Phlebotonics for venous insufficiency

The potential use of flavonoids as venoactive drugs and the role of citrus fruits

“…So, in Scandinavia drugs are hardly ever prescribed for chronic venous disease [9]. In Spain, for certain phlebotonics the indication for CVI has been withdrawn, and for several other countriessuch as diosmine, hidrosmine, escin, and some rutosides-the use during exacerbations of CVI has been limited to two or three months [10].…”

“…The action mechanisms are not well established [6,10,11] and not clearly understandable theoretically. The smooth muscles (SM) of large and medium-sized veins studied in vitro had no tone and did not relax under the impact of vasodilators [12].…”

“…The most common events were skin changes (including eczema), gastrointestinal disturbances, and hypertension [7,10]. Without going into details of Fl biology, their role as repellents should be noted, protecting plants from herbivores.…”

Prevention of venous leg ulcer recurrence

“…Most of these drugs are natural flavonoids extracted from plants. [25] Synthetic products with flavonoid-like properties are also used. There are not enough evidences that they have any role in the prevention of venous ulcers.…”

Venous leg ulcer: Systemic therapy

“…No evidence was obtained to recommend global use of phlebotonic drugs in cases of CVI. They helped in relieving edema in some studies, but this was of uncertain clinical relevance[31] (evidence Level A). Gastrointestinal disorders were the most common adverse event.…”