Phlebopha, pills 600mg, 30pcs

Composition

1 tablet contains:

Active ingredient:

diosmin 600 mg;

Auxiliary substances:

gelatin 50 mg,

sodium carboxymethyl starch 40 mg,

magnesium stearate 10 mg,

microcrystalline cellulose up to 1000 mg

Pharmacological action

Pharmacotherapy group: Angioprotective agent.

ATX Code: C 05 CA 03

PHARMACOLOGICAL PROPERTIES

Pharmacodynamics

Diosmin belongs to the group of bioflavonoids, has a phlebotonic effect (reduces the extensibility of veins, increases the tone of veins (dose – dependent effect), reduces venous congestion), improves lymphatic drainage (increases the tone and frequency of contraction of lymphatic capillaries, increases their functional density, reduces lymphatic pressure), improves microcirculation (increases capillary resistance (dose – dependent effect), reduces their permeability), reduces the adhesion of leukocytes to venous wall and their migration to paravenous tissues, improves oxygen diffusion and perfusion in the skin tissue, has an anti-inflammatory effect. Increases the vasoconstrictive effect of epinephrine, norepinephrine, blocks the production of free radicals, the synthesis of prostaglandins and thromboxane.

Pharmacokinetics

Diosmin is rapidly absorbed from the gastrointestinal tract. It is detected in the blood plasma 2 hours after use. The bioavailability of the drug after oral use is approximately 40-57.9%. Part of the drug is metabolized by cecal bacteria to form hippuric and benzoic acids. The maximum concentration in the blood plasma is reached 5 hours after use. The drug accumulates in all layers of the wall of the vena cava and subcutaneous veins of the lower extremities, to a lesser extent-in the kidneys, liver and lungs and other tissues. The volume of distribution of the drug is 62.1 l. The maximum selective accumulation of diosmin and/or its metabolites in the venous vessel wall is observed 9 hours after use and persists for 96 hours.

Diosmin is rapidly metabolized in the liver. The main metabolite is hydroxyphenylpropionic acid. Diosmin metabolites are mainly excreted by the kidneys in the form of conjugates with glucuronic acid. 79% of diosmin taken is excreted by the kidneys,11% – by the intestines,2.4% – with bile. Enterohepatic circulation of the drug is noted. After taking diosmin labeled with a radioactive isotope, approximately 86% of the drug is excreted by the kidneys and intestines within 48 hours.

Indications

• Varicose veins of the lower extremities (elimination of symptoms);
• chronic lymphovenous insufficiency of the lower extremities (elimination of symptoms);
• acute hemorrhoids (in complex therapy to relieve symptoms);
• microcirculation disorders (for example, with idiopathic edema).

Contraindications

• Hypersensitivity to the components of the drug; 
• children under 18 years of age (limited experience);
• pregnancy (first trimester) and lactation (limited experience).

Side effects

the Frequency of side effects is determined in accordance with the classification of the who adverse drug reactions by frequency of occurrence: very often – more than 1/10, often more and less than 1/10 1/100, rare – less than 1/1000 and 1/100, rare – 1/10000 more and less than 1/1000, very rare – less than 1/10000, including individual cases; the frequency is unknown (to determine the frequency of adverse reactions according to the available data impossible).

From the gastrointestinal tract: often – nausea, vomiting, diarrhea (diarrhea), dyspeptic disorders, heartburn, constipation; infrequently-colitis.

From the central nervous system: rarely-headache, dizziness.

From the skin and subcutaneous fat, rarely-skin rashes, itching;

Allergic reactions: rarely-urticaria, unknown frequency-isolated swelling of the face, lips, eyelids; in exceptional cases-angioedema (angioedema).

General disorders: rarely-malaise.

If any of the side effects listed in the instructions get worse, or you notice any other side effects not listed in the instructions, tell your doctor.

Interaction

Clinically significant interactions of diosmin with other drugs have not been described.

How to take, course of use and dosage

The drug is intended for oral use.

With varicose veins of the lower extremities and chronic lymphovenous insufficiency. The drug is prescribed 1 tablet per day in the morning on an empty stomach. The duration of therapy is usually 2 months.

In severe forms of chronic lymphovenous insufficiency (edema, pain, convulsions, etc. ) treatment may be longer (the total duration of continuous therapy should not exceed three to four months). Courses of treatment with the drug are repeated in 2-3 months.

For the treatment of chronic lymphovenous insufficiency during the II and III trimester of pregnancy, the drug is prescribed 1 tablet 1 time a day. It is necessary to stop taking the drug 2-3 weeks before delivery.

With an exacerbation of hemorrhoids. The drug is prescribed 2-3 tablets a day with meals for 7 days. Further, if necessary, you can continue taking the drug 1 tablet 1 time a day for 1-2 months.

In case of microcirculation disorders. The drug is prescribed 1 tablet per day in the morning on an empty stomach. The duration of therapy is usually 1-2 months. If one or more doses of the drug are missed, it is necessary to continue using the drug in the usual mode and in the usual dose.

Overdose

Cases of overdose are not described. Given the wide therapeutic range of diosmin, the risk of intoxication in overdose is insignificant. The specific antidote is unknown. If you overdose, seek immediate medical attention!

Special instructions

Treatment of acute hemorrhoids is carried out in combination with other drugs. In the absence of a rapid clinical effect, it is recommended to consult a proctologist, if necessary, conduct an additional examination and adjust the therapy.

In cases of venous circulatory disorders (varicose veins of the lower extremities, chronic lymphovenous insufficiency of the lower extremities), the maximum effect of treatment is provided by combining therapy with lifestyle changes: it is advisable to avoid prolonged stay in an upright position, reduce excess body weight. In some cases, the wearing of special stockings (compression knitwear) helps to improve blood circulation.

Experience with the use of diosmin in children under 18 years of age is insufficient. If there is no reduction or if the symptoms of the disease become more severe, consult your doctor! Do not exceed the maximum time and recommended doses of the drug without consulting your doctor!

Influence on the ability to drive vehicles and mechanisms

The drug does not affect the ability to drive vehicles and mechanisms.

Storage conditions

In a dark place, at a temperature not exceeding 25 °C.

Shelf life

3 years

Active ingredient

Diosmin

Dosage form

Tablets