This article reviews the mechanisms by which micronized purified
flavonoid fraction (MPFF;
Daflon 500 mg) acts on symptoms as well as on
edema in patients with chronic venous disease, in the light of new advances in the understanding of the pathophysiology of this
chronic condition. Deterioration of venous wall tone followed by valve dysfunction leading eventually to
varicose veins are the key pathophysiologic features that produce venous
hypertension. Both mechanical and
biological factors are responsible for the deterioration of the venous wall in large veins. These are decreased shear stress and
hypoxia of the media and of the endothelium, which act as triggering factors for biochemical reactions leading to
inflammation. There is a body of evidence that
inflammation in chronic
venous insufficiency (CVI) plays a role right from the early stages of venous dysfunction and venous valve restructuring. The whole process of venous wall stretching and dilation is painful and may present as leg heaviness, a sensation of swelling, and
paresthesia.
Daflon 500 mg relieves symptoms,
edema, and red blood cell aggregation, which cause
paresthesia and
restless legs. At the level of the microcirculation, dysfunction of microvessels is observed, characterized by an increase in capillary permeability followed by skin changes. The earliest manifestation of microcirculatory disorder is
edema. At this level,
Daflon 500 mg acts favorably on microcirculatory complications by normalizing the synthesis of
prostaglandins and
free radicals. It decreases
bradykinin-induced microvascular leakage and inhibits leukocyte activation, trapping, and migration. Its efficacy in decreasing CVI
edema and ankle swelling has been proven in rigorous studies that are reviewed in this paper.
Daflon 500 mg, a well-established oral
flavonoid that consists of 90% micronized
diosmin and 10%
flavonoids expressed as
hesperidin, may be prescribed from the very beginning of the disease for the relief of
pain and
edema, and in any CVI patient presenting with symptoms as well.
Daflon 500 mg is thus the first-line treatment for
edema and symptoms of CVI at any stage of the disease. At advanced disease stages,
Daflon 500 mg may be used in conjunction with
sclerotherapy, surgery, and/or compression
therapy or as an alternative treatment when other treatments are not indicated or not feasible.