Diosmin
Also called diosmine, micronized diosmin, MPFF (with hesperidin), citrus bioflavonoid diosmin, venoactive flavonoid.
Best grade B across 8 graded outcomes Other Last checked
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The short answer
From 19 sourcesDiosmin is a citrus flavonoid used for heavy, swollen legs from chronic venous disease. Trials of diosmin alone are small, but a meta-analysis of 7 placebo-controlled trials in 1,692 people found the diosmin-hesperidin mix MPFF reduced leg pain, heaviness and swelling (grade B). In 2026 Health Canada linked diosmin to a possible bleeding risk.
Quick pick
From a partner brand · paid link
Natural Balance Diosmin, 500 mg, 60 Tablets
from HerbsPro
Label: 1 tablet: 500 mg diosmin (from hesperidin).
Best for trying one bottle: $31.09 one-time (checked Oct 15, 2026).
Every graded outcome on this page
8 rows · line = participants- BGrade BBleeding, pain and swelling after hemorrhoid surgery (MPFF)After hemorrhoid surgeryn 2,335
- BGrade BLeg pain, heaviness, swelling and quality of life in chronic venous disease (MPFF)Leg vein symptomsn 1,692
- CGrade CHemorrhoid symptoms (MPFF)Hemorrhoidsn 1,164
- CGrade CLeg swelling and pain after total knee replacementPost-surgery swellingn 330
- CGrade CRadicular (nerve root) pain vs intravenous mannitol and dexamethasoneNerve painn 300
- CGrade CPost-thrombotic syndrome after deep vein thrombosisAfter a leg clotn 90
- CGrade CLeg swelling, pain and quality of life in chronic venous diseaseLeg vein symptomsn 72
- DGrade DMuscle soreness and performance after hard exerciseExercise recoveryn 15
Key facts
- Chronic venous disease
- 450 mg/day for 8 weeks reduced leg edema from week 4 and improved pain and severity scores vs placebo in 72 adults (CEAP C2-C4)1
- Diosmin-hesperidin (MPFF) for leg veins
- A meta-analysis of 7 double-blind placebo-controlled trials (1,692 patients) found MPFF reduced leg pain, heaviness, feeling of swelling and cramps; a 2025 single-group analysis co-authored by Servier staff (51 randomized and non-randomized studies, 39,878 patients taking MPFF) reported the same direction; the independent 2020 Cochrane review of all phlebotonics found they probably reduce leg edema slightly but make little or no difference to quality of life91819
- After knee replacement
- 1.8 g/day for 14 days reduced calf and thigh swelling and pain on movement in 330 patients (open-label, no placebo)2
- Hemorrhoids
- An independent meta-analysis of 10 RCTs (1,164 participants) found MPFF improved bleeding vs placebo but not other symptoms, with low-quality evidence10
- Effect on other drugs
- 500 mg/day of diosmin for 10 days raised fexofenadine exposure (AUC) by 64% in 12 healthy men; 9 days raised metronidazole AUC by 27%1314
- Bleeding signal
- Health Canada (2026) found a possible link between diosmin, with or without hesperidin, and bleeding, with greater severity in people on anticoagulants5
- Health Canada dose cap (antioxidant claim)
- Citrus bioflavonoids, including diosmin, capped at 600 mg/day under the antioxidant monograph; products with 50 mg/day or more must advise checking with a practitioner if on blood thinners6
- Industry funding
- The 72-person venous trial was run by a contract research organization on behalf of Giellepi, maker of the tested diosmin product1
What it is
Diosmin is a semisynthetic citrus flavonoid sold for leg vein symptoms such as heaviness and swelling.
How it works
ProposedDiosmin is classed as a venoactive flavonoid and is used to support vein tone and reduce leg swelling. Health Canada's review cites studies suggesting diosmin may slow the clearance of some drugs, including anticoagulants, and may itself have blood-thinning effects, which could explain the bleeding signal. Its effects on veins in people are inferred from symptom trials, not measured mechanisms.15
Forms, side by side
2 forms named in our sources. The rest show what our data holds, and say plainly where it holds nothing yet.
Diosmin forms compared
2 forms| 2 forms | Tablets (semi-synthetic, micronized or non-micronized) | With hesperidin (about 90:10) |
|---|---|---|
| Absorption in people | No head-to-head human data on clinical outcomes; the 72-person trial used a formulation marketed as more bioavailable.1 | No head-to-head human data comparing it with diosmin alone7 |
| GI tolerance | Health Canada product labels list headache, dizziness, itchiness and stomach irritation or pain as known adverse reactions.7 | Covered by the same Health Canada bleeding review as diosmin alone.5 |
| Studied for | Leg vein symptoms, swelling after knee replacement, post-thrombotic syndrome | Leg vein symptoms and swelling (meta-analysis of 7 placebo-controlled trials), hemorrhoid bleeding, and recovery after hemorrhoid surgery; shown as separate MPFF rows in the evidence table |
- Diosmin tablets (semi-synthetic, micronized or non-micronized)
- Absorption in people
- No head-to-head human data on clinical outcomes; the 72-person trial used a formulation marketed as more bioavailable.1
- GI tolerance
- Health Canada product labels list headache, dizziness, itchiness and stomach irritation or pain as known adverse reactions.7
- Studied for
- Leg vein symptoms, swelling after knee replacement, post-thrombotic syndrome
- Diosmin with hesperidin (about 90:10)
- Absorption in people
- No head-to-head human data comparing it with diosmin alone7
- GI tolerance
- Covered by the same Health Canada bleeding review as diosmin alone.5
- Studied for
- Leg vein symptoms and swelling (meta-analysis of 7 placebo-controlled trials), hemorrhoid bleeding, and recovery after hemorrhoid surgery; shown as separate MPFF rows in the evidence table
What the human research says
Human trials only, one row per outcome. The form line shows what each trial actually tested. Grades follow our evidence-grading policy.
Trial map
8 graded outcomes, largest study first8 graded outcomes: 6 improved, 1 mixed, 1 no effect. The largest, a 2022 meta-analysis of 2,335 people on bleeding, pain and swelling after hemorrhoid surgery (MPFF), found an improvement.
1Bleeding, pain and swelling after hemorrhoid surgery (MPFF)
Improved · Grade B · Meta-analysis, 2,335 people, 2022
Patients after hemorrhoid surgery in 22 randomized controlled trials
Dose, result and source| Outcome | Found | People | Study | Who was studied |
|---|---|---|---|---|
| Bleeding, pain and swelling after hemorrhoid surgery (MPFF) | Improved | 2,335 | Grade B · Meta-analysis, 2022 | Patients after hemorrhoid surgery in 22 randomized controlled trials |
| Leg pain, heaviness, swelling and quality of life in chronic venous disease (MPFF) | Improved | 1,692 | Grade B · Meta-analysis, 2018 | Patients with chronic venous disease in 7 randomized double-blind placebo-controlled trials |
| Hemorrhoid symptoms (MPFF) | Mixed | 1,164 | Grade C · Meta-analysis, 2018 | People with hemorrhoids in 10 randomized controlled trials |
| Leg swelling and pain after total knee replacement | Improved | 330 | Grade C · RCT, 2024 | Patients undergoing total knee arthroplasty at 13 hospitals in China |
| Radicular (nerve root) pain vs intravenous mannitol and dexamethasone | Improved | 300 | Grade C · RCT, 2017 | Patients with radicular pain, China |
| Post-thrombotic syndrome after deep vein thrombosis | Improved | 90 | Grade C · RCT, 2020 | Adults with a first femoropopliteal deep vein thrombosis on rivaroxaban and compression stockings, Moscow |
| Leg swelling, pain and quality of life in chronic venous disease | Improved | 72 | Grade C · RCT, 2021 | Adults with chronic venous disease, CEAP class C2-C4, Italy (multicenter) |
| Muscle soreness and performance after hard exercise | No effect | 15 | Grade D · Crossover RCT, 2025 | Professional female futsal players, Brazil (pre-season) |
Every graded row
8 rowsShowing 8 of 8 outcomes. Human trials only.
BGrade BBleeding, pain and swelling after hemorrhoid surgery (MPFF)After hemorrhoid surgeryLess bleeding, pain, swellingMeta-analysis · 22 studies
n 2,335 · 2022
Improved MPFF improved clinical efficacy after hemorrhoidectomy and reduced bleeding rate, pain score and edema score, with no significant difference in adverse reactions. 1,800 to 2,700 mg/day reduced edema and pain scores in subgroup analyses.
- Design
- Meta-analysis, 22 studies, n = 2,335, 2022
- Population
- Patients after hemorrhoid surgery in 22 randomized controlled trials
- Form
- Micronized purified flavonoid fraction (MPFF): diosmin with hesperidin
- Dose
- Under 1,800 mg/day to 2,700 mg/day across trials
- Duration
- Varied by trial (subgroups of 4 to 10 days and 10 days or more)
- Source
- Reference 11 · PubMed 35752073 (opens PubMed)
BGrade BLeg pain, heaviness, swelling and quality of life in chronic venous disease (MPFF)Leg vein symptomsLess pain, heaviness, swellingMeta-analysis · 7 studies
n 1,692 · 2018
Improved MPFF reduced leg pain (RR 0.53), heaviness (RR 0.35), feeling of swelling (RR 0.39), cramps (RR 0.51) and functional discomfort vs placebo; as continuous scores pain fell slightly (SMD -0.25) and feeling of swelling more (SMD -0.99). Ankle circumference, leg redness, skin changes and quality of life (SMD -0.21) also improved.
- Design
- Meta-analysis, 7 studies, n = 1,692, 2018
- Population
- Patients with chronic venous disease in 7 randomized double-blind placebo-controlled trials
- Form
- Micronized purified flavonoid fraction (MPFF, Daflon): diosmin with hesperidin
- Dose
- As given in each trial
- Duration
- Varied by trial
- Source
- Reference 9 · PubMed 29385792 (opens PubMed)
CGrade CHemorrhoid symptoms (MPFF)HemorrhoidsLess bleeding onlyMeta-analysis · 10 studies
n 1,164 · 2018
Mixed Pooled data from 3 trials favoured MPFF for bleeding (RR 1.46, 95% CI 1.10 to 1.93); no significant effect on any other outcome vs placebo. Quality of evidence for bleeding was low.
- Design
- Meta-analysis, 10 studies, n = 1,164, 2018
- Population
- People with hemorrhoids in 10 randomized controlled trials
- Form
- Micronized purified flavonoid fraction (MPFF): diosmin with hesperidin
- Dose
- As given in each trial
- Duration
- Varied by trial
- Source
- Reference 10 · PubMed 30012392 (opens PubMed)
CGrade CLeg swelling and pain after total knee replacementPost-surgery swellingLess swellingRCT
n 330 · 2024
Improved Less swelling of the calf, thigh and upper kneecap at days 1, 2, 3 and 14, and lower pain scores during movement. Pain at rest, knee function score, range of motion, inflammatory markers and complication rates did not differ.
- Design
- RCT, n = 330, 2024
- Population
- Patients undergoing total knee arthroplasty at 13 hospitals in China
- Form
- Diosmin (semi-synthetic)
- Dose
- 0.9 g twice daily (1.8 g/day)
- Duration
- 14 days after surgery
- Source
- Reference 2 · PubMed 38109425 (opens PubMed)
CGrade CRadicular (nerve root) pain vs intravenous mannitol and dexamethasoneNerve painSimilar to IV drug comparisonRCT
n 300 · 2017
Improved Radicular pain fell with diosmin; total satisfaction was 84.7% (95% CI 77.9% to 90.0%) and did not differ significantly from the active-control group. No adverse effects were found with diosmin.
- Design
- RCT, n = 300, 2017
- Population
- Patients with radicular pain, China
- Form
- Oral diosmin
- Dose
- 50 mg/kg/day (vs IV mannitol 1 g/kg/day for 7 days and dexamethasone 10 mg/day for 3 days)
- Duration
- 1 month
- Source
- Reference 12 · PubMed 29119110 (opens PubMed)
CGrade CPost-thrombotic syndrome after deep vein thrombosisAfter a leg clotLess post-thrombotic syndromeRCT
n 90 · 2020
Improved Post-thrombotic syndrome at 12 months in 8.9% with diosmin vs 48.9% with standard care alone (relative risk 0.14); faster vein recanalization and better quality of life. Recurrent clots and adverse events did not differ.
- Design
- RCT, n = 90, 2020
- Population
- Adults with a first femoropopliteal deep vein thrombosis on rivaroxaban and compression stockings, Moscow
- Form
- Diosmin 600
- Dose
- 600 mg once daily, added to standard care
- Duration
- 12 months
- Source
- Reference 3 · PubMed 32348101 (opens PubMed)
CGrade CLeg swelling, pain and quality of life in chronic venous diseaseLeg vein symptomsLess swelling and painRCT
n 72 · 2021
Improved Leg edema fell vs placebo from week 4 (p < 0.001); pain (VAS) improved at week 8 (p < 0.05); Global Index Score and Venous Clinical Severity Score improved at week 8 (p < 0.001). No treatment-related side effects. 72 completed.
- Design
- RCT, n = 72, 2021
- Population
- Adults with chronic venous disease, CEAP class C2-C4, Italy (multicenter)
- Form
- Bioavailable diosmin tablets (μsmin Plus)
- Dose
- 450 mg once daily
- Duration
- 8 weeks
- Source
- Reference 1 · PubMed 33808784 (opens PubMed)
DGrade DMuscle soreness and performance after hard exerciseExercise recoveryNo significant effectCrossover RCT
n 15 · 2025
No effect No significant difference from placebo in athletic performance, soreness, oxidative stress, strength recovery or balance; the authors highlight small non-significant effect sizes.
- Design
- Crossover RCT, n = 15, 2025
- Population
- Professional female futsal players, Brazil (pre-season)
- Form
- Diosmin capsules
- Dose
- 750 mg/day
- Duration
- 3 days before an eccentric exercise session
- Source
- Reference 4 · PubMed 40818103 (opens PubMed)
What the numbers add up to
Each point is worked out from the data and the sources numbered on this page, with the arithmetic shown under it. It adds no new data and is not medical advice.
Studied doses
Doses used in research, shown against the official limits. They describe the studies, not a recommendation for you.
Studied doses in research, not advice. These are amounts used in research, not personal advice. Your clinician or pharmacist can say what fits you.
Doses studied in human trials
Doses studied in human trials ranged from 450 mg a day of diosmin for 8 weeks and 600 mg a day for 12 months to 1.8 g a day for 14 days after knee surgery; one trial used a weight-based 50 mg/kg a day for 1 month. Trials of the diosmin-hesperidin mix after hemorrhoid surgery used up to 2,700 mg a day. These are research doses, not recommendations.1231211
When trials measured an effect
3 outcomes| Outcome | Measured at | Basis |
|---|---|---|
| Leg swelling (diosmin alone) | From week 4 of an 8-week trial | Placebo-controlled trial in 72 adults1 |
| Ankle and calf circumference (MPFF) | Reduced after 2 months and still reduced at 6 months or more | Single-group meta-analysis of 8 studies (1,635 patients), only 1 placebo-controlled; co-authored by Servier staff17 |
| Swelling after knee replacement | Days 1, 2, 3 and 14 after surgery | Open-label trial in 330 patients2 |
Interactions and safety
Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.
What Diosmin meets
4 cited rows 1 tested togetherMedicines 4
Supplements and foods 1
- Drug label or FDA notice
- Measured in a human study
- Tested together in a graded trial
Choose a medicine or supplement above to read its cited rows here.
Also cited: 1 tested together
Anticoagulants (blood thinners)
FDA safety communicationDrug label or FDA notice
Anticoagulants (blood thinners): Health Canada found a possible link between diosmin and bleeding, with greater severity in people taking medicines that affect clotting; it cites studies suggesting diosmin may slow the clearance of some anticoagulants and may itself have blood-thinning effects. Health Canada expects licensed products to add label advice to consult a health professional first, and its citrus bioflavonoids monograph requires that warning at 50 mg/day or more.
Source 5, Health Canada (2026); Source 6, Health Canada (NNHPD) (2026)
Prescription medicines in general
Drug labelDrug label or FDA notice
Prescription medicines in general: Health Canada product labels for diosmin advise consulting a physician before use if taking any prescription medication.
Source 7, Health Canada (2026)
Drugs cleared by liver CYP enzymes
PK studyMeasured in a human study
Drugs cleared by liver CYP enzymes, for example metronidazole, diclofenac, chlorzoxazone: In small studies in 12 healthy volunteers each, 500 mg/day of diosmin for 9 days raised metronidazole AUC by 27% and peak level by 24%, and raised blood levels and half-life of diclofenac (CYP2C9) and chlorzoxazone (CYP2E1).
Source 14, Eur J Clin Pharmacol (2003); Source 15, Drug Metabol Drug Interact (2007); Source 16, Drug Metabol Drug Interact (2008)
P-glycoprotein substrates
PK studyMeasured in a human study
P-glycoprotein substrates, for example fexofenadine: In 12 healthy men, diosmin 500 mg/day for 10 days raised fexofenadine peak level by 49% and total exposure (AUC) by 64%, consistent with P-glycoprotein inhibition.
Source 13, Xenobiotica (2017)
TroxerutinTroxerutin page
Tested together
Pain, bleeding, swelling and thrombosis in an acute hemorrhoid attack. Graded on the Troxerutin page; tested together is not a claim that they work better together.
Interactions
4 agents| Agent | What the source says | Evidence |
|---|---|---|
| Medicines4 | ||
| Anticoagulants (blood thinners) | Health Canada found a possible link between diosmin and bleeding, with greater severity in people taking medicines that affect clotting; it cites studies suggesting diosmin may slow the clearance of some anticoagulants and may itself have blood-thinning effects. Health Canada expects licensed products to add label advice to consult a health professional first, and its citrus bioflavonoids monograph requires that warning at 50 mg/day or more.56 | FDA safety communication |
| Prescription medicines in general | Health Canada product labels for diosmin advise consulting a physician before use if taking any prescription medication.7 | Drug label |
| P-glycoprotein substratese.g. fexofenadine | In 12 healthy men, diosmin 500 mg/day for 10 days raised fexofenadine peak level by 49% and total exposure (AUC) by 64%, consistent with P-glycoprotein inhibition.13 | PK study |
| Drugs cleared by liver CYP enzymese.g. metronidazole, diclofenac, chlorzoxazone | In small studies in 12 healthy volunteers each, 500 mg/day of diosmin for 9 days raised metronidazole AUC by 27% and peak level by 24%, and raised blood levels and half-life of diclofenac (CYP2C9) and chlorzoxazone (CYP2E1).141516 | PK study |
Check with what you take
Kept on this device onlyAdd what you take. We list every interaction our evidence profiles cite between Diosmin and your picks, and between your picks.
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Add a supplement or medicine you take to check it against Diosmin.
Starting from one medicine? The interaction checker rates how serious each pair is, on a curated list of 19 entries for 11 medicines. This cabinet has no severity rating: it lists every interaction row our supplement pages cite.
Who should be careful
4 groups- People on blood thinners
- Health Canada's 2026 review found a possible bleeding risk with diosmin that may be more severe with anticoagulants; one review case involved severe rectal bleeding after 2 days of a diosmin product taken with an anticoagulant.5
- Pregnancy and breastfeeding
- Health Canada-licensed diosmin products carry the warning to consult a physician before use if pregnant or breastfeeding.7
- Before surgery or procedures
- Given the bleeding signal, NCCIH's general advice applies: tell your surgical team about all supplements well in advance, since some raise bleeding risk.58
- Symptoms that persist or worsen
- Health Canada-licensed diosmin labels advise consulting a physician if symptoms persist or worsen.7
Where to buy Diosmin
Products from brands we partner with that contain Diosmin. Check the amount per serving against the doses studied above, and the label for other ingredients.
Diosmin products from partner brands
1 product Paid links · we earn a commission- Quick pickHerbsProNatural Balance Diosmin, 500 mg, 60 Tablets
1 tablet: 500 mg diosmin (from hesperidin)
$31.09one-timeChecked Oct 15, 2026
Frequently asked questions
Short answers to common questions; the numbers link to the sources below.
Common questions
8 answersDoes diosmin reduce leg swelling?
Does diosmin help muscle soreness after exercise?
A 15-athlete crossover trial of 750 mg/day for 3 days found no significant difference from placebo.4
What are the side effects of diosmin?
Health Canada product labels list headache, dizziness, itchiness and stomach irritation or pain. In 2026 Health Canada also found a possible link with bleeding, more severe in people on anticoagulants. The 330-patient knee trial and the 12-month clot trial found no difference in complication or adverse event rates.7523
Is it safe to take diosmin long term?
How long does diosmin take to work for leg swelling?
Is diosmin safe with blood thinners?
Diosmin vs diosmin-hesperidin products: what is the difference?
Sources
19 sources: trial abstracts, NIH fact sheets and reference databases. Numbers in the text link here.
Sources cited on this page
19 sources- 1Efficacy of a Low-Dose Diosmin Therapy on Improving Symptoms and Quality of Life in Patients with Chronic Venous Disease: Randomized, Double-Blind, Placebo-Controlled Trial.RCT Nutrients, 2021 · PMID 33808784
- 2Efficacy of Diosmin in Reducing Lower-Extremity Swelling and Pain After Total Knee Arthroplasty: A Randomized, Controlled Multicenter Trial.RCT J Bone Joint Surg Am, 2024 · PMID 38109425
- 3Diosmin 600 in adjunction to rivaroxaban reduces the risk of post-thrombotic syndrome after femoropopliteal deep vein thrombosis: results of the RIDILOTT DVT study.RCT Int Angiol, 2020 · PMID 32348101
- 4Effects of the Flavonoid Diosmin on Post Exercise Muscle Soreness - A Randomized Controlled Trial.Crossover RCT J Diet Suppl, 2025 · PMID 40818103
- 5Summary Safety Review - Diosmin and Hesperidin - Assessing the Potential Increased Risk of BleedingSafety communication Health Canada, 2026 · dhpp.hpfb-dgpsa.ca
- 6Natural Health Product Monograph: Citrus BioflavonoidsGuideline Health Canada (NNHPD), 2026 · webprod.hc-sc.gc.ca
- 7Licensed Natural Health Products Database: diosmin 450 mg + hesperidin 50 mg tablets (NPN 80127770)Label Health Canada, 2026 · health-products.canada.ca
- 8Using Dietary Supplements WiselyFact sheet National Center for Complementary and Integrative Health (NCCIH), 2019 · nccih.nih.gov
- 9Efficacy of micronized purified flavonoid fraction (Daflon®) on improving individual symptoms, signs and quality of life in patients with chronic venous disease: a systematic review and meta-analysis of randomized double-blind placebo-controlled trials.Meta-analysis Int Angiol, 2018 · PMID 29385792
- 10Efficacy and tolerability of micronized purified flavonoid fractions (MPFF) for haemorrhoids: A systematic review and meta-analysis.Meta-analysis Complement Ther Med, 2018 · PMID 30012392
- 11Efficacy and safety of micronized purified flavonoid fractions for the treatment of postoperative hemorrhoid complications: A systematic review and meta-analysis.Meta-analysis Phytomedicine, 2022 · PMID 35752073
- 12A Randomized Controlled Trial Evaluating the Effects of Diosmin in the Treatment of Radicular Pain.RCT Biomed Res Int, 2017 · PMID 29119110
- 13The effect of diosmin on the pharmacokinetics of fexofenadine in healthy human volunteers.PK study Xenobiotica, 2017 · PMID 27151911
- 14Diosmin pretreatment affects bioavailability of metronidazole.PK study Eur J Clin Pharmacol, 2003 · PMID 12698306
- 15Bioavailability of diclofenac sodium after pretreatment with diosmin in healthy volunteers.PK study Drug Metabol Drug Interact, 2007 · PMID 17708066
- 16Influence of diosmin pretreatment on the pharmacokinetics of chlorzoxazone in healthy male volunteers.PK study Drug Metabol Drug Interact, 2008 · PMID 19326774
- 17Reduction of lower-limb edema in patients with chronic venous disease by micronized purified flavonoid fraction: a systematic literature review and meta-analysis.Meta-analysis Int Angiol, 2023 · PMID 38131655
- 18Effectiveness of micronized purified flavonoid fraction on venous symptoms and signs in patients at all stages of chronic venous disease: a systematic review and meta-analysis. Part I: symptoms.Meta-analysis Int Angiol, 2025 · PMID 41324419
- 19Phlebotonics for venous insufficiency.Meta-analysis Cochrane Database Syst Rev, 2020 · PMID 33141449
What changed
Every dated change to this page: what changed, who made it and why.
Change log
3 entries| Date | Change | Who and why |
|---|---|---|
| summary, key facts, evidence, studied doses, forms, interactions, FAQ, questions, time to effect, related | Added the diosmin-hesperidin mix (MPFF) evidence as separately labelled rows: a meta-analysis of 7 placebo-controlled trials for leg vein symptoms (1,692 patients, grade B), an independent hemorrhoid meta-analysis (10 RCTs, bleeding only, grade C) and a post-hemorrhoid-surgery meta-analysis (22 RCTs, grade B); added a 300-patient radicular pain trial of diosmin alone (grade C). Added the 2020 Cochrane phlebotonics review as context. Added drug interactions from four human pharmacokinetic studies (fexofenadine, metronidazole, diclofenac, chlorzoxazone). Added FAQ items on side effects, long-term safety and time to effect, time-to-effect rows, page questions and a goal-hub link. Checked LactMed and LiverTox: neither has a diosmin entry, so the pregnancy note stays on the Health Canada label. Not added: a 2026 diosmin-hesperidin knee-replacement trial (PMID 41161507; participant numbers not in the abstract), a 2023 diabetes trial (PMID 35946912; analysed numbers not in the abstract) and the Servier-funded single-group MPFF meta-analyses as graded rows (mostly uncontrolled studies). | Writer: Kymata Health EditorialTrigger: A–Z audit against docs/supplements/AUDIT-STANDARD.md |
| interactions | Health Canada label wording corrected to match the 2026 Summary Safety Review (expects label updates; monograph warning at 50 mg/day or more) | Writer: Kymata Health EditorialTrigger: adversarial review |
| all | Initial editorial evidence review | Writer: Kymata Health EditorialTrigger: new page |
Supplement & Nutrient Encyclopedia. Educational information only; it is not medical advice and does not replace a clinician. Dietary supplements are not intended to diagnose, treat, cure or prevent any disease. Statements about supplements have not been evaluated by the FDA.