Drug & supplement interaction

Diosmin + Roflumilast

Roflumilast brand names: Daliresp, Zoryve.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Diosmin has a moderate interaction with Roflumilast. Theoretically, diosmin might inhibit the metabolism of CYP3A4 substrates.

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

Diosmin and Roflumilast

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Roflumilast

Roflumilast falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Diosmin interacts with.

Theoretically, diosmin might inhibit the metabolism of CYP3A4 substrates.
Laboratory research is conflicting with respect to the effects of diosmin on CYP3A4. Some research suggests that diosmin does not affect CYP3A4 activity. However, other research suggests that diosmin alters the metabolism of carbamazepine, a CYP3A4 substrate. Laboratory and animal research show that oral administration of diosmin for 7 days prior to oral administration of carbamazepine increases plasma concentrations of carbamazepine, decreases the clearance of carbamazepine, and decreases the formation of carbamazepine's active metabolite. Additionally, pharmacokinetic research in healthy male subjects shows that taking diosmin (Venex) 500 mg daily for 10 days prior to oral administration of carbamazepine 200 mg increases blood levels of carbamazepine by approximately 58% and decreases carbamazepine clearance by 42%. It is speculated that diosmin reduces the metabolism of carbamazepine by inhibiting CYP3A4. Diosmetin, a metabolite of diosmin, may also inhibit CYP3A4.
Severity Moderate Likelihood Possible Evidence B

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 connection: your body relies partly on an enzyme called CYP3A4 to break down roflumilast into its active form and then clear it out. Diosmin may gently slow that same enzyme. If it does, roflumilast could build up a bit more than usual, which might make its common side effects more noticeable, things like nausea, diarrhea, headache, trouble sleeping, weight loss, or feeling off your appetite.

I want to be honest about the evidence, though. This is mostly theoretical, and lab studies actually disagree on whether diosmin affects CYP3A4 at all. The clearest signal came from a different drug (carbamazepine), not roflumilast. So this is a maybe, not a sure thing. If you'd like to use both, just run it by your pharmacist or doctor first and watch for stomach upset.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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
  2. 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
  3. Bedada SK, Boga PK. Influence of diosmin on the metabolism and disposition of carbamazepine in healthy subjects. Xenobiotica. 2017;47(10):879-84. 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 Roflumilast one above is one of them. If you take anything else, check it against the full list below.

Moderate 883 No known interaction 1,947 (incl. Roflumilast)
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 Roflumilast

This page covers Diosmin only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Roflumilast page lists 141 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 96 moderate · 42 minor.

From our pharmacist’s overview on the Roflumilast page

“Roflumilast (Daliresp for severe COPD, Zoryve as a cream for skin conditions) is cleared almost entirely by one liver enzyme, CYP3A4, which is why 121 of the 141 supplements on this page can push its level up or down, and why real caution is warranted here. Start with the three rated major: grapefruit blocks that enzyme and can raise r…”

Reviewed by 2 · Jul 18, 2026

Open the Roflumilast 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 Roflumilast 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 Roflumilast 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

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

29 days ago today
Medication Roflumilast
Steady interest

#2,029 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 Roflumilast

What Is Roflumilast Used For?

Brand names: Daliresp, Zoryve

Daliresp and roflumilast tablets are used to reduce the risk of COPD (chronic obstructive pulmonary disease) flare-ups in adults with severe COPD linked to chronic bronchitis who have had flare-ups in the past. They are not rescue inhalers and will not relieve a sudden breathing attack.

Zoryve cream is used topically to treat plaque psoriasis (adults and children 2+) and mild to moderate atopic dermatitis (eczema) in adults and children as young as 2. Zoryve topical foam is used to treat seborrheic dermatitis (adults and children 9+) and plaque psoriasis of the scalp and body (adults and children 12+).

See full Roflumilast 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
883 Moderate 1,946 No 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

We also checked Diosmin against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,946 medications checked with no known interaction — see the full Diosmin list.

See the full Diosmin interactions page
See every supplement checked against Roflumilast, ranked by severity
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

Keep exploring
Diosmin monograph › Uses, safety, and every drug interaction in one place Roflumilast supplement interactions › Every supplement checked against Roflumilast, ranked by severity Roflumilast drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Diosmin and Roflumilast Together: Common Questions

Can you take Diosmin with Roflumilast?
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 Roflumilast 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

Still Have a Question About Roflumilast 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.