Red vine leaf extract (Vitis vinifera leaf)

Q: Does red vine leaf extract reduce leg swelling?

Two placebo-controlled trials of AS 195 found less lower-leg volume after 12 weeks in chronic venous insufficiency: about 76–100 g in 2000 and about 20 ml in 2011. A 2020 systematic review of 5 trials found improvements in only some trials and called for higher-quality studies.

Q: How long before effects appear?

The trials ran 6 to 12 weeks; the EU monograph describes a 12-week course and says to see a doctor if swelling does not respond within 2 weeks.

Q: Does it interact with medicines?

The EU monograph lists interactions as not known; formal interaction studies are lacking in our sources.

Q: Can it be used in pregnancy?

The EU monograph does not recommend it during pregnancy or breastfeeding, or for anyone under 18.

Q: Is it the same as grape seed extract?

No. AS 195 is a water extract of red grapevine leaves containing flavonoids; the trials here tested the leaf extract only.

Also called red vine leaf, grapevine leaf, Vitis viniferae folium, AS 195, red vine leaves extract, RVLE.

Best grade B across 4 graded outcomes Botanical Last checked Oct 21, 2026

The short answer

From 8 sources

Red vine leaf extract, best known as AS 195, is a flavonoid-rich water extract of red grapevine leaves. In two placebo-controlled trials of about 250 adults each with chronic venous insufficiency, 360–720 mg a day for 12 weeks reduced lower-leg volume and some symptoms. The newer, manufacturer-funded trial found a smaller effect.

Every graded outcome on this page

4 rows · line = participants

Grade BLower-leg volume and symptoms in chronic venous insufficiencyChronic venous insufficiencyn 257
Grade BLower-limb volume and leg painChronic venous insufficiencyn 248
Grade CSkin microcirculation, oxygen supply and leg circumferenceChronic venous insufficiencyn 71
Grade DLeg symptoms (tired, heavy legs, tension, tingling, pain)Chronic venous insufficiencyn 65

Key facts

What it is: Dry aqueous extract (4–6:1) of red grapevine leaves; main flavonoids quercetin-3-O-glucuronide and isoquercitrin^7,1
EU status: Well-established use for chronic venous insufficiency at 360–720 mg/day, with a 12-week course⁷
Leg volume: 2000 trial: −76 to −100 g lower-leg volume vs placebo; 2011 trial: −19.9 ml^1,2
Funding: The 2011 trial was funded by Boehringer Ingelheim, maker of the AS 195 product²
Tolerability: A 2026 network meta-analysis of 51 RCTs linked red vine leaf extract with fewer adverse events than control (RR 0.62)⁵

What it is

Red vine leaf extract is a flavonoid-rich water extract of red grapevine leaves, studied for leg swelling in venous insufficiency.

How it works

Proposed

The EU monograph says the extract improves microvascular blood flow in people with chronic venous insufficiency and lists its pharmacokinetics as not known. A 2019 review of non-clinical and clinical data proposes that its active ingredients accumulate in the vein wall and preserve endothelial barrier function.^7,3,6

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.

Red vine leaf extract (Vitis vinifera leaf) forms compared

2 forms

Red vine leaf extract (Vitis vinifera leaf) forms compared: 2 forms by 3 attributes. Empty cells are labelled No data yet, or Not graded in the evidence row.
2 forms	AS 195 dry extract (4–6:1, water) tablets or capsules	Traditional grapevine leaf tea, powder or soft extract
Absorption in people	No human pharmacokinetic data; the EU monograph lists pharmacokinetics as not known.⁷	No human absorption data.⁷
GI tolerance	Tolerability similar to placebo in the 2011 trial; adverse events rare and usually mild in the 2000 trial.^2,1	EU monograph lists nausea, gastrointestinal complaints, headache and skin reactions, frequency not known.⁷
Studied for	Chronic venous insufficiency (leg volume, symptoms, microcirculation)	Traditional use only for heavy legs, haemorrhoid itching and capillary fragility; not tested in the trials above

AS 195 dry extract (4–6:1, water) tablets or capsules
Absorption in people
No human pharmacokinetic data; the EU monograph lists pharmacokinetics as not known.⁷
GI tolerance
Tolerability similar to placebo in the 2011 trial; adverse events rare and usually mild in the 2000 trial.^2,1
Studied for
Chronic venous insufficiency (leg volume, symptoms, microcirculation)
Traditional grapevine leaf tea, powder or soft extract
Absorption in people
No human absorption data.⁷
GI tolerance
EU monograph lists nausea, gastrointestinal complaints, headache and skin reactions, frequency not known.⁷
Studied for
Traditional use only for heavy legs, haemorrhoid itching and capillary fragility; not tested in the trials above

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

4 graded outcomes, largest study first

All 4 graded outcomes found an improvement. The largest, a 2000 randomized trial of 257 people on Lower-leg volume and symptoms in chronic venous insufficiency, found an improvement.

By ageBy sizeTable

AgeAll ages

Bar: the ages a study enrolled (running to the edge when it states no upper or lower limit). Dot: only a mean age, counted as near your age within 5 years. Tick: the mean age inside a range.

3Skin microcirculation, oxygen supply and leg circumference: improved, 18+

1Lower-leg volume and symptoms in chronic venous insufficiency: improved, 25–75

4Leg symptoms (tired, heavy legs, tension, tingling, pain): improved, 25–82

2Lower-limb volume and leg pain: improved, ages not stated

1Lower-leg volume and symptoms in chronic venous insufficiency

Improved · Grade B · RCT, 257 people, 2000

Outpatients aged 25–75 with stage I to early stage II chronic venous insufficiency, not using compression stockings

Dose, result and source

Every graded outcome on this page, largest study first
Outcome	Found	People	Study	Who was studied
Lower-leg volume and symptoms in chronic venous insufficiency	Improved	257	Grade B · RCT, 2000	Outpatients aged 25–75 with stage I to early stage II chronic venous insufficiency, not using compression stockings
Lower-limb volume and leg pain	Improved	248	Grade B · RCT, 2011	Adults with chronic venous insufficiency (CEAP C3–C4a) and moderate-to-severe symptoms
Skin microcirculation, oxygen supply and leg circumference	Improved	71	Grade C · Crossover RCT, 2004	Adults with stage I–II chronic venous insufficiency
Leg symptoms (tired, heavy legs, tension, tingling, pain)	Improved	65	Grade D · Open-label trial, 2003	Adults aged 25–82 with grade I–II chronic venous insufficiency

Every graded row

4 rows

Form tested

Showing 4 of 4 outcomes. Human trials only.

Grade BLower-leg volume and symptoms in chronic venous insufficiencyChronic venous insufficiencyImprovedRCT
n 257 · 2000

Improved Lower-leg volume fell by 75.9 g (360 mg) and 99.9 g (720 mg) versus placebo; calf circumference and key symptoms also improved more (p<0.001). Adverse events were rare and usually mild.

Design: RCT, n = 257, 2000
Population: Outpatients aged 25–75 with stage I to early stage II chronic venous insufficiency, not using compression stockings
Form: Red vine leaf extract AS 195
Dose: 360 mg or 720 mg once daily
Duration: 12 weeks
Source: Reference 1 · PubMed 10719612 (opens PubMed)

Grade BLower-limb volume and leg painChronic venous insufficiencyImprovedRCT
n 248 · 2011

Improved Limb volume fell by 19.9 ml more than placebo (p=0.027) and leg pain by 6.6 mm on a 10-cm scale (p=0.047); other symptoms did not change significantly. Tolerability was similar to placebo.

Design: RCT, n = 248, 2011
Population: Adults with chronic venous insufficiency (CEAP C3–C4a) and moderate-to-severe symptoms
Form: Red vine leaf extract AS 195
Dose: 720 mg daily
Duration: 12 weeks
Source: Reference 2 · PubMed 21239190 (opens PubMed)

Grade CSkin microcirculation, oxygen supply and leg circumferenceChronic venous insufficiencyImprovedCrossover RCT
n 71 · 2004

Improved Microvascular blood flow and transcutaneous oxygen rose versus placebo, and ankle and calf circumference fell (all p<0.0001).

Design: Crossover RCT, n = 71, 2004
Population: Adults with stage I–II chronic venous insufficiency
Form: Red vine leaf extract AS 195
Dose: 360 mg once daily
Duration: 6 weeks per period
Source: Reference 3 · PubMed 15293865 (opens PubMed)

Grade DLeg symptoms (tired, heavy legs, tension, tingling, pain)Chronic venous insufficiencyImprovedOpen-label trial
n 65 · 2003

Improved All subjective symptoms improved significantly from baseline; 6 people had adverse events possibly related to the extract, 4 of them gastrointestinal.

Design: Open-label trial, n = 65, 2003
Population: Adults aged 25–82 with grade I–II chronic venous insufficiency
Form: AS 195 film-coated tablets
Dose: 360 mg once daily
Duration: 6 weeks
Source: Reference 4 · PubMed 12785119 (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.

Two trials, different sizes of effect

Leg-volume reduction was about 76–100 g in the 2000 trial but about 20 ml in the 2011 trial, which enrolled people with CEAP C3–C4a disease and moderate-to-severe symptoms.^1,2

Newest pooled finding is about tolerability

Neither the 2020 systematic review of 5 trials nor the 2026 network meta-analysis reported a newer placebo-controlled leg-swelling result than the 2011 trial; the 2026 analysis linked red vine leaf extract only with fewer adverse events than control (RR 0.62).^8,5

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 360 mg to 720 mg of AS 195 dry extract once daily for 6 to 12 weeks, matching the 360–720 mg daily range and 12-week course in the EU monograph.^1,2,3,7

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.

Interactions

0 agents

None found in our sources.

Check with what you take

Kept on this device only

Add what you take. We list every interaction our evidence profiles cite between Red vine leaf extract and your picks, and between your picks.

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Most cited:

Add a supplement or medicine you take to check it against Red vine leaf extract.

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

5 groups

Sudden swelling, clots or ulcers: The EU monograph says to see a doctor with skin inflammation, thrombophlebitis, hardened tissue under the skin, severe pain, ulcers, sudden swelling of one or both legs, or heart or kidney insufficiency.⁷
No improvement in 2 weeks: If swelling does not respond within 2 weeks, the EU monograph advises seeing a doctor because oedema may have other causes.⁷
Under 18: Not recommended for children and adolescents under 18 because of insufficient safety data.⁷
Pregnancy and breastfeeding: Safety has not been established, and the EU monograph does not recommend use during pregnancy or lactation.⁷
Allergy: Contraindicated with hypersensitivity to the extract; itching, redness and urticaria have been reported.⁷

Frequently asked questions

Short answers to common questions; the numbers link to the sources below.

Common questions

5 answers

Does red vine leaf extract reduce leg swelling?

Two placebo-controlled trials of AS 195 found less lower-leg volume after 12 weeks in chronic venous insufficiency: about 76–100 g in 2000 and about 20 ml in 2011. A 2020 systematic review of 5 trials found improvements in only some trials and called for higher-quality studies.^1,2,8

How long before effects appear?

The trials ran 6 to 12 weeks; the EU monograph describes a 12-week course and says to see a doctor if swelling does not respond within 2 weeks.^1,3,7

Does it interact with medicines?

The EU monograph lists interactions as not known; formal interaction studies are lacking in our sources.⁷

Can it be used in pregnancy?

The EU monograph does not recommend it during pregnancy or breastfeeding, or for anyone under 18.⁷

Is it the same as grape seed extract?

No. AS 195 is a water extract of red grapevine leaves containing flavonoids; the trials here tested the leaf extract only.^7,1

Sources

8 sources: trial abstracts, NIH fact sheets and reference databases. Numbers in the text link here.

Sources cited on this page

8 sources

1Efficacy of orally administered extract of red vine leaf AS 195 (folia vitis viniferae) in chronic venous insufficiency (stages I-II). A randomized, double-blind, placebo-controlled trial.RCT Arzneimittelforschung, 2000 · PMID 10719612
2Efficacy and tolerability of a red-vine-leaf extract in patients suffering from chronic venous insufficiency--results of a double-blind placebo-controlled study.RCT Eur J Vasc Endovasc Surg, 2011 · PMID 21239190
3Improvement of cutaneous microcirculation and oxygen supply in patients with chronic venous insufficiency by orally administered extract of red vine leaves AS 195: a randomised, double-blind, placebo-controlled, crossover study.Crossover RCT Drugs R D, 2004 · PMID 15293865
4Oedema protective properties of the red vine leaf extract AS 195 (Folia vitis viniferae) in the treatment of chronic venous insufficiency. A 6-week observational clinical trial.Open-label trial Arzneimittelforschung, 2003 · PMID 12785119
5Pharmacological interventions to treat chronic venous disease: A network meta-analysis.Meta-analysis Phlebology, 2026 · PMID 42529868
6Therapeutic approach to chronic venous insufficiency - clinical benefits of red-vine-leaf-extract AS 195 (Antistax(®)).Review Pharmazie, 2019 · PMID 30940301
7European Union herbal monograph on Vitis vinifera L., folium (Revision 1, EMA/HMPC/464684/2016)Guideline European Medicines Agency (HMPC), 2017 · ema.europa.eu
8Red vine leaf extract (AS 195) can improve some signs and symptoms of chronic venous insufficiency, a systematic review.Systematic review Phytother Res, 2020 · PMID 32314844

What changed

Every dated change to this page: what changed, who made it and why.

Change log

2 entries

Dated changes to this page
Date	Change	Who and why
Oct 21, 2026FAQ, insights	PubMed search for 2012–2026 trials and reviews of red vine leaf extract found no newer placebo-controlled trial; added the 2020 systematic review of 5 trials (PMID 32314844) to the FAQ and an insight on the age of the efficacy evidence. Interactions re-checked: the EU monograph lists none known; LactMed has no entry. Fact-checked against the sources; corrected: the insight is reworded to what the two reviews report, without claiming that no newer trial exists.	Writer: Kymata Health EditorialTrigger: A–Z page audit
Oct 14, 2026all	Initial editorial evidence review	Writer: Kymata Health EditorialTrigger: new page

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