Drug & supplement interaction

Diosmin + Defibrotide Sodium

Defibrotide Sodium brand name: Defitelio.

Moderate Interaction
The bottom line Moderate

Diosmin has a moderate interaction with Defibrotide Sodium. Theoretically, diosmin may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

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

Diosmin and Defibrotide Sodium

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Defibrotide Sodium

Defibrotide Sodium falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Diosmin interacts with.

Theoretically, diosmin may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
A case of spontaneous intraventricular hemorrhage has been reported for a 77-year-old female after 6 weeks of warfarin therapy, despite an international normalized ratio (INR) of only 1.8. The patient had also been taking aspirin and diosmin for several years. Experts speculate that chronic intake of diosmin predisposed the patient to spontaneous intraventricular hemorrhage by inducing chronic microcirculatory hypertension and inhibiting platelet aggregation. The presence of aspirin was also thought to play a role in this event.
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 thing to keep in mind: defibrotide already works to keep your blood from clotting too easily, and it carries a known risk of bleeding on its own. Diosmin, a citrus flavonoid used for vein and hemorrhoid problems, may have a mild blood-thinning effect of its own by nudging platelets to be a little less sticky. Stacked together, the worry is simply additive bleeding risk, meaning more bruising, nosebleeds, bleeding gums, or in rare cases something more serious.

I'll be honest with you, this is mostly theoretical and based on a single case report involving warfarin and aspirin, not defibrotide directly. Still, since defibrotide is given in a fragile hospital setting where bleeding really matters, please loop in your care team before adding diosmin so they can weigh it for you.

References
  1. Kumar RM, Van Gompel JJ, Bower R, Rabinstein AA. Spontaneous intraventricular hemorrhage associated with prolonged diosmin therapy. Neurocrit Care. 2011 Jun;14(3):438-40. 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 Defibrotide Sodium 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 Defibrotide Sodium

This page covers Diosmin only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Defibrotide Sodium page lists 202 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Danshen (major), Piracetam (major), Aconite (moderate), Allspice (moderate) and Aloe (moderate).

By severity: 2 major · 183 moderate · 17 minor.

From our pharmacist’s overview on the Defibrotide Sodium page

“Defibrotide (Defitelio) is an intravenous drug for severe veno-occlusive disease of the liver after a stem cell transplant, and part of how it works is by reducing the blood's tendency to clot. That makes bleeding the single thread running through this entire list, and it deserves real care.”

Reviewed by 2 · Jul 18, 2026

Open the Defibrotide Sodium 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 Defibrotide Sodium 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 Defibrotide Sodium 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

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

29 days ago today
Medication Defibrotide Sodium
Steady interest

#1,536 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
Medication

About Defibrotide Injection

What Is Defibrotide Injection Used For?

Brand name: Defitelio

Defitelio (defibrotide injection) is used to treat hepatic veno-occlusive disease (VOD) — also called sinusoidal obstruction syndrome (SOS) — in adult and pediatric patients. This is a serious condition where small blood vessels in the liver become blocked, most often after a hematopoietic stem-cell transplant (HSCT).

Defitelio is specifically indicated when VOD is accompanied by kidney dysfunction or pulmonary (lung) dysfunction, making it a treatment for one of the most severe forms of this complication.

See full Defibrotide Injection drug information
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 Defibrotide Sodium Together: Common Questions

Can you take Diosmin with Defibrotide Sodium?
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 Defibrotide Sodium 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.