Drug & supplement interaction

Diosmin + Atropine, morphine sulfate

Atropine, morphine sulfate brand name: Atropine, Morphine Sulfate.

Moderate Interaction
The bottom line Moderate

Diosmin has a moderate interaction with Atropine, morphine sulfate. Theoretically, diosmin might increase levels of drugs that are substrates of P-glycoprotein (P-gp).

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Diosmin and Atropine, morphine sulfate

Here is the interaction we found between these two, with the evidence behind it.

Moderate

P-GLYCOPROTEIN SUBSTRATES

Why this applies to Atropine, morphine sulfate

Atropine, morphine sulfate falls under P-GLYCOPROTEIN SUBSTRATES — the group Diosmin interacts with.

Theoretically, diosmin might increase levels of drugs that are substrates of P-glycoprotein (P-gp).
Preliminary laboratory research suggests that diosmin inhibits P-gp. Additionally, pharmacokinetic research in healthy male subjects shows that taking diosmin (Venex) 500 mg daily for 10 days prior to oral administration of fexofenadine 120 mg increases blood levels of fexofenadine, a P-gp substrate, by approximately 49% and decreases the apparent oral clearance of fexofenadine by 41%. The time taken to reach maximum plasma concentration, the half-life, and the apparent renal clearance of fexofenadine are not affected. For this reason, it is speculated that diosmin inhibits P-gp in the intestine, but not in the kidney or liver.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the short version: this combo product (atropine plus morphine) is moved through your gut by a kind of cellular pump called P-glycoprotein. Diosmin may gently block that pump in the intestine, which in theory could let a bit more of each drug slip into your bloodstream. For morphine, that might mean more drowsiness, slower breathing, constipation, or feeling lightheaded. For the atropine piece, you could notice dry mouth, blurry vision, or a faster heartbeat.

That said, the evidence here is weak. It comes mostly from lab work and one study using a different drug, so a big real-world problem is unlikely. Still, please don't start or stop anything on your own. Run it by your pharmacist or doctor first, especially since morphine is a strong medication.

References
  1. Yoo HH, Lee M, Chung HJ, Lee SK, Kim DH. Effects of diosmin, a flavonoid glycoside in citrus fruits, on P-glycoprotein-mediated drug efflux in human intestinal Caco-2 cells. J Agric Food Chem. 2007 Sep 5;55(18):7620-5. PubMed
  2. Bedada SK, Boga PK, Kotakonda HK. The effect of diosmin on the pharmacokinetics of fexofenadine in healthy human volunteers. Xenobiotica. 2017;47(3):230-35. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Diosmin Also Interacts With Other Medications

Diosmin has 883 moderate known drug interactions in our database — the Atropine, morphine sulfate one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Diosmin

Covers the 2,830 medications we’ve checked against Diosmin. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Atropine, morphine sulfate

This page covers Diosmin only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Atropine, morphine sulfate page lists 179 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major), Henbane (major) and Kava (major).

By severity: 9 major · 150 moderate · 20 minor.

Open the Atropine, morphine sulfate interaction page

One more smart check

Taking Diosmin as Part of a Dietary Supplement Product? Check It for Interactions

We hold 121 real supplement products containing Diosmin, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Diosmin. Your product may carry other ingredients that interact with Atropine, morphine sulfate too, on top of Diosmin — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Diosmin and Atropine, morphine sulfate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Diosmin
Top half

#522 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Atropine, morphine sulfate
Steady interest

#2,243 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Diosmin

What is Diosmin?

  • Chronic venous insufficiency
  • Hemorrhoids
  • Leg swelling and heaviness
  • Varicose veins
  • Spider veins

Diosmin is a citrus-derived flavonoid most often used for vein-related problems such as chronic venous insufficiency and hemorrhoids, and it is usually combined with a related flavonoid called hesperidin. Some studies suggest it may help relieve leg swelling and hemorrhoid symptoms, but quality varies. Talk to your pharmacist or doctor before starting it, especially if you are pregnant or breastfeeding.

Read the full Diosmin monograph & all interactions
Keep checking

Other Drugs & Diosmin

Browse every other medication we’ve checked against Diosmin — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
883Moderate
0Minor
1,946No known interaction
Moderate

883 interactions

Showing 60 of 883 moderate interactions — see all 883 on the Diosmin page.

No interaction 1,946 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Diosmin and Atropine, morphine sulfate Together: Common Questions

Can you take Diosmin with Atropine, morphine sulfate?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Diosmin and Atropine, morphine sulfate interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.