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Hesperidin (citrus flavonoid)

Citrus flavonoid with EMA-monograph support for chronic venous insufficiency and a body of RCTs for endothelial function.

Why

Hesperidin is a flavanone glycoside concentrated in citrus peel (orange, lemon). The micronised purified flavonoid fraction (MPFF, Daflon/Diosmin 500) is a registered medicinal product in many EU countries for chronic venous insufficiency, with EMA HMPC monograph support. Beyond CVI, RCTs report improved endothelial function and modest blood pressure reductions at 500 mg/day. Diosmin is the dehydrogenated form used in most CVI products; hesperidin is the parent.

How it works

Increases venous tone via noradrenergic modulation, reduces capillary hyperpermeability, and modulates leukocyte-endothelium interaction, the latter underlying both the CVI and haemorrhoid effects. Endothelial nitric oxide synthase activation contributes to the systemic-circulation effect.

Expected onset · CVI symptoms within 2–4 weeks; haemorrhoid flare relief within days

How to take

Dosage

MPFF (Daflon): 500 mg twice daily for CVI. Acute haemorrhoid flare: 3 tablets twice daily for 4 days, then 2 twice daily for 3 days, then 500 mg twice daily. Hesperidin alone: 500 mg/day for endothelial / BP effect.

Timing

With meals; divided 2–3 times daily

On the label

'Diosmin' or 'micronised purified flavonoid fraction' (MPFF) for CVI use; hesperidin standardised extract for general use. Daflon is the trade name for the studied formulation.

Ideal for

Adults with chronic venous insufficiency, varicose vein discomfort, haemorrhoids, or mild hypertension exploring botanical adjuncts.

Safety

Generally very well tolerated. Mild GI upset. Theoretical CYP3A4 inhibition (citrus family) at high doses. Caution with calcium channel blockers and other CYP3A4 substrates. Pregnancy and breastfeeding: dietary doses safe; supplement doses limited data.

Evidence

At a glance

Lyseng-Williamson 2003 Drugs review summarises consistent CVI symptom improvement (oedema, heaviness, pain) with MPFF/Daflon across multiple RCTs. Salden 2016 meta-analysis (4 RCTs) reported modest BP reduction with hesperidin supplementation. Daflon is a registered medicinal product across most of Europe, the regulatory anchor is clinical-grade.

Where to get it

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