Interactions on record — worth a quick check against your medications. Check your meds →
Dietary supplement

Nuvaprin HD Ingredients & Drug Interactions

by Purity Products

Nuvaprin HD label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Nuvaprin HD against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Moderate

Nuvaprin HD is a dietary supplement by Purity Products with 3 active ingredients. Its ingredients are commonly taken for hemorrhoids, varicose veins and poor circulation, leg swelling (venous insufficiency).Based on those ingredients, 1,140 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Diosmin, Hesperidin, Horse Chestnut extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Nuvaprin HD by Purity Products

Ask about any prescription or over-the-counter medication and we check it for interactions with Nuvaprin HD by Purity Products — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Nuvaprin HD by Purity Products

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 3 of its 3 active ingredients.
  • “Horse Chestnut extract” is listed as a grouped ingredient — the label gives one combined amount (250 mg) without saying how much of each component you get.

Nuvaprin HD has three active ingredients. Hesperidin is a bioflavonoid (plant compound) that research has examined for effects on blood vessel health and cholesterol.

Diosmin is another bioflavonoid studied for chronic venous insufficiency and related circulatory concerns. The product also contains horse chestnut extract, whose active components are listed separately in the supplement facts.

The capsules themselves are made with inactive ingredients — hypromellose, microcrystalline cellulose, stearic acid, and silica — that serve as binders and fillers to form the capsule.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: Promotes healthy vein appearance and function.
  • We looked for evidence on: Chronic venous insufficiency (CVI), Hemorrhoids, Varicose veins, Postoperative swelling, Venous leg ulcers, Lymphedema — and 3 related terms.
  • The strongest evidence on file: Diosmin is rated "Possibly Effective" for Chronic venous insufficiency (CVI) (Natural Medicines).
  • Also on file: Diosmin is rated "Possibly Effective" for Hemorrhoids, Venous leg ulcers.
  • Also on file: Diosmin is rated "Insufficient Reliable Evidence To Rate" for Lymphedema, Varicose veins.

The evidence for these ingredients is mixed. Hesperidin shows possibly ineffective ratings for obesity and high cholesterol — meaning the data we hold doesn't support its use for those purposes.

For diosmin, research suggests it's possibly effective for chronic venous insufficiency (poor blood circulation in the legs), venous leg ulcers, and hemorrhoids. For back pain and diabetic nerve pain, the evidence is insufficient to rate it either way.

We hold no effectiveness data in our files for horse chestnut extract.

The evidence, ingredient by ingredient Hesperidin Diosmin Horse Chestnut

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 2 of the 2 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 2 of 2.
  • General safety write-ups exist for 2 of 2.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Hesperidin is generally well tolerated in food amounts and short-term supplement use, though long-term safety data is limited. One case of allergic skin irritation was reported with a topical hesperidin product in an older person with no known allergies.

For pregnancy and breastfeeding, the safety data advises against it — there isn't enough reliable information to know it's safe, so talk with your doctor or pharmacist about whether it's right for you. Diosmin is generally well tolerated short-term, but long-term safety is less studied.

Common side effects include abdominal pain, diarrhea, dizziness, nausea, and skin redness. Rarely, it can cause cardiac arrhythmias (irregular heartbeat) or hemolytic anemia (breakdown of red blood cells).

Like hesperidin, the safety data for diosmin advises against use in pregnancy and breastfeeding — there isn't enough information to know it's safe, so discuss this with your doctor or pharmacist.

Side effects, ingredient by ingredient Hesperidin Diosmin Horse Chestnut

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 2 of the 2 matched ingredients can interact with medications — Diosmin, Hesperidin.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs.
  • For scale: 1,141 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Double-check the following medication types before you take Nuvaprin HD: blood thinners and antiplatelet drugs (Moderate risk of increased bleeding), pain relievers metabolized by liver enzymes like diclofenac (Moderate), blood pressure medications (Moderate), sedating drugs like diazepam (Moderate), muscle relaxants like chlorzoxazone (Moderate), seizure medications like carbamazepine (Moderate), heart rate or rhythm drugs like verapamil and diltiazem (Moderate), and other drugs processed by liver enzymes — specifically CYP2C9, CYP3A4, CYP2E1, and P-glycoprotein substrates (Moderate).

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

Nuvaprin HD may be worth considering if you're interested in venous circulation support and have checked with your pharmacist on your medications. If you take any blood thinners, pain relievers, seizure medications, muscle relaxants, heart drugs, or blood pressure medications, this product isn't the one to start without talking to us first.

The interaction list is long, so run your meds through the checker before you buy.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 2 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 25, 2021.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Nuvaprin HD, straight from the product label.

Brand Purity Products
Net contents 60 Vegetarian Capsule(s)
Market status On market
Date entered into DSLD Feb 25, 2021
DSLD ID 243914
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Nuvaprin HD by Purity Products, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
2 Vegetarian Capsule(s)
Maximum serving Sizes:
2 Vegetarian Capsule(s)
Servings per container
30
IngredientAmount% DV
Hesperidin50 mg--
Aescin50 mg--
Diosmin450 mg--
Horse Chestnut extract250 mg--

Other ingredients: Hypromellose, Microcrystalline Cellulose, Stearic Acid, Silica

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements

Intelligent nutritional solutions

Premium grade supplements Since 1993

Formula

Hesperidin and diosmin complex

Formulation

Promotes healthy vein appearance Supports vein function and integrity

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Suggested Use: Adults take 2 capsules daily. Optimally, for the first 15 days, take two servings daily. For daily use.

Brand IP Statement(s)

DiosVein is a registered trademark of Exquim S.A.

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Nuvaprin HD by Purity Products label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Nuvaprin HD label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Nuvaprin HD by Purity Products

These are the 3 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Vegetarian Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Hesperidin

Interacts with
702 drugs
50 mg per serving

Hesperidin is a flavonoid found in citrus fruits that is often combined with diosmin and used for vein and circulation problems like hemorrhoids and v...

Hesperidin monograph & interactions

Diosmin

Interacts with
884 drugs
450 mg per serving Form: micronized DiosVein

Diosmin is a citrus-derived flavonoid most often used for vein-related problems such as chronic venous insufficiency and hemorrhoids, and it is usuall...

Diosmin monograph & interactions

Horse Chestnut extract

Interacts with
122 drugs
250 mg per serving

Horse chestnut seed extract is most often used for chronic venous insufficiency, where standardized products may help reduce leg swelling, pain, and h...

Horse Chestnut extract monograph & interactions
  • › Aescin

Other (inactive) ingredients: Hypromellose, Microcrystalline Cellulose, Stearic Acid, Silica. These complete the product’s ingredient list but are not active constituents.

Interaction report

Nuvaprin HD by Purity Products Drug Interactions

Want to check YOUR meds against Nuvaprin HD?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
1,140Drugs
1,140 Moderate

Ingredients driving the most interactions

Diosmin 884
Hesperidin 702
Horse Chestnut extract 122

Individual Drug Interactions

The ingredients in Nuvaprin HD interact with 1,140 drugs. Click any drug to see the details.

3 of the 3 ingredients in Nuvaprin HD interact with drugs. Each result below shows which ingredient is responsible. Diosmin Hesperidin Horse Chestnut extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Nuvaprin HD with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Diosmin9 drug types · 884 drugs

Anticoagulant/Antiplatelet Drugs

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.

Likelihood Possible Evidence D
Carbamazepine (Tegretol)

Theoretically, diosmin might reduce the effects of carbamazepine and increase the risk for convulsions.
A pharmacokinetic study in humans 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 also decreases the formation of carbamazepine's active metabolite. It is speculated that diosmin reduces the metabolism of carbamazepine by inhibiting cytochrome P450 3A4 (CYP3A4).

Likelihood Probable Evidence B
Chlorzoxazone (Parafon Forte, Paraflex)

Theoretically, diosmin might increase the levels and clinical effects of chlorzoxazone.
A pharmacokinetic study in humans shows that taking diosmin (Venex 500) 500 mg daily for 9 days prior to oral administration of chlorzoxazone 250 mg increases blood levels of chlorzoxazone by 53% and decreases chlorzoxazone clearance by 40%. It is speculated that diosmin reduces the metabolism of chlorzoxazone by inhibiting cytochrome P450 2E1 (CYP2E1).

Likelihood Probable Evidence B
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, diosmin might inhibit the metabolism of CYP2C9 substrates.
Diclofenac is metabolized by CYP2C9 enzymes. Clinical and laboratory research shows that diosmin inhibits the metabolism of diclofenac. A pharmacokinetic study in humans shows that taking diosmin (Venex 500) 500 mg daily for 9 days prior to oral administration of diclofenac 100 mg increases blood levels of diclofenac and decreases diclofenac clearance.

Likelihood Possible Evidence D
Cytochrome P450 2E1 (Cyp2E1) Substrates

Theoretically, diosmin might inhibit the metabolism of CYP2E1 substrates.
Chlorzoxazone is metabolized by CYP2E1 enzymes. A pharmacokinetic study in humans shows that taking diosmin (Venex 500) 500 mg daily for 9 days prior to oral administration of chlorzoxazone (Paraflex 250) 250 mg increases blood levels of chlorzoxazone by 34% and decreases chlorzoxazone clearance by 40%. It is speculated that diosmin reduces the metabolism of chlorzoxazone by inhibiting CYP2E1.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

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.

Likelihood Possible Evidence B
Diclofenac (Voltaren, Others)

Theoretically, diosmin might increase the levels and clinical effects of diclofenac.
Clinical and laboratory research shows that diosmin inhibits the metabolism of diclofenac. A pharmacokinetic study in humans shows that taking diosmin (Venex 500) 500 mg daily for 9 days prior to oral administration of diclofenac 100 mg increases blood levels of diclofenac and decreases diclofenac clearance. It is speculated that diosmin reduces the metabolism of diclofenac by inhibiting cytochrome P450 2C9 (CYP2C9).

Likelihood Probable Evidence B
Fexofenadine (Allegra)

Theoretically, diosmin might increase the levels and clinical effects of fexofenadine.
A pharmacokinetic study in humans shows that taking diosmin (Venex) 500 mg daily for 10 days prior to oral administration of fexofenadine 120 mg increases blood levels of fexofenadine 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 alters the pharmacokinetics of fexofenadine via inhibition of P-glycoprotein in the intestine, but not in the kidney or liver.

Likelihood Probable Evidence B
P-Glycoprotein Substrates

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.

Likelihood Possible Evidence D
Diosmin full monograph & interactions

Hesperidin7 drug types · 702 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, hesperidin may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Animal research suggests that hesperetin, a bioflavonoid aglycone derivative of hesperidin, may have antiplatelet activity.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, taking hesperidin with antihypertensive drugs might increase the risk of hypotension.
Some clinical and animal research shows that hesperidin can decrease blood pressure. However, other clinical research shows that hesperidin does not affect blood pressure.

Likelihood Possible Evidence D
Celiprolol (Celicard)

Theoretically, hesperidin may decrease the levels and clinical effects of celiprolol.
Animal research shows that concomitant use of hesperidin may reduce the plasma area under the curve of celiprolol by up to 75%. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, concomitant use with CNS depressants may cause additive sedative effects.
Animal studies show that hesperidin has sedative effects, due to opioid receptor activity and can increase sedation when used with diazepam. This effect has not been reported in humans.

Likelihood Possible Evidence D
Diltiazem (Cardizem, Others)

Theoretically, hesperidin may increase the levels and clinical effects of diltiazem.
Animal research suggests that hesperidin may enhance the bioavailability of diltiazem, increasing the plasma area under the curve of diltiazem by up to 65.3%. This effect has not been reported in humans.

Likelihood Possible Evidence D
P-Glycoprotein Substrates

Theoretically, hesperidin might inhibit P-glycoprotein-mediated drug efflux and potentially increase levels of drugs that are substrates of P-glycoprotein.
In vitro research shows that hesperidin can inhibit P-glycoprotein efflux. This effect has not been reported in humans.

Likelihood Possible Evidence D
Verapamil (Calan, Others)

Theoretically, hesperidin might increase the levels and clinical effects of verapamil.
Animal research suggests that hesperidin may enhance the bioavailability of verapamil, increasing the plasma area under the curve of verapamil by 96.8%. This effect has not been reported in humans

Likelihood Possible Evidence D
Hesperidin full monograph & interactions

Horse Chestnut extract1 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Horse chestnut may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Horse chestnut contains the constituent esculin which has been shown to have antithrombotic effects. Therefore, horse chestnut might have antiplatelet effects. This has not been shown in humans.

Likelihood Possible Evidence D
Horse Chestnut extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Nuvaprin HD, from the product label.

Purity Products

See all Purity Products products
Name
Purity Products
Pharmacist Counseling Corner

Nuvaprin HD by Purity Products: Common Questions

Does Nuvaprin HD by Purity Products interact with any medications?
Yes. Based on its ingredients, Nuvaprin HD has a known interaction with 1,140 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Nuvaprin HD contains 3 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take Nuvaprin HD while I'm pregnant or breastfeeding?
The safety data advises against it — there isn't enough reliable information to know it's safe during pregnancy or while breastfeeding. Talk with your doctor or pharmacist about whether it's right for you and your situation.
What side effects might I notice from diosmin?
Most commonly, people report abdominal pain, diarrhea, dizziness, nausea, and skin redness. Rarely, more serious side effects like irregular heartbeat or a type of anemia can occur. If you notice any of these, stop and talk to your pharmacist.
Does hesperidin actually help with weight or cholesterol?
The research we have shows hesperidin is possibly ineffective for obesity and high cholesterol — meaning the evidence doesn't support using it for those purposes.
What is diosmin actually used for?
Research suggests diosmin is possibly effective for chronic venous insufficiency (poor blood circulation in the legs), venous leg ulcers, and hemorrhoids. For other uses like back pain or diabetic nerve pain, we don't have enough evidence to say whether it works.
How long can I safely take Nuvaprin HD?
Short-term use is generally well tolerated, but long-term safety data for both hesperidin and diosmin is limited. If you're planning to use it beyond a few weeks, check with your pharmacist first.
Is this product free of fillers?
No — the capsule contains inactive ingredients including hypromellose, microcrystalline cellulose, stearic acid, and silica, which serve as binders and fillers.

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

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Nuvaprin HD label
Go deeper

The Full Monographs Behind Nuvaprin HD’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Hesperidin

Interacts with 702 drugs

Hesperidin is a flavonoid found in citrus fruits that is often combined with diosmin and used for vein and circulation problems like hemorrhoids and varicose veins. Some evidence supports th...

Read the full Hesperidin monograph → Herb & supplement monograph

Diosmin

Interacts with 884 drugs

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 call...

Read the full Diosmin monograph → Herb & supplement monograph

Horse Chestnut

Interacts with 122 drugs

Horse chestnut seed extract is most often used for chronic venous insufficiency, where standardized products may help reduce leg swelling, pain, and heaviness. Raw, unprocessed horse chestnu...

Read the full Horse Chestnut monograph →
Sources

Sources & How We Checked

Nuvaprin HD's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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

The 55 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Hesperidin 14 references
  1. Fernandez, S. P., Wasowski, C., Paladini, A. C., and Marder, M. Synergistic interaction between hesperidin, a natural flavonoid, and diazepam. Eur.J.Pharmacol. 4-11-2005;512(2-3):189-198. PubMed
  2. Jin, Y. R., Han, X. H., Zhang, Y. H., Lee, J. J., Lim, Y., Chung, J. H., and Yun, Y. P. Antiplatelet activity of hesperetin, a bioflavonoid, is mainly mediated by inhibition of PLC-gamma2 phosphorylation and cyclooxygenase-1 activity. Atherosclerosis 200
  3. Loscalzo, L. M., Wasowski, C., Paladini, A. C., and Marder, M. Opioid receptors are involved in the sedative and antinociceptive effects of hesperidin as well as in its potentiation with benzodiazepines. Eur.J.Pharmacol. 2-12-2008;580(3):306-313. PubMed
  4. Yamamoto, M., Suzuki, A., Jokura, H., Yamamoto, N., and Hase, T. Glucosyl hesperidin prevents endothelial dysfunction and oxidative stress in spontaneously hypertensive rats. Nutrition 2008;24(5):470-476. PubMed
  5. El-Readi, M. Z., Hamdan, D., Farrag, N., El-Shazly, A., and Wink, M. Inhibition of P-glycoprotein activity by limonin and other secondary metabolites from Citrus species in human colon and leukaemia cell lines. Eur.J.Pharmacol. 1-25-2010;626(2-3):139-145 PubMed
  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. Uesawa, Y. and Mohri, K. Hesperidin in orange juice reduces the absorption of celiprolol in rats. Biopharm Drug Dispos. 2008;29(3):185-188. PubMed
  8. Cho, YA, Choi, DH, and Choi, JS. Effect of hesperidin on the oral pharmacokinetics of diltiazem and its main metabolite, desacetyldiltiazem, in rats. J Pharm Pharmacol. 2009;61(6):825-829. PubMed
  9. Piao, YJ and Choi, JS. Enhanced bioavailability of verapamil after oral administration with hesperidin in rats. Arch Pharm Res. 2008;31(4):518-522. PubMed
  10. Andersen KE. Hesperidin methyl chalcone?-?a new cosmetic contact allergen. Contact Dermatitis. 2015;72(6):402-4. PubMed
  11. Morand C, Dubray C, Milenkovic D, et al. Hesperidin contributes to the vascular protective effects of orange juice: a randomized crossover study in healthy volunteers. Am J Clin Nutr 2011;93(1):73-80. PubMed
  12. Homayouni F, Haidari F, Hedayati M, Zakerkish M, Ahmadi K. Blood pressure lowering and anti-inflammatory effects of hesperidin in type 2 diabetes; a randomized double-blind controlled clinical trial. Phytother Res. 2018;32(6):1073-1079. PubMed
  13. Mohammadi M, Ramezani-Jolfaie N, Lorzadeh E, Khoshbakht Y, Salehi-Abargouei A. Hesperidin, a major flavonoid in orange juice, might not affect lipid profile and blood pressure: A systematic review and meta-analysis of randomized controlled clinical trials PubMed
  14. Valls RM, Pedret A, Calderón-Pérez L, et al. Effects of hesperidin in orange juice on blood and pulse pressures in mildly hypertensive individuals: a randomized controlled trial (Citrus study). Eur J Nutr. 2021;60(3):1277-1288. PubMed

See these in context on the Hesperidin monograph →

Diosmin 20 references
  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
  16. Poór M, Boda G, Mohos V, et al. Pharmacokinetic interaction of diosmetin and silibinin with other drugs: Inhibition of CYP2C9-mediated biotransformation and displacement from serum albumin. Biomed Pharmacother. 2018;102:912-921. PubMed
  17. Gavrilov SG, Karalkin AV, Moskalenko YP, Grishenkova AS. Efficacy of two micronized purified flavonoid fraction dosing regimens in the pelvic venous pain relief. Int Angiol. 2021;40(3):180-186. PubMed
  18. 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
  19. Schastlivtsev I, Lobastov K, Barinov V, Kanzafarova I. Diosmin 600 in adjunction to rivaroxaban reduces the risk of post-thrombotic syndrome after femoropopliteal deep vein thrombosis: results of the RIDILOTT DVT study. Int Angiol. 2020;39(5):361-371. PubMed
  20. Mansilha A, Caldevilla H, Puskás A, Lucien A, Roby L, Kirienko A. MPFF 1000 mg chewable once daily vs. MPFF 500 mg twice daily in chronic venous disease: the double-blind, randomized, non-inferiority CHEWY trial. Int Angiol 2022;41(6):464-475. PubMed

See these in context on the Diosmin monograph →

Horse Chestnut 21 references
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  2. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
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  5. Greeske K, Pohlmann BK. Horse chestnut seed extract-an effective therapy principle in general practice. Drug therapy of chronic venous insufficiency. Fortschr Med 1996;114:196-200.
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  9. Popp W, Horak F, Jager S, et al. Horse chestnut (Aesculus hippocastanum) pollen: a frequent cause of allergic sensitization in urban children. Allergy 1992;47:380-3.
  10. Diaz-Perales A, Collada C, Blanco C, et al. Cross-reactions in the latex-fruit syndrome: A relevant role of chitinases but not of complex asparagine-linked glycans. J Allergy Clin Immunol 1999;104:681-7. PubMed
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See these in context on the Horse Chestnut monograph →

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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