Treatment of hemorrhoids in the first stages is possible with conservative therapy. The treatment regimen includes numerous groups of internal and local drugs, which together help get rid of the pathology.
Phlebodia for hemorrhoids refers to venotonic drugs that reduce congestion in the venous vessels, tones them, and also helps improve microcirculation and increase capillary resistance.
The drug has a pronounced positive effect and is very often part of the complex treatment of hemorrhoids.
pharmachologic effect
Venotonic effect: reduces the distensibility of veins, increases the tone of veins, reduces venous congestion, enhances the vasoconstrictor effect of adrenaline, norepinephrine. One tablet contains 600 mg of diosmin, which is the optimal daily dose for the venotonic effect.
Angioprotective effect: improves microcirculation; increases capillary resistance; reduces their permeability.
Effect on the lymphatic system: improves lymphatic drainage, increases the tone and frequency of contraction of lymphatic capillaries, increases their functional density, reduces lymphatic pressure.
Has an anti-edematous effect. Reduces symptoms of inflammation (dose-dependent effect).
Reduces the adhesion of leukocytes to the venous wall and their migration into paravasal tissues; improves oxygen diffusion and perfusion in tissue. Blocks the production of free radicals, the synthesis of prostaglandins and thromboxane.
A decrease in mean venous pressure in the system of superficial and deep veins of the lower extremities was confirmed, demonstrated in a double-blind, placebo-controlled study conducted under Doppler ultrasound control; as well as increased systolic and diastolic blood pressure in patients with postoperative orthostatic hypotension.
Release form and composition
Phlebodia 600 is in tablet form. One blister contains 15 round, pink, film-coated tablets with a grey-brown center. Available options allow up to 2 records to be included in the package.
Diosmin (600 mg) is the main active substance, the properties of which provide the drug with a therapeutic effect. The component has the following effects:
- tones venous vessels;
- stimulates blood circulation;
- reduces and prevents venous stagnation;
- improves blood supply to tissues;
- helps normalize lymph outflow;
- increases the resistance of capillaries to various factors;
- prevents excessive vascular permeability;
- has a vasoconstrictor effect;
- eliminates and prevents inflammatory processes;
- eliminates pain and swelling;
- helps improve lymphatic drainage.
Phlebodia contains:
- microcrystalline cellulose (910 mg);
- talc (10.24 mg);
- colloidal silicon dioxide (3.5 mg);
- stearic acid (50.05 mg);
- opaglos 6000 (beeswax and palm wax, 95% ethanol, gummilak)
The shell is formed by: hypromellose, microcrystalline cellulose, polyethylene glycol stearate 400.
This is what Phlebodia tablets look like
Pharmacokinetics
Suction and distribution
After oral administration, it is quickly absorbed from the gastrointestinal tract and is found in plasma 2 hours after administration. Cmax in blood plasma is achieved 15 hours after administration.
It is evenly distributed and accumulates in all layers of the wall of the vena cava and saphenous veins of the lower extremities, to a lesser extent in the kidneys, liver and lungs and other tissues.
Selective accumulation of diosmin and/or its metabolites in venous vessels reaches a maximum at 9 hours after administration and persists for 96 hours.
Removal
It is excreted mainly by the kidneys - 79%, as well as by the intestines - 11%, with bile - 2.4%.
Clinical manifestations of external hemorrhoids
With external hemorrhoids the following clinical manifestations appear:
- Discomfortable sensations in the perineum, which then turn into pain;
- The pain can be of varying intensity and nature (stabbing, cutting, etc.);
- Usually the pain intensifies after defecation after some time (therefore, patients try to avoid defecation, which closes the vicious circle);
- Bloody discharge in the stool, and sometimes there may be obvious bleeding, which will require urgent surgical intervention;
- The presence of visually detectable nodes in the rectal area;
- Constipation, increasing the progression of the disease;
- Feeling of itching and burning in the perineal area.
It should be emphasized that the severity and number of symptoms of hemorrhoids depend on its stage. The more advanced the pathological process, the more inconvenience it causes a person. Therefore, it is quite obvious that the sooner hemorrhoids are diagnosed, the more successful its treatment will be, and the person will be able to return to their normal lifestyle as soon as possible.
Over time, other symptoms join the typical clinical picture. They are caused by the development of complications, namely:
- inflammation of hemorrhoids;
- their thrombosis;
- anal fissures;
- rectal prolapse, etc.
The disease is chronic, that is, periods of exacerbation are followed by periods of remission. Therefore, vivid clinical manifestations appear precisely during exacerbation of the disease. In the remission stage, as a rule, patients do not feel any unpleasant symptoms. All this causes patients to seek medical help late (they rely on “maybe it will pass,” but this does not happen).
Dosage regimen
The drug is intended for oral administration.
For chronic lymphovenous insufficiency
Prescribe 1 tablet/day in the morning, preferably before meals. The duration of therapy is usually 2 months.
For acute hemorrhoids and exacerbation of chronic hemorrhoids
the drug is prescribed in the first 4 days, 1 tablet. 3 times/day, during meals; in the next 3 days - 1 tablet. 2 times/day, during meals. If symptoms recur, the course of treatment can be repeated as recommended by your doctor.
For chronic hemorrhoids after relief of acute phenomena
It is recommended to continue taking the drug 1 tablet. 1 time/day for 1-2 months.
If one or more doses of the drug are missed, it is necessary to continue using the drug as usual and at the usual dose.
Before using the drug, the patient should consult a doctor.
Contraindications and side effects
The instructions for use of Phlebodia precisely define the groups of patients for whom the drug is not recommended. The product is not used:
- with hypersensitivity to the active substance of the drug;
- during lactation;
- in the 1st trimester of pregnancy.
Phlebodia is not recommended for children and adolescents
In rare cases, use of the drug may lead to:
- to dyspeptic symptoms in the form of diarrhea, heartburn, nausea or vomiting;
- headaches or dizziness;
- allergic reactions (redness, rashes, itching);
- unpleasant odor from the mouth.
It is possible to eliminate unpleasant manifestations after stopping taking the drug.
Clinical manifestations of a drug overdose, as well as its interaction with other medications, have not been described.
Side effect
The incidence of adverse reactions is presented as follows: very often (>1/10 cases), often (>1/100 and 1/1000 and 1/10000 and
The following adverse reactions have been reported while taking Phlebodia 600.
From the gastrointestinal tract:
rarely - dyspeptic disorders (heartburn, nausea, abdominal pain).
From the side of the central nervous system:
rarely - headache.
If any of the side effects indicated in the instructions are aggravated or any other side effects not specified in the instructions are noted, the patient should inform the doctor.
Therapeutic effect
Reviews of Phlebodia for hemorrhoids are extremely positive. This is due to the following effects of the drug:
- reduces the fragility and permeability of blood vessels and capillaries, promotes increased tone. Prevents the distensibility of veins;
- normalizes metabolism;
- eliminates congestion in the veins, relieves swelling;
- reduces blood pressure;
- saturates tissues with oxygen;
- relieves inflammation, eliminates pain;
- prevents cellular aging;
- improves lymphatic drainage;
- prevents the effects of free radicals by blocking their production.
Phlebodia 600 for hemorrhoids has a positive effect on the affected vessels of the hemorrhoidal plexuses, with significant relief of the patient’s condition and accelerated recovery.
In addition to the positive effect in the treatment of hemorrhoids, the advantages of the drug include:
- ease of use. Phlebodia is available in the form of tablets for oral use, which allows them to be used regardless of the situation. This property of the drug greatly facilitates the treatment of such a delicate disease as hemorrhoids;
- Phlebodia fights the main cause of the disease – obstructed venous blood flow;
- symptoms after taking the drug disappear in a short period of time, which significantly improves the quality of life;
- the drug suppresses the progression of the disease;
- prevents complications;
- has a small number of contraindications;
- has few side effects that occur quite rarely;
- has an affordable price.
Use during pregnancy and breastfeeding
Pregnancy
The use of the drug during pregnancy is possible only as prescribed by a doctor in cases where the expected benefit to the mother outweighs the potential risk to the fetus.
Experimental studies have not revealed any teratogenic effects on the fetus. Until now, in clinical practice there have been no reports of cases of malformation or fetotoxic effects on the fetus when using the drug in pregnant women.
Breastfeeding period
Due to the lack of data on the excretion of the drug in breast milk, nursing women are not recommended to use the drug.
Indications for use
The use of Phlebodia for hemorrhoids is similar to other medications and should be carried out exclusively as prescribed by a doctor. It is prescribed for hemorrhoidal manifestations and for the treatment of other diseases associated with vascular pathology.
The drug helps eliminate:
- chronic form of hemorrhoids;
- impaired microcirculation;
- increased capillary fragility;
- varicose veins of the lower extremities;
- spider veins;
- pain, swelling, feeling of heaviness in the legs;
- chronic venous and lymphatic insufficiency;
- a sharp drop in systolic and diastolic pressure when a person stands up, caused by weakened vascular tone (orthostatic hypotension) in the postoperative period;
- trophic lesions of the legs.
Phlebodia is actively involved in the fight against thrombophlebitis
Also, the drug facilitates exacerbations and is used as a component of complex treatment.
It is possible to use the drug in the postoperative period after phlebectomy to avoid the risk of bleeding.
Phlebodia helps prevent hemorrhagic complications during the insertion of an intrauterine device.
How to deal with hemorrhoids
It is important for pregnant women to pay attention to their diet, difficulties with bowel movements, stool retention, and discomfort when going to the toilet. Remember: it is better to start working on the situation at the first unpleasant manifestations in order to reduce the risks of developing hemorrhoids and establish a natural physiological process
The most important conditions for the comprehensive fight against hemorrhoids and improving the quality of life of a pregnant woman are:
- increasing physical activity (of course, if possible);
- balanced diet rich in fiber;
- consuming a sufficient amount of fluid in order to normalize the functioning of the gastrointestinal tract, soften stools and mildly comfortable cleansing of the intestines2,4. Moreover, when pregnancy is accompanied by constipation, it is important to pay special attention to this.
Phlebodia tablets 600 mg No. 18
Compound
Active substance: diosmin in terms of dry matter 600 mg.
Excipients: talc - 10.24 mg, colloidal silicon dioxide - 3.5 mg, stearic acid - 50.05 mg, microcrystalline cellulose - up to 910 mg. Film shell composition: Sepifilm® 002 (hypromellose (E 464) - 9.832 mg, microcrystalline cellulose - 7.866 mg, macrogol 8 stearate type 1 - 1.967 mg); Sepispers® AP 5523 pink (propylene glycol - traces, hypromellose (E 464) - 0.458 mg, titanium dioxide (E 171) - 4.026 mg, crimson dye [Ponceau 4R] (E 124) - 0.401 mg, iron oxide black (E 172) - 0.13 mg, iron oxide red (E 172) - 0.02 mg); Opaglos® 6000 (carnauba wax (E 903) - 0.075 mg, beeswax (E 901) - 0.075 mg, shellac (E 904) - 0.15 mg, ethanol 95° - traces).
Pharmacokinetics
Suction and distribution
After oral administration, it is quickly absorbed from the gastrointestinal tract and is found in plasma 2 hours after administration. Cmax in blood plasma is achieved 15 hours after administration.
It is evenly distributed and accumulates in all layers of the wall of the vena cava and saphenous veins of the lower extremities, to a lesser extent in the kidneys, liver and lungs and other tissues.
Selective accumulation of diosmin and/or its metabolites in venous vessels reaches a maximum at 9 hours after administration and persists for 96 hours.
Removal
It is excreted mainly by the kidneys - 79%, as well as by the intestines - 11%, with bile - 2.4%.
Indications for use
- Treatment of symptoms of lymphovenous insufficiency of the lower extremities (feeling of heaviness, fatigue, fullness in the legs; pain that increases towards the end of the day; swelling);
- additional treatment for microcirculation disorders;
- treatment of symptoms of acute hemorrhoids.
Contraindications
- Hypersensitivity to the components of the drug;
- breastfeeding period (experience of use is limited);
- children and adolescents up to 18 years of age (experience of use is limited).
Directions for use and doses
The drug is intended for oral administration.
For chronic lymphovenous insufficiency, 1 tablet/day is prescribed in the morning, preferably before meals. The duration of therapy is usually 2 months.
For acute hemorrhoids and exacerbation of chronic hemorrhoids, the drug is prescribed in the first 4 days, 1 tablet. 3 times/day, during meals; in the next 3 days - 1 tablet. 2 times/day, during meals. If symptoms recur, the course of treatment can be repeated as recommended by your doctor.
For chronic hemorrhoids, after relief of acute effects, it is recommended to continue taking the drug 1 tablet. 1 time/day for 1-2 months.
If one or more doses of the drug are missed, it is necessary to continue using the drug as usual and at the usual dose.
Before using the drug, the patient should consult a doctor.
Storage conditions
Store at a temperature not exceeding 30 °C. Keep out of the reach of children.
Best before date
3 years. Do not use after expiration date.
special instructions
Treatment of an acute attack of hemorrhoids is carried out in combination with other drugs; in the absence of a rapid clinical effect, it is necessary to conduct an additional examination and adjust the therapy.
Description
Angioprotective agent.
Use in children
The use of the drug is contraindicated in people under 18 years of age.
Pharmacodynamics
Venotonic effect: reduces the distensibility of veins, increases the tone of veins, reduces venous congestion, enhances the vasoconstrictor effect of adrenaline, norepinephrine. One tablet contains 600 mg of diosmin, which is the optimal daily dose for the venotonic effect.
Angioprotective effect: improves microcirculation; increases capillary resistance; reduces their permeability.
Effect on the lymphatic system: improves lymphatic drainage, increases the tone and frequency of contraction of lymphatic capillaries, increases their functional density, reduces lymphatic pressure.
Has an anti-edematous effect. Reduces symptoms of inflammation (dose-dependent effect).
Reduces the adhesion of leukocytes to the venous wall and their migration into paravasal tissues; improves oxygen diffusion and perfusion in tissue. Blocks the production of free radicals, the synthesis of prostaglandins and thromboxane.
A decrease in mean venous pressure in the system of superficial and deep veins of the lower extremities was confirmed, demonstrated in a double-blind, placebo-controlled study conducted under Doppler ultrasound control; as well as increased systolic and diastolic blood pressure in patients with postoperative orthostatic hypotension.
Side effects
The frequency of adverse reactions is presented as follows: very often (>1/10 cases), often (>1/100 and <1/10 cases), infrequently (>1/1000 and <1/100 cases), rarely (>1 /10000 and <1/1000 cases) and very rarely (<1/10000 cases). Adverse reactions, the frequency of which cannot be estimated from the available data, are designated “frequency unknown.”
The following adverse reactions have been reported while taking Phlebodia 600.
From the gastrointestinal tract: rarely - dyspeptic disorders (heartburn, nausea, abdominal pain).
From the side of the central nervous system: rarely - headache.
If any of the side effects indicated in the instructions are aggravated or any other side effects not specified in the instructions are noted, the patient should inform the doctor.
Use during pregnancy and breastfeeding
Pregnancy
The use of the drug during pregnancy is possible only as prescribed by a doctor in cases where the expected benefit to the mother outweighs the potential risk to the fetus.
Experimental studies have not revealed any teratogenic effects on the fetus. Until now, in clinical practice there have been no reports of cases of malformation or fetotoxic effects on the fetus when using the drug in pregnant women.
Breastfeeding period
Due to the lack of data on the excretion of the drug in breast milk, nursing women are not recommended to use the drug.
Interaction
Clinically significant effects of interaction with other drugs have not been described.
The patient should inform the attending physician about all medications taken.
Overdose
Overdose symptoms are not described.
Impact on the ability to drive vehicles and operate machinery
There is no data on the negative effect of the drug on the ability to drive vehicles and other mechanisms.
Treatment of external hemorrhoids
We treat external hemorrhoids together with a proctologist! This is exactly the motto that people facing this problem should have, since they cannot cope with this disease on their own. Need help from a specialist.
In general, treatment of external hemorrhoids is fundamentally divided into three main groups:
- Conservative treatment, which involves drug therapy in conjunction with general recommendations.
- Traditional hemorrhoid surgery.
- Minimally invasive methods for treating hemorrhoids.
Medicines that are prescribed as the first stage of treatment for hemorrhoids should have the following therapeutic effects:
- Strengthen the venous wall of hemorrhoidal veins.
- Effectively eliminate pain syndrome.
- Fight the inflammatory response.
- Have a hemostatic effect, that is, eliminate bleeding.
To achieve maximum effectiveness, medications must be prescribed both systemically and locally. Systemic drugs are prescribed orally in the form of tablets and capsules. Local therapy involves the use of ointment for external hemorrhoids, rectal suppositories, etc.
The main drug for systemic treatment of hemorrhoids is phlebotonic. These drugs strengthen the vascular wall, which prevents the formation of new hemorrhoids and leads to regression of old nodes. Phlebotonic drugs include Detralex, Venorutin, Phlebodia. Painkillers from the group of non-steroidal anti-inflammatory drugs can also be prescribed systemically.
Local therapy for hemorrhoids allows for the elimination of clinical symptoms as soon as possible. This is explained by the fact that the drugs used have their effect directly on the pathological focus. Treatment with local drugs usually lasts 10 days, and systemic therapy lasts 3 months or more.
Minimally invasive methods for treating hemorrhoids include:
- Laser cauterization of hemorrhoids.
- Infrared ligation of nodes, that is, their cauterization with infrared rays.
- Injection of sclerosing substances into hemorrhoids, which causes them to collapse.
All these methods compare favorably with traditional surgical ones, which makes them very popular. The main advantages are:
- Minimal invasiveness of the intervention.
- Low pain syndrome in the postoperative period.
- Minimal blood loss.
- Short rehabilitation period.
- Quick return to normal lifestyle.
But there are still minor disadvantages to drug interventions, namely:
- The impossibility of simultaneously removing a large number of hemorrhoids.
- The relatively high cost of the treatment, which is explained by the use of expensive equipment.
Traditional surgical intervention is performed less and less nowadays, which is associated with a relatively high intervention and traumatic operation. The main types of surgical interventions used for this disease are:
- Direct removal of hemorrhoids, which are located outside in the external form of the disease.
- Tightening of the mucous membrane of the rectum, while removing hemorrhoids is not performed (it is the most expensive and most painless).
The choice of one or another operation is made by the proctologist depending on the existing clinical situation.
In conclusion, it should be noted that external hemorrhoids cause a lot of inconvenience to the patient. Therefore, it is required to treat it as early as possible. There are various ways to do this - both conservative and operational. The need for one or another method is determined by the attending physician (proctologist). However, it is worth noting that in modern medicine, hemorrhoids respond very well to treatment if it is started in a timely manner.
