Drug & supplement interaction

Diosmin + Duloxetine

Duloxetine brand names: Cymbalta, Drizalma Sprinkle, Irenka.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Diosmin and Duloxetine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Diosmin and Duloxetine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Duloxetine and Diosmin in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Diosmin safety at a glance

Diosmin overall Use caution Generally well tolerated short-term, but long-term safety is less well studied.
Pregnancy Likely Safe When used orally in amounts found in foods. Read the full pregnancy detail
Breastfeeding Likely Safe When used orally in amounts found in foods. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Duloxetine and Diosmin? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Duloxetine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Duloxetine is filed under 8 classifications — including antidepressant drugs, cytochrome p450 2d6 (cyp2d6) inhibitors, serotonergic drugs. Diosmin has documented interactions with 9 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), carbamazepine (tegretol) (moderate) and chlorzoxazone (parafon forte, paraflex) (moderate) — and none of Duloxetine’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Diosmin Does Interact With Other Medications

Diosmin has 884 moderate known drug interactions in our database — Duloxetine isn’t 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.

What to actually watch for

No Interaction Found — But Data Suggests Diosmin and Duloxetine May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Muscle pain Additional detail

    Diosmin

    “Orally, one case report of muscle pain was thought to be related to diosmin use.”

    Diosmin · Natural Medicines adverse-effect record, reported in pain.

    1 source cited
    1. 93887. Milano G, Leone S, Fucile C, Zuccoli ML, Stimamiglio A, Martelli A, Mattioli F. Uncommon serum creatine phosphokinase and lactic dehydrogenase increase during diosmin therapy: two case reports. J Med Case Rep. 2014 Jun 16;8:194. PubMed

    Duloxetine

    Listed in the ADVERSE REACTIONS section of the FDA label for Duloxetine. Read the label on DailyMed ›

  • Stomach upset / Stomach pain / Diarrhea / Nausea Additional detail

    Diosmin

    “Orally, diosmin can cause gastrointestinal side effects, including abdominal pain, diarrhea, nausea, flatulence, and gastritis. In one case, exacerbation of chronic colopathy was reported after taking a specific diosmin-containing product (Daflon 500, Les Laboratoires Servier).”

    Diosmin · Natural Medicines adverse-effect record, reported in diarrhea.

    6 sources cited
    1. 4861. Misra MC, Parshad R. Randomized clinical trial of micronized flavonoids in the early control of bleeding from acute internal haemorrhoids. Br J Surgery 2000;87:868-72. PubMed
    2. 4898. Thanapongsathorn W, Vajrabukka T. Clinical trial of oral diosmin (Daflon) in the treatment of hemorrhoids. Dis Colon Rectum 1992;35:1085-8. PubMed
    3. 4900. Cospite M. Double-blind, placebo-controlled evaluation of clinical activity and safety of Daflon 500 mg in the treatment of acute hemorrhoids. Angiology 1994;45:566-73.
    4. 10229. Guilhou JJ, Dereure O, Marzin L, et al. Efficacy of Daflon 500 mg in venous leg ulcer healing: a double-blind, randomized, controlled versus placebo trial in 107 patients. Angiology 1997;48:77-85.. PubMed
    5. 54935. Cospite, M. and Dominici, A. Double blind study of the pharmacodynamic and clinical activities of 5682 SE in venous insufficiency. Advantages of the new micronized form. Int Angiol. 1989;8(4 Suppl):61-65.
    6. 54970. Buckshee, K., Takkar, D., and Aggarwal, N. Micronized flavonoid therapy in internal hemorrhoids of pregnancy. Int J Gynaecol Obstet 1997;57(2):145-151. PubMed

    Duloxetine

    Listed in the ADVERSE REACTIONS section of the FDA label for Duloxetine. Read the label on DailyMed ›

  • Tiredness / Headache Additional detail

    Diosmin

    “Orally, diosmin can cause headache, low energy, and dizziness in some patients.”

    Diosmin · Natural Medicines adverse-effect record, reported in cluster headache.

    6 sources cited
    1. 4861. Misra MC, Parshad R. Randomized clinical trial of micronized flavonoids in the early control of bleeding from acute internal haemorrhoids. Br J Surgery 2000;87:868-72. PubMed
    2. 4898. Thanapongsathorn W, Vajrabukka T. Clinical trial of oral diosmin (Daflon) in the treatment of hemorrhoids. Dis Colon Rectum 1992;35:1085-8. PubMed
    3. 4900. Cospite M. Double-blind, placebo-controlled evaluation of clinical activity and safety of Daflon 500 mg in the treatment of acute hemorrhoids. Angiology 1994;45:566-73.
    4. 10229. Guilhou JJ, Dereure O, Marzin L, et al. Efficacy of Daflon 500 mg in venous leg ulcer healing: a double-blind, randomized, controlled versus placebo trial in 107 patients. Angiology 1997;48:77-85.. PubMed
    5. 93887. Milano G, Leone S, Fucile C, Zuccoli ML, Stimamiglio A, Martelli A, Mattioli F. Uncommon serum creatine phosphokinase and lactic dehydrogenase increase during diosmin therapy: two case reports. J Med Case Rep. 2014 Jun 16;8:194. PubMed
    6. 105293. Steinbruch M, Nunes C, Gama R, et al. Is nonmicronized diosmin 600?mg as effective as micronized diosmin 900?mg plus hesperidin 100?mg on chronic venous disease symptoms? Results of a noninferiority study. Int J Vasc Med. 2020;2020:4237204. PubMed

    Duloxetine

    Listed in the ADVERSE REACTIONS section of the FDA label for Duloxetine. Read the label on DailyMed ›

  • Dizziness Additional detail

    Diosmin

    Recorded for Diosmin in the same Natural Medicines adverse-effect record shown under Stomach upset / Stomach pain / Diarrhea / Nausea above.

    Duloxetine

    Listed in the ADVERSE REACTIONS section of the FDA label for Duloxetine. Read the label on DailyMed ›

Reported for Diosmin but not commonly for Duloxetine: an irregular heartbeat, bloating or gas, itching and anemia.

Effects for Duloxetine come from the ADVERSE REACTIONS section of its FDA label; effects for Diosmin come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Diosmin in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Safe

When used orally in amounts found in foods.

Pregnancy And Lactation Possibly Safe

When used orally in doses of up to 900 mg daily for 30 days in combination with other flavonoids, such as hesperidin. Some evidence suggests that taking this combination may be associated with placental insufficiency when used during the third trimester of pregnancy; however, the combination does not seem to induce fetal abnormalities, retard fetal growth, increase the risk of intrauterine death, or affect birth weight. Also, when breastfeeding, this combination does not seem to affect infant growth or feeding.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Overlapping uses

What Duloxetine Is Prescribed For, and What Diosmin Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Duloxetine is a prescription medicine with approved uses on its FDA label. Diosmin is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Duloxetine is prescribed for: Duloxetine delayed-release capsules treat major depressive disorder (MDD) and generalized anxiety disorder (GAD) in adults. They also manage diabetic peripheral neuropathic pain (nerve pain from diabetes), fibromyalgia, and chronic musculoskeletal pain (such as chronic low back pain and pain from osteoarthritis) in adults. GAD is also approved in pediatric patients 7 years and older for Cymbalta, Drizalma Sprinkle, and certain duloxetine delayed-release capsule products. Fibromyalgia is approved in patients 13 years and older for Cymbalta and some duloxetine delayed-release capsule products.

Read the rest of what Duloxetine is prescribed for

Age-specific approvals vary by product — follow your prescriber's guidance on which product is right for your age group.

Diosmin has been studied for:

  • Back pain studied, not established Diosmin has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Diosmin for back pain

    It is unclear if oral diosmin is beneficial for back pain.

  • Diabetic neuropathy studied, not established Diosmin has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Diosmin for diabetic neuropathy

    It is unclear if oral diosmin is beneficial for diabetic neuropathy.

  • Diabetes studied, not established Diosmin has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Diosmin for diabetes

    It is unclear if oral diosmin, as part of a micronized purified flavonoid fraction or in combination with other compounds, is beneficial for diabetes.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Duloxetine on your own; if you are taking Diosmin for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Diosmin or Duloxetine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Diosmin or Duloxetine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Duloxetine

This page covers Diosmin only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Duloxetine page lists 132 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Lithium (major), Siberian Cocklebur (major) and Wine (major).

By severity: 5 major · 107 moderate · 20 minor.

Open the Duloxetine 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. Even though Diosmin itself has no known interaction with Duloxetine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Diosmin and Duloxetine 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

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

29 days ago today
Medication Duloxetine
Top 5%

#47 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Diosmin reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Diosmin and Duloxetine records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

A flavonoid derived from citrus fruit peels (often made from hesperidin) · Tablets, capsules (often combined with hesperidin)

An interaction check asks whether these two react with each other — it does not ask whether Diosmin is a good idea for someone in your situation. Here is what our Diosmin record says about it on its own.

Diosmin: dosing

There is no single official dose of diosmin for supplement use. Do not assume that taking more will work better or be safer.

From our Diosmin monograph — the full record covers uses, side effects and every documented interaction.

Read the full Diosmin monograph & all interactions
Medication

About Duloxetine

What Is Duloxetine Used For?

Brand names: Cymbalta, Drizalma Sprinkle, Irenka

Duloxetine delayed-release capsules treat major depressive disorder (MDD) and generalized anxiety disorder (GAD) in adults. They also manage diabetic peripheral neuropathic pain (nerve pain from diabetes), fibromyalgia, and chronic musculoskeletal pain (such as chronic low back pain and pain from osteoarthritis) in adults.

GAD is also approved in pediatric patients 7 years and older for Cymbalta, Drizalma Sprinkle, and certain duloxetine delayed-release capsule products. Fibromyalgia is approved in patients 13 years and older for Cymbalta and some duloxetine delayed-release capsule products. Age-specific approvals vary by product — follow your prescriber's guidance on which product is right for your age group.

See full Duloxetine 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
884Moderate
0Minor
1,945No known interaction
Moderate

884 interactions

Showing 60 of 884 moderate interactions — see all 884 on the Diosmin page.

No interaction 1,945 drugs checked — show the list
Evidence & sources

Diosmin References

The 20 references that drive our Diosmin monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Misra MC, Parshad R. Randomized clinical trial of micronized flavonoids in the early control of bleeding from acute internal haemorrhoids. Br J Surgery 2000;87:868-72. PubMed
  2. Thanapongsathorn W, Vajrabukka T. Clinical trial of oral diosmin (Daflon) in the treatment of hemorrhoids. Dis Colon Rectum 1992;35:1085-8. PubMed
  3. Cospite M. Double-blind, placebo-controlled evaluation of clinical activity and safety of Daflon 500 mg in the treatment of acute hemorrhoids. Angiology 1994;45:566-73.
  4. Guilhou JJ, Dereure O, Marzin L, et al. Efficacy of Daflon 500 mg in venous leg ulcer healing: a double-blind, randomized, controlled versus placebo trial in 107 patients. Angiology 1997;48:77-85.. PubMed
  5. Cospite, M. and Dominici, A. Double blind study of the pharmacodynamic and clinical activities of 5682 SE in venous insufficiency. Advantages of the new micronized form. Int Angiol. 1989;8(4 Suppl):61-65.
  6. Buckshee, K., Takkar, D., and Aggarwal, N. Micronized flavonoid therapy in internal hemorrhoids of pregnancy. Int J Gynaecol Obstet 1997;57(2):145-151. PubMed
  7. 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
  8. Milano G, Leone S, Fucile C, Zuccoli ML, Stimamiglio A, Martelli A, Mattioli F. Uncommon serum creatine phosphokinase and lactic dehydrogenase increase during diosmin therapy: two case reports. J Med Case Rep. 2014 Jun 16;8:194. PubMed
  9. Rajnarayana K, Venkatesham A, Krishna DR. Bioavailability of diclofenac sodium after pretreatment with diosmin in healthy volunteers. Drug Metabol Drug Interact. 2007;22(2-3):165-74. PubMed
  10. Rajnarayana K, Venkatesham A, Nagulu M, Srinivas M, Krishna DR. Influence of diosmin pretreatment on the pharmacokinetics of chlorzoxazone in healthy male volunteers. Drug Metabol Drug Interact. 2008;23(3-4):311-21. PubMed
  11. 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
  12. Bedada SK, Neerati P. Modulation of CYP3A enzyme activity by diosmin and its consequence on carbamazepine pharmacokinetics in rats. Naunyn Schmiedebergs Arch Pharmacol. 2018;391(2):115-21. PubMed
  13. Burkina V, Zlabek V, Halsne R, Ropstad E, Zamaratskaia G. In vitro effects of the citrus flavonoids diosmin, naringenin and naringin on the hepatic drug-metabolizing CYP3A enzyme in human, pig, mouse and fish. Biochem Pharmacol. 2016;110-111:109-16 PubMed
  14. Bedada SK, Boga PK. Influence of diosmin on the metabolism and disposition of carbamazepine in healthy subjects. Xenobiotica. 2017;47(10):879-84. PubMed
  15. 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

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Diosmin and Duloxetine Together: Common Questions

Is it safe to take Diosmin with Duloxetine?
We do not list a known interaction between Diosmin and Duloxetine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Diosmin and Duloxetine have any of the same side effects?
Yes — our sources link each of them separately to 8 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Are Diosmin and Duloxetine used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Diosmin in each. That is a conversation for your prescriber, especially if Duloxetine is being adjusted to a target.
How was the Diosmin and Duloxetine combination checked?
Interactions in our licensed database are recorded against drug classes. Duloxetine is filed under 8 classifications, and Diosmin has documented interactions with 9 drug classes — none of Duloxetine's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Diosmin interact with any other medications?
Yes. Diosmin has 884 documented drug interactions in our database — Duloxetine is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Duloxetine interact with any supplements?
Yes. Duloxetine has documented interactions with 132 supplements in our database — Diosmin is not one of them. The Duloxetine interaction page linked on this page lists every one, ranked by severity.

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

Still Have a Question About Duloxetine and Diosmin?

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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.