by 45%.
* Postsurgical and postradiotherapy lymphedema
Administration of DAFLON 500 mg, 2 tablets daily, for 6 months in patients who had lymphedema after breast cancer surgery leads to a 1.5% to 13.4% decrease in circumference of the affected arm, an improvement in tissue elasticity, and an improvement in lymphatic drainage functional parameters, evaluated by isotope scan.(26) Another double-blind, placebo controlled study, with an equal treatment period and dosage, demonstrated that DAFLON 500 mg induces and increases the velocity of lymphatic drainage on isotope scan, improves functional disturbances, and constantly decreases the volume of the affected arm.(27)
What about the efficacy of DAFLON 500 mg in haemorroidal disease?
In acute haemorrhoidal attacks, DAFLON 500 mg is highly effective, right from the second day of treatment, in improving all signs and symptoms, such as bleeding, pain, discharge, tenesmus, and proctitis, thereby reducing the consumption of oral analgesics.(28,29)
The efficacy of DAFLON 500 mg associated with fiber supplement has been superior to fiber supplement alone and equivalent to rubber-band ligation plus fiber supplement in stopping anal bleeding due to haemorrhoids.(31)
DAFLON 500 mg combined with haemorrhoidectomy significantly reduces the risk of postoperative bleeding.(31) In a recent study , Daflon 500 when used in combination with short- term antibiotic and anti-inflammatory treatment reduced both the duration and extent of post operative symptoms ( pain, tenesmus, pruritus ) and wound bleeding following haemorrhoidectomy.(32)
In long-term treatment for chronic haemorrhoidal disease, DAFLON 500 mg has been proven to significantly reduce recurrence, duration, number, and severity of haemorrhoidal attacks.(30,33)
What is the dosage of DAFLON 500 mg?
Chronic venous insufficiency: 2 tablets daily
- Haemorrhoidal attacks: 6 tablets daily for 4 days followed by 4 tablets daily for 3 days
- Chronic haemorrhoids: 2 tablets daily
Manufactured by: SERDIA PHARMACEUTICALS LTD