Troxerutin
Also called trihydroxyethylrutin, vitamin P4, hydroxyethylrutosides, oxerutins, O-(beta-hydroxyethyl)-rutosides.
Best grade C across 6 graded outcomes Other Last checked
The short answer
From 9 sourcesTroxerutin is a semi-synthetic rutin derivative used for vein health. Hydroxyethylrutoside mixtures that contain it modestly eased leg pain, heaviness and cramps in chronic venous insufficiency across 15 trials of limited quality (grade C). A flavonoid mix with troxerutin eased acute hemorrhoid symptoms. Pure troxerutin has little trial data of its own.
Every graded outcome on this page
6 rows · line = participants- CGrade CLeg pain, heaviness and cramps in chronic venous insufficiencyVenous insufficiencyn 1,643
- CGrade CVenous leg ulcer closureVenous leg ulcersn 279
- CGrade CPain, bleeding, swelling and thrombosis in an acute hemorrhoid attackHemorrhoidsn 134
- DGrade DCommon cold symptomsCommon coldn 94
- DGrade DSuperficial vein reflux during leg cast immobilizationVenous insufficiencyn 60
- DGrade DLeftover clot (residual venous obstruction) after deep vein thrombosisDeep vein thrombosisn 43
- 3 more graded outcomes, in the evidence chapter
Key facts
- What it is
- 3',4',7-trihydroxyethylrutin, a semi-synthetic derivative of rutin1
- Venous insufficiency
- Hydroxyethylrutosides reduced leg pain, heaviness and cramps versus placebo across 15 trials and 1,643 people2
- Trial quality
- All 15 venous insufficiency trials were rated of limited quality2
- Hemorrhoids
- A diosmin, troxerutin and hesperidin mix eased pain and bleeding in 134 people over 12 days4
- Pregnancy
- A Cochrane review found a troxerutin trial in 30 pregnant women, but its data could not be used5
What it is
Troxerutin is a semi-synthetic derivative of the flavonoid rutin, used in vein products alone or as part of hydroxyethylrutoside mixtures.
Forms, side by side
3 forms named in our sources. The rest show what our data holds, and say plainly where it holds nothing yet.
Troxerutin forms compared
3 forms| 3 forms | (trihydroxyethylrutin) | Hydroxyethylrutosides (oxerutins) | Diosmin, troxerutin and hesperidin combination |
|---|---|---|---|
| Absorption in people | No head-to-head human data in our sources. | No head-to-head human data in our sources. | No head-to-head human data in our sources. |
| GI tolerance | No serious adverse effects were reported across hydroxyethylrutoside trials.2 | No serious adverse effects in 15 trials; no venous thrombosis in a 60-person cast trial.23 | Described as safe in a 12-day hemorrhoid trial.4 |
| Studied for | Tested mainly within hydroxyethylrutoside mixtures and flavonoid combinations | Chronic venous insufficiency; vein reflux during immobilization | Acute hemorrhoidal disease |
- Troxerutin (trihydroxyethylrutin)
- Absorption in people
- No head-to-head human data in our sources.
- GI tolerance
- No serious adverse effects were reported across hydroxyethylrutoside trials.2
- Studied for
- Tested mainly within hydroxyethylrutoside mixtures and flavonoid combinations
- Hydroxyethylrutosides (oxerutins)
- Diosmin, troxerutin and hesperidin combination
- Absorption in people
- No head-to-head human data in our sources.
- GI tolerance
- Described as safe in a 12-day hemorrhoid trial.4
- Studied for
- Acute hemorrhoidal disease
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
6 graded outcomes, largest study first6 graded outcomes: 4 improved, 2 mixed. The largest, a 2015 meta-analysis of 1,643 people on leg pain, heaviness and cramps in chronic venous insufficiency, found an improvement.
1Leg pain, heaviness and cramps in chronic venous insufficiency
Improved · Grade C · Meta-analysis, 1,643 people, 2015
Adults with chronic venous insufficiency (15 RCTs)
Dose, result and source| Outcome | Found | People | Study | Who was studied |
|---|---|---|---|---|
| Leg pain, heaviness and cramps in chronic venous insufficiency | Improved | 1,643 | Grade C · Meta-analysis, 2015 | Adults with chronic venous insufficiency (15 RCTs) |
| Venous leg ulcer closure | Improved | 279 | Grade C · Systematic review, 2013 | Adults with venous leg ulcers in 3 hydroxyethylrutoside trials (part of a 9-trial flavonoid review) |
| Pain, bleeding, swelling and thrombosis in an acute hemorrhoid attack | Improved | 134 | Grade C · RCT, 2015 | Adults with acute hemorrhoidal disease at five colorectal units |
| Common cold symptoms | Mixed | 94 | Grade D · RCT, 2004 | Adults with common cold symptoms |
| Superficial vein reflux during leg cast immobilization | Improved | 60 | Grade D · RCT, 2017 | Adults with a lower-limb fracture in a plaster cast (Turkey) |
| Leftover clot (residual venous obstruction) after deep vein thrombosis | Mixed | 43 | Grade D · Pilot RCT, 2026 | Adults with acute proximal deep vein thrombosis on standard care (44 randomized) |
Every graded row
6 rowsShowing 6 of 6 outcomes. Human trials only.
CGrade CLeg pain, heaviness and cramps in chronic venous insufficiencyVenous insufficiencyImprovedMeta-analysis
n 1,643 · 2015
Improved Compared with placebo, hydroxyethylrutosides reduced leg pain (SMD -1.07), heavy legs (OR 0.50) and cramps (SMD -1.07). No serious adverse effects were reported.
- Design
- Meta-analysis, n = 1,643, 2015
- Population
- Adults with chronic venous insufficiency (15 RCTs)
- Form
- Hydroxyethylrutosides (oxerutins), of which troxerutin is a component
- Dose
- As used in the pooled trials
- Duration
- As used in the pooled trials
- Source
- Reference 2 · PubMed 25630350 (opens PubMed)
CGrade CVenous leg ulcer closureVenous leg ulcersRR 1.70 for complete ulcer closureSystematic review · 3 studies
n 279 · 2013
Improved More ulcers closed completely with hydroxyethylrutosides than with control (RR 1.70, 95% CI 1.24 to 2.34).
- Design
- Systematic review, 3 studies, n = 279, 2013
- Population
- Adults with venous leg ulcers in 3 hydroxyethylrutoside trials (part of a 9-trial flavonoid review)
- Form
- Hydroxyethylrutosides (oxerutins)
- Dose
- As used in the pooled trials
- Duration
- As used in the pooled trials
- Source
- Reference 6 · PubMed 23728661 (opens PubMed)
CGrade CPain, bleeding, swelling and thrombosis in an acute hemorrhoid attackHemorrhoidsImprovedRCT
n 134 · 2015
Improved Pain, bleeding and persisting swelling and thrombosis fell more than with placebo by day 12, and fewer paracetamol tablets were needed after 6 days.
- Design
- RCT, n = 134, 2015
- Population
- Adults with acute hemorrhoidal disease at five colorectal units
- Form
- Mixture of diosmin, troxerutin and hesperidin
- Dose
- Not stated in the abstract (vs placebo)
- Duration
- 12 days
- Source
- Reference 4 · PubMed 25893991 (opens PubMed)
DGrade DCommon cold symptomsCommon coldMixedRCT
n 94 · 2004
Mixed Total symptom score over 4 days did not differ significantly (27.7 vs 33.0; p = 0.10); day-1 symptoms and runny-nose scores were lower with troxerutin plus zinc.
- Design
- RCT, n = 94, 2004
- Population
- Adults with common cold symptoms
- Form
- Troxerutin with zinc gluconate
- Dose
- Troxerutin 50 mg with zinc gluconate 25 mg (control: zinc gluconate 10 mg)
- Duration
- 4 days
- Source
- Reference 8 · PubMed 15601310 (opens PubMed)
DGrade DSuperficial vein reflux during leg cast immobilizationVenous insufficiencyImprovedRCT
n 60 · 2017
Improved Great saphenous vein dysfunction below the knee occurred in 13.3% with oxerutin versus 46.7% without, and small saphenous vein reflux in 10% versus 40%. No one developed venous thrombosis.
- Design
- RCT, n = 60, 2017
- Population
- Adults with a lower-limb fracture in a plaster cast (Turkey)
- Form
- O-(beta-hydroxyethyl)-rutosides (oxerutin)
- Dose
- 500 mg every 12 hours (1,000 mg/day) vs no treatment
- Duration
- 6 to 8 weeks of cast immobilization
- Source
- Reference 3 · PubMed 26924360 (opens PubMed)
DGrade DLeftover clot (residual venous obstruction) after deep vein thrombosisDeep vein thrombosisMixedPilot RCT
n 43 · 2026
Mixed The primary outcome, residual obstruction of 2 mm or more, was lower with oxerutin but not significantly (42.9% vs 59.1%; OR 0.34, 95% CI 0.08 to 1.28). A sensitivity analysis at 4 mm or more favoured oxerutin (28.6% vs 54.5%; OR 0.21, 95% CI 0.04 to 0.85); post-thrombotic syndrome did not differ significantly (28.6% vs 40.9%).
- Design
- Pilot RCT, n = 43, 2026
- Population
- Adults with acute proximal deep vein thrombosis on standard care (44 randomized)
- Form
- Oxerutin (hydroxyethylrutosides)
- Dose
- Not stated in the abstract
- Duration
- 2 months of oxerutin, assessed at 3 months
- Source
- Reference 7 · PubMed 41197809 (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.
Modest effects, weak trials
The venous insufficiency benefits are consistent across symptoms, but the review authors judged every included trial to be of limited quality.2
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 50 mg of troxerutin (with zinc, for 4 days in a cold trial) to 1,000 mg/day (500 mg every 12 hours) of hydroxyethylrutosides for 6 to 8 weeks in the cast trial; the meta-analysis and hemorrhoid trial abstracts do not state doses. The hemorrhoid trial lasted 12 days.8324
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 Troxerutin meets
0 cited rows 2 tested togetherMedicines 0
No medicine rows in our sources.
Supplements and foods 2
- Tested together in a graded trial
Choose a medicine or supplement above to read its cited rows here.
Also cited: 2 tested together
DiosminDiosmin 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.
HesperidinHesperidin 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
0 agentsNone found in our sources.
Check with what you take
Kept on this device onlyAdd what you take. We list every interaction our evidence profiles cite between Troxerutin and your picks, and between your picks.
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Add a supplement or medicine you take to check it against Troxerutin.
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- Pregnancy and breastfeeding
- A Cochrane review found only one small placebo-controlled troxerutin trial in pregnancy, with data not in a usable format, so safety in pregnancy is not established. LactMed has no troxerutin record, so there are no breastfeeding data in our sources.59
- Blood clots
- In a 2026 pilot trial, oxerutin was added to standard anticoagulant care for deep vein thrombosis, not used instead of it.7
Reading the label, and the cost per dose
Compare any product you already have by the amount it delivers, not by capsule count or front-of-pack weight.
How to read the label
1 checksHave the bottle? Photograph its Supplement Facts panel and see each line, troxerutin included, beside the doses and forms the trials used in Label X-Ray.
Cost per studied dose, without the sales pitch
Your numbers, no product dataEnter the price, servings and the amount per serving from your label.
Frequently asked questions
Short answers to common questions; the numbers link to the sources below.
Common questions
6 answersDoes troxerutin help varicose veins and heavy legs?
Hydroxyethylrutosides, which contain troxerutin, modestly reduced leg pain, heaviness and cramps versus placebo in chronic venous insufficiency, though all 15 trials were of limited quality.2
Does troxerutin help hemorrhoids?
A mix of diosmin, troxerutin and hesperidin eased pain, bleeding and swelling over 12 days in 134 people with an acute hemorrhoid attack. Troxerutin alone was not tested.4
Does troxerutin help leg ulcers?
Possibly. In a Cochrane review, three hydroxyethylrutoside trials (279 people) closed more venous leg ulcers than control (RR 1.70), but the trials were poorly reported and publication bias was possible (grade C).6
Is troxerutin safe?
Does troxerutin interact with medicines?
We found no published interaction study or case report for troxerutin or hydroxyethylrutosides. That reflects limited data, not proven safety, so check with a pharmacist if you take blood thinners or other regular medicines.2
How is troxerutin related to rutin?
Troxerutin is rutin with three added hydroxyethyl groups, made semi-synthetically.1
Sources
9 sources: trial abstracts, NIH fact sheets and reference databases. Numbers in the text link here.
Sources cited on this page
9 sources- 1Troxerutin (CID 5486699): compound summaryDatabase PubChem, U.S. National Library of Medicine, 2026 · pubchem.ncbi.nlm.nih.gov
- 2A systematic review of the efficacy and tolerability of hydroxyethylrutosides for improvement of the signs and symptoms of chronic venous insufficiency.Meta-analysis J Clin Pharm Ther, 2015 · PMID 25630350
- 3The efficiency of O-(beta-hydroxyethyl)-rutosides in reducing the incidence of superficial venous insufficiency in patients with calf muscle pump dysfunction.RCT Phlebology, 2017 · PMID 26924360
- 4Flavonoids mixture (diosmin, troxerutin, hesperidin) in the treatment of acute hemorrhoidal disease: a prospective, randomized, triple-blind, controlled trial.RCT Tech Coloproctol, 2015 · PMID 25893991
- 5Interventions for varicose veins and leg oedema in pregnancy.Systematic review Cochrane Database Syst Rev, 2015 · PMID 26477632
- 6Flavonoids for treating venous leg ulcers.Systematic review Cochrane Database Syst Rev, 2013 · PMID 23728661
- 7Additional oxerutin therapy to promote deep vein thrombus resolution (RESOLVE-DVT): a randomized controlled pilot trial.RCT J Thromb Haemost, 2026 · PMID 41197809
- 8Treatment of the common cold with troxerutin.RCT APMIS, 2004 · PMID 15601310
- 9Drugs and Lactation Database (LactMed): searched October 21, 2026, no troxerutin or hydroxyethylrutoside recordDatabase National Institute of Child Health and Human Development (LactMed), 2026 · ncbi.nlm.nih.gov
What changed
Every dated change to this page: what changed, who made it and why.
Change log
4 entries| Date | Change | Who and why |
|---|---|---|
| evidence, studied doses, who should be careful, FAQ, related | Added the Cochrane venous leg ulcer review (PMID 23728661), a 2026 deep vein thrombosis pilot trial (41197809) and a 2004 common cold trial (15601310); widened studied doses; added breastfeeding, blood-clot and medicines notes. Interaction check: no published troxerutin or hydroxyethylrutoside interaction found in PubMed, LiverTox or LactMed (no record in either), so the interactions list stays empty. Added horse chestnut and hesperidin links. Fact-checked against the sources; corrected: the deep vein thrombosis trial now leads with its primary 2 mm outcome, which was not significant (the 4 mm result was a sensitivity analysis), and its direction is now mixed. | Writer: Kymata Health EditorialTrigger: A–Z page audit |
| evidence | Independent review: lowered the venous insufficiency row from grade B to C because the review rated all 15 trials of limited quality and they tested hydroxyethylrutoside mixtures rather than pure troxerutin. | Writer: Kymata Health EditorialTrigger: review |
| all | First draft. Every PMID checked against NCBI E-utilities esummary (title and year taken from the record) and abstracts read for every cited row. | Writer: Kymata Health EditorialTrigger: new page |
| all | Adversarial review pass: every evidence row's numbers machine-checked against its PubMed abstract, retraction and erratum flags checked for all PMIDs, unverified country and affiliation details removed, and claims not supported by the cited abstracts reworded or dropped. | Writer: Kymata Health EditorialTrigger: review |
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