Indications:
Improvement of symptoms related to venous-lymphatic insufficiency: Heavy legs, pain, restlessness of the first decubitus.
Supportive treatment of dysfunction due to fragile capillaries.
Treatment of symptoms related to hemorrhoidal crisis.
Administration, dosage:
Administration:
For oral use.
Dosage:
Venous-lymphatic insufficiency: 1 tablet daily with meal.
Hemorrhoidal crisis: 2-3 tablets daily with meals.
Children
The safety and effectiveness of diosmin in children and adolescents under 18 years of age have not been established.
Some special attention on the handling of the medicine before and after use:
There are no special requirements for handling the drug after use.
Contraindications:
Hypersensitivity to any of the excipients.
Do not use this medicine during lactation.
Warnings and precautions for use:
Hemorrhoidal crisis:
PLEMINOS is not a substitute for specific treatment of other anal disorders.
Treatment should only be of short duration.
If symptoms persist, a proctologic examination should be performed and treatment should be reviewed.
Excipient warnings:
The excipients of this medicine contain lactose: This medicine should not be used in patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption.
The excipients of this medicine contain Ponceau lake which may cause allergic reactions. Caution should be exercised when using the medicine for patients allergic to dyes.
Pregnancy and lactation:
Pregnancy:
Research data on the use of diosmin in pregnant women are limited.
No teratogenicity has been observed in animal studies.
As a precautionary measure, it is preferable to avoid using diosmin during pregnancy.
Lactation:
It is not known whether diosmin is excreted in breast milk. Therefore, this medicine should not be used
during breast-feeding.
Fertility:
Reproductive toxicity studies showed that diosmin had no effect on fertility in male and female rats.
Effects on ability to drive, use machines:
No studies on the ability to drive or use machines have been performed.
Interactions, incompatibilities of medicine:
Interaction of the drug with other drugs and other types of interactions:
Interaction studies were not performed.
Incompatibilities:
Because there are no studies of drug incompatibility, do not mix this drug with other drugs.
Undesirable effects:
Adverse reactions are ranked according to frequency: Very common (ADR > 1/10), common (1/100 ≤ ADR < 1/10), uncommon (1/1,000 ≤ ADR < 1/100), rare (1/10,000 ≤ ADR < 1/1,000), very rare (ADR < 1/10,000), cannot be estimated from the available data “Unknown”.
| System organ class | Common | Uncommon | Rare |
| Gastrointestinal disorders* | Stomachache | Flatulence, diarrhea, indigestion, nausea | Vomiting |
| Skin and subcutaneous tissue disorders | Allergic reactions such as rash, itching, hives, angioedema |
* Gastrointestinal disorders rarely lead to discontinuation of treatment.
Overdose and management:
No cases of overdose have been reported.
Pharmacodynamics:
Pharmacological group: Cardiovascular system – Vasoprotectives – Capillary stabilizing agents
ATC code: C05CA03
As a venotonic and vasculoprotective agent results in vasoconstriction, increases vessel resistance and decreases their permeability.
Various pharmacodynamic studies have been conducted to demonstrate these properties:
In humans:
Venotonic properties demonstrated in clinical pharmacology:
Increase in vasoconstrictor action of adrenaline, noradrenaline and serotonin on superficial hand veins or on isolated saphenous veins.
Increase in venous tone, demonstrated by measurement of venous capacitance using strain gauge plethysmography; decreased volume of venous stasis.
The vasoconstrictor effect is related to the dose administered.
Lowering of mean venous pressure both in the superficial and deep systems, demonstrated by a double-blind trial against placebo under Doppler control.
Increased systolic and diastolic blood pressure in postoperative orthostatic hypotension.
Activity in the aftermath of saphenectomy.
Vasculoprotective properties:
Increased capillary resistance, effects related to the oral dose administered.
Pharmacokinetics:
Absorption & metabolism: After oral administration of Pleminos, diosmin is converted to diosmetin by intestinal bacteria. Diosmetin is then absorbed and metabolized in the bloodstream as glucuronide and sulfoconjugate. Diosmetin-3-glucuronide has been shown to be one of the major metabolites of diosmin.
Peak plasma concentrations are achieved 12 to 15 hours after taking Pleminos.
Distribution: In animals, pharmacokinetic studies of radiolabeled diosmin (C14) have shown preferential distribution of radioactivity in the vena cava and saphenous veins.
Elimination: In animals, the drug is excreted primarily in urine (79%), via feces (11%) and bile (2.4%), with the existence of enterohepatic circulation.
In humans, diosmetin-3 glucuroconjugate is found in the urine.
