Micronization means that the active ingredient Diosmin with Hesperidin 500 mg undergoes a high-tech grinding process with a jet of air at supersonic velocities, reducing the size of standard particles from more then 20 micron to less than 2 micron. Diosmin + Hesperidin has better and faster absorption, and thus an increased bioavailability, which leads to faster and more powerful clinical efficacy in venous diseases.
Diosmin + Hesperidin (Normanal) is a smooth well-formed spring green colored, caplet shaped film-coated tablet with bisect line on one side and engraved RENATA on the other side.
Each film-coated tablet contains: Micronized purified flavonoid fraction 500 mg, Diosmin 450 mg, Hesperidin 50 mg.
Pharmacology: Pharmacokinetics: Diosmin + Hesperidin has a unique and rigorously demonstrated mode of action, which enables it to fight simultaneously all the pathophysiological aspects of venous disease, affecting the veins, lymphatics, and microcirculation.
Veins: Diosmin + Hesperidin prolongs the vasoconstrictor effect of noradrenaline on the vein wall, even under warm and acidotic conditions, increasing venous tone, and therefore reducing venous capacitance, distensibility, and stasis. This increases the venous return and reduces venous hyperpressure present in patients suffering from chronic venous disease. At the macrocirculatory level, Diosmin + Hesperidin has been recently proven to protect the venous valves from leukocyte-induced inflammation and destruction, preventing the appearance of reflux, and therefore protecting against the progression of chronic venous disease toward complications.
Lymphatics: Diosmin + Hesperidin improves lymphatic drainage by increasing the frequency and intensity of lymphatic contractions, and by increasing the total number of functional lymphatic capillaries. Furthermore, Diosmin + Hesperidin decreases the diameter of lymphatic capillaries and the intralymphatic pressure.
Microcirculation: At the microcirculation level, Diosmin + Hesperidin reduces capillary hyperpermeability and increases capillary resistance by protecting the microcirculation from inflammatory damaging processes. Diosmin + Hesperidin reduces the expression of adhesion molecules on endothelial cells (ICAM1, VCAM1) and on leukocytes (L-selectin, VLA-4, CD 11b), and inhibits the adhesion, migration, and activation of leukocytes at the capillary level. This leads to a reduction in the release of inflammatory mediators, principally oxygen free radicals and prostaglandins (PGE2, PGF2a).
This protective and reinforcing action on the venous and lymphatic system, associated with the vasculoprotective effect on the macro- and the microcirculation, explains the restorative and protective efficacy of Diosmin + Hesperidin in chronic venous disease and hemorrhoidal disease, both of which are associated with perivascular inflammation and edema.
Used to relieve capillary impairment and venous insufficiency of the lower limbs, and for hemorrhoids.
Chronic venous disease: 2 tablets daily.
Hemorrhoidal disease: Hemorrhoidal attacks: 6 tablets daily for 4 days followed by 4 tablets daily for 3 days.
Chronic hemorrhoids: 2 tablets daily.
To be taken orally. In all cases, the patients must comply with doctor's prescription.
Acute hemorrhoidal attack: Doctors are to be consulted for advice if the hemorrhoid symptoms do not disappear within 15 days.
Various circulation disorders: The most effective way of giving this treatment is in combination with a healthy lifestyle. Exposure to the sun, heat, excessive standing and being overweight are to be avoided. Walking and wearing special support stockings stimulate blood circulation.
Use in Pregnancy & Lactation: See Use in Pregnancy & Lactation section for further information.
Pregnancy: Experimental studies in animals have not demonstrated any teratogenic effects, and no harmful effects have been reported in man to date.
Lactation: In the absence of data concerning the diffusion into breast milk, breast feeding is not recommended during treatment.
Some cases of routine gastric disorders and neurovegetative disorders (feeling of discomfort) have been reported, not requiring discontinuation of treatment. Any untoward or undesirable effect which has not been mentioned in monograph are to be reported to the doctor.
Any other treatment being received must be reported to the doctor.
Store at temperatures not exceeding 30°C. Protect from light.
C05CA53 - diosmin, combinations ; Belongs to the class of bioflavonoids used as capillary stabilizing agents.
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