Diosmin
Sources réglementaires consultées
Indications approuvées
- Soulagement chez l'adulte des symptômes liés aux hémorroïdes, tels que la douleur ou l'inflammation de la région anale.
Contre-indications
Absolues
- Hypersensibilité à la diosmine ou à l'un des excipients.
Mises en garde cliniques
- Mise en garde majeure · Le traitement est uniquement de courte durée et ne remplace pas le traitement spécifique d'autres affections anales. Si les symptômes persistent, effectuer une évaluation proctologique et revoir le traitement. — https://cima.aemps.es/cima/dochtml/ft/86038/FT_86038.html
- Contient du lactose ; ne pas utiliser en cas d'intolérance héréditaire au galactose, de déficit total en lactase ou de malabsorption du glucose-galactose. — https://cima.aemps.es/cima/dochtml/ft/86038/FT_86038.html
Effets indésirables
Communs (≥1%)
Diarrhée · Dyspepsie · Nausées · Vomissements
Rares mais graves
Œdème de Quincke de fréquence indéterminée
Grossesse et allaitement
Par précaution, il est préférable d'éviter l'utilisation pendant la grossesse. Pendant l'allaitement, décider d'interrompre soit l'allaitement, soit le traitement, en tenant compte du bénéfice pour l'enfant et pour la mère.
Bibliographie récente (PubMed)
Kidney stone disease (KSD) (alternatively nephrolithiasis or urolithiasis) is a global health care problem that affects people in almost all of developed and developing countries. Its prevalence has been continuously increasing with a high recurrence rate after stone removal. Although effective therapeutic modalities are available, preventive strategies for both new and recurrent stones are required to reduce physical and financial burdens of KSD. To prevent kidney stone formation, its etiology and risk factors should be first considered. Low urine output and dehydration are the common risks of all stone types, whereas hypercalciuria, hyperoxaluria, and hypocitraturia are the major risks of calcium stones. In this article, up-to-date knowledge on strategies (nutrition-based mainly) to prevent KSD is provided. Important roles of fluid intake (2.5-3.0 L/d), diuresis (>2.0-2.5 L/d), lifestyle and habit modifications (for example, maintain normal body mass index, fluid compensation for working in high-temperature environment, and avoid cigarette smoking), and dietary management [for example, sufficient calcium at 1000-1200 mg/d, limit sodium at 2 or 3-5 g/d of sodium chloride (NaCl), limit oxalate-rich foods, avoid vitamin C and vitamin D supplements, limit animal proteins to 0.8-1.0 g/kg body weight/d but increase plant proteins in patients with calcium and uric acid stone and those with hyperuricosuria, increase proportion of citrus fruits, and consider lime powder supplementation] are summarized. Moreover, uses of natural bioactive products (for example, caffeine, epigallocatechin gallate, and diosmin), medications (for example, thiazides, alkaline citrate, other alkalinizing agents, and allopurinol), bacterial eradication, and probiotics are also discussed.
Flavonoids are phytochemicals that are well known for their beneficial pharmacological properties. Diosmin is a flavone glycoside derived from hesperidin, a flavanone abundantly found in citrus fruits. Daflon is an oral phlebotonic flavonoid combination containing diosmin and hesperidin (9:1) that is commonly used for the management of blood vessel disorders. After oral administration, diosmin is converted to diosmetin, which is subsequently absorbed and esterified into glucuronide conjugates that are excreted in the urine. Pharmacological effects of diosmin have been investigated in several in vitro and in vivo studies, and it was found to possess anti-inflammatory, antioxidant, antidiabetic, antihyperlipidemic, and antifibrotic effects in different disease models. Diosmin also demonstrated multiple desirable properties in several clinical studies. Moreover, toxicological studies showed that diosmin has a favorable safety profile. Accordingly, diosmin is a potential effective and safe treatment for many diseases. However, diosmin exhibits inhibitory effects on different metabolic enzymes. This encourages the investigation of its potential therapeutic effect and safety in different diseases in clinical trials, while taking potential interactions into consideration.
Postoperative swelling is a common complication after total knee arthroplasty (TKA), associated with pain, limited mobility, and delayed recovery. This study aimed to systematically review the literature on interventions that reduce postoperative swelling, categorized into preoperative, intraoperative, and postoperative phases. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant search of PubMed, Medline, Embase, and Cochrane databases was performed for clinical studies evaluating interventions to reduce swelling after primary TKA. Data were grouped by intervention timing. Methodological quality was appraised using the Modified Jadad Score, Methodological Index for Non-Randomized Studies, and AMSTAR 2 tools. A total of 140 clinical studies were included, encompassing 7 meta-analyses, 125 randomized controlled trials, and 8 cohort studies. Tranexamic acid (TXA) was the most consistently effective intervention, particularly in repeated or combined regimens. Avoiding or limiting tourniquet (TQ) use, maintaining postoperative knee flexion (30°-90° for 6-72 hours), and applying cryotherapy during the first 2 weeks were consistently associated with reduced swelling. Other promising strategies included prehabilitation, aspirin cessation, cold intra-articular irrigation, mechanical compression, and adjunctive therapies like diosmin, acupuncture, and kinesiotaping. Interventions such as manual lymphatic drainage, continuous passive movement, and static compression bandaging showed inconsistent or no significant effects. Several perioperative strategies reduce postoperative swelling after TKA, with the strongest evidence supporting TXA, TQ minimization, knee flexion, and cryotherapy. These findings should inform the design of multimodal enhanced recovery protocols optimized for swelling management. Future research should prioritize standardized outcome reporting and assess synergistic effects of combined interventions. Level I, systematic review. Se
Chronic venous disease (CVD) is a major global health issue, affecting millions of people and contributing to significant morbidity and economic strain. The condition's pathophysiology is complex, involving both mechanical and biochemical processes that lead to venous reflux, obstruction, and chronic inflammation. This review focuses on the role of venoactive compounds (VACs), also known as venoactive drugs in Europe and other parts of the world, in managing CVD. The aim was to review the scientific evidence and to define the role of VACs within the comprehensive treatment algorithm for CVD, alongside established and well adopted interventional therapies and noninterventional therapies such as compression. The review of the scientific evidence was done on VACs mechanism of action and efficacy in alleviating CVD symptoms, reducing swelling or venous edema, and improving healing of venous leg ulcers. Whenever available, systematic reviews, meta-analyses and randomized controlled trials were used. The quality of evidence assessment followed the GRADE methodology from A (high), B (moderate), to C (low to very low) quality. Venoactive drugs or compounds share similar effects, such as sealing the endothelial barrier, enhancing lymphatic drainage, reducing edema, improving venous tone, inhibiting leukocyte adhesion to vein walls/valves and inflammatory mediator release, lowering blood viscosity, and promoting red blood cell flexibility. Scientific evidence on the VACs effectiveness on CVD symptoms (pain, cramps, and heaviness) and swelling or edema have shown some variability. Micronized purified flavonoid fraction (MPFF) and Ruscus extract combined with hesperidin methyl chalcone and ascorbic acid had the highest, mostly level A, quality of evidence. In venous leg ulcers, micronized purified flavonoid fraction, sulodexide, and pentoxifylline were the most effective adjunctive treatments, with evidence level A. The existing scientific evidence provides a strong rationale f
Citrus flavonoids are highly bioactive compounds exerting numerous health benefits including anticancer, antioxidant, antimicrobial, anti-inflammatory, mitoprotective, and neuroprotective activity. Research on their broad-scope bioactivity experienced a renaissance in the early 2000s, and further accelerated after COVID-19, including research on their antimicrobial properties. Summarizing selected research achievements on the antimicrobial activity of the main Citrus flavonoids, this study aims to provide a unified picture on the antimicrobial properties of these valued compounds that will hopefully assist in the development of flavonoid-based antimicrobials, including antibacterial treatments suitable for clinical use minimizing antimicrobial resistance.