Alvenor

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Alvenor

Method of action: Angioprotective, Venotonic

Treatment option:

Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Alvenor

Quick Facts

Property Description
Active Ingredients Diosmin, Hesperidin (as MPFF)
Form Film-Coated Tablet
Pharmacological Class Phlebotonic Drug, Vascular Protecting Agent
Common Use Circulatory support and venous insufficiency symptoms
Origin Derived from natural bioflavonoids

What Type of Medicine is Alvenor?

Alvenor is classified as a phlebotonic drug and a vascular protecting agent, primarily supporting the structural integrity and function of the veins and capillaries. It is a fixed-dose combination product intended for oral administration as a film-coated tablet.

The medication belongs to the phlebotonic class because it is designed to increase venous tone, which is the necessary firmness of the vein walls for efficient blood circulation. This mechanism serves as an approach for managing microvascular issues. This action distinguishes it from simple dietary supplements, establishing its role as a targeted intervention for vascular physiology.

Composition and Source: The Micronized Flavonoid Combination

The active components in Alvenor are the two synergistic flavonoid glycosides: Diosmin and Hesperidin. These ingredients are derived from natural bioflavonoid compounds and are then refined for pharmaceutical use.

A crucial attribute of this composition, which serves as its differentiating feature, is its presentation as a Micronized Purified Flavonoid Fraction (MPFF). The term micronized denotes a specific process where the particle size is significantly reduced. This technical detail is significant as it improves the absorption and subsequent bioavailability of the active ingredients compared to conventional, non-micronized forms.

General Role in Circulatory Support

The general purpose of this medication is to offer focused circulatory support by addressing functional deficiencies within the veno-lymphatic system. The combined action of Diosmin and Hesperidin helps to decrease the excessive distensibility of the veins and capillaries. This targeted support is typically used to manage discomfort related to impaired blood return, a characteristic of symptomatic venous issues.

This utility is rooted in its ability to protect the delicate microcirculation and enhance lymphatic function, key physiological factors in tissue fluid management. By supporting these structural and functional elements of the circulation, the drug assists in maintaining vascular competence.

What side effects are possible with Alvenor?

Possible Side Effects and Safety Information

The safety profile of Alvenor, a micronized purified flavonoid fraction, is classified in regulatory labeling according to the body system affected and the reported frequency of occurrence. This classification is consistent with regulatory standards for communicating risks in a medically grounded, non-instructional manner.

Adverse Reactions by Frequency

Official documents classify potential adverse reactions across several frequency tiers, with the most commonly reported effects involving the gastrointestinal system.

Frequency Classification Examples of Officially Listed Reactions System-Organ Class (SOC)
Common (1 to 10 users out of 100) Diarrhea, Dyspepsia, Nausea, Vomiting Gastrointestinal Disorders
Uncommon (1 to 10 users out of 1,000) Colitis (Inflammation of the colon) Gastrointestinal Disorders
Rare (1 to 10 users out of 10,000) Dizziness, Headache, Malaise, Rash, Pruritus, Urticaria Nervous System, Skin Disorders
Frequency Not Known Abdominal pain, Isolated edema, Quincke's edema Gastrointestinal, Skin Disorders

Serious Adverse Reactions

The regulatory safety documentation includes the occurrence of certain reactions that may be serious, though the frequency is not known. These include Quincke's edema (angioedema), which involves rapid and significant swelling of the tissues, as well as isolated swelling (edema) of the face, eyelids, or lips.

Population-Specific Safety Statements

Specific safety statements are provided for certain populations. The use of the medication during pregnancy is advised to be avoided as a precautionary measure due to limited available data. Similarly, since it is not known whether the active ingredients are excreted in human milk, treatment is generally considered inadvisable for patients who are breastfeeding.

Safety Restrictions and Interactions

The official post-marketing experience cited in regulatory documents indicates that no clinically relevant drug interaction has been reported with this formulation of Diosmin and Hesperidin. The primary risk profile is centered on the officially classified gastrointestinal and dermatological reactions.

Overdose and Emergency Response

Overdose and When to Seek Help

The official regulatory documents regarding an overdose of Alvenor (Diosmin, Hesperidin as MPFF) define a profile characterized by limited experience and generally low acute toxicity. Acute ingestion exceeding the standard recommended amount has resulted in manifestations that are non-severe and transient, primarily affecting two systems.

Documented Clinical Signs

Overdose manifestations most frequently reported in regulatory documents are gastrointestinal events, including nausea, vomiting, diarrhea, abdominal pain, and dyspepsia. These disturbances are consistent with the compound's general absorption profile. Additionally, neurovegetative disorders, such as dizziness and headache, have been noted. The official profile does not document severe or life-threatening systemic toxicity specifically resulting from an overdose of this compound alone, aligning with its low acute risk classification.

Mandated Emergency Response

Regulatory guidance is explicit that if a patient has taken more than the recommended dose, they must consult a physician or healthcare provider immediately. This immediate action is mandated regardless of the severity of the presenting symptoms. Since no specific antidote is known for Alvenor overdose, management consists solely of symptomatic treatment and general supportive measures to address the documented clinical signs. This approach, outlined in official prescribing information, establishes the urgent help-seeking condition based on the level of ingestion.

Therapeutic Uses of Alvenor

What Alvenor Treats: Main Uses and Benefits

The medication is commonly used to help with conditions affecting the veins, particularly those in the lower limbs, as well as hemorrhoids. The medication, which contains a Micronized Purified Flavonoid Fraction (MPFF), is applied across domains where additional symptomatic support is needed in contexts associated with functional deficiencies in the veno-lymphatic system. It supports relief within two key therapeutic domains: Chronic Venous Insufficiency (CVI) and Hemorrhoidal Disease.


Relief of Chronic Venous Insufficiency Symptoms

This domain covers symptoms that interfere with daily functioning and are associated with Chronic Venous Disease (CVD) and CVI. Alvenor is relevant for easing symptoms related to physical discomfort, including the sensation of heavy legs, persistent pain, night cramps, and restless legs. This symptomatic relief supports general well-being during symptomatic periods and may assist patients with maintaining functional stability.


Management of Edema and Acute Hemorrhoidal Episodes

This cluster addresses conditions presenting with symptomatic discomfort and swelling. It is commonly used to help with leg and ankle edema which is associated with increased fluid accumulation in the lower limbs. It is relevant in clinical settings marked by heightened symptoms of Hemorrhoidal Disease, such as episodes involving acute pain, inflammation, swelling, and bleeding. It provides support that helps ease the overall symptom load. Additionally, it may be part of symptomatic management to support the treatment of venous leg ulcers alongside compression therapy.


Quick Fact: Relief for Venous Swelling

The medication is considered relevant for managing leg edema, which is associated with increased fluid accumulation in the lower limbs.

Eligibility and Restrictions for Use

This section outlines the official population eligibility criteria for using Alvenor (Diosmin, Hesperidin MPFF) based on governmental regulatory documents.

Eligibility Scope

Category Regulatory Status & Description
Populations Allowed Adults only (18 years of age and older).
Populations Contraindicated Individuals with known hypersensitivity to the active substances or any excipients.

Age-Related and Conditional Use Restrictions

  • Pediatric Population: Use is not recommended for children and adolescents under 18 years of age. Safety and efficacy in this age group have not been formally established in regulatory documentation.
  • Pregnancy: The use of the medicine is preferably avoided as a precautionary measure due to limited or absent clinical data on use in pregnant women.
  • Lactation: Use during breastfeeding is generally inadvisable. Regulatory documents state that a risk to the nursing infant cannot be excluded due to a lack of data on the excretion of the active substance into human milk.
  • Organ Function: For older adults and patients with hepatic or renal impairment, use is typically permitted, though a regulatory note advises taking the medicine with caution, as no specific dose adjustment studies have been performed.

Connection to the Overall Eligibility Profile

The regulatory profile strictly defines who can and cannot use the medicine by establishing one absolute prohibition (hypersensitivity) and clear demographic exclusions. Official labeling restricts standard use to the adult population and advises against use in children, pregnant, and breastfeeding women due to insufficient data.

What should I know about interactions with other medicines?

Interactions with other medicines and products

The official regulatory profile for Alvenor (Diosmin, Hesperidin MPFF) is structured around potential pharmacokinetic and pharmacodynamic interactions. While generally reported to have no clinically relevant interactions in post-marketing experience, the official information cites specific drug classes and substances for which an interaction may be expected.

Pharmacodynamic and Exposure-Altering Interactions

Co-administration with anticoagulants (such as Warfarin) and antiplatelet agents (such as Aspirin) carries a potential for additive pharmacodynamic interaction, which increases the theoretical risk of bleeding or bruising. Due to this potential effect on blood clotting, regulatory guidance requires the medication to be discontinued at least two weeks prior to any scheduled surgical procedure.

Separately, one of the active ingredients, Diosmin, may interfere with the body’s metabolic and transport systems. This pharmacokinetic interaction includes the potential inhibition of liver enzymes, notably CYP3A4, and the transport system P-Glycoprotein (P-gp). This interference could decrease the clearance and potentially increase the plasma concentrations of co-administered medicines that are substrates for these systems, such as Carbamazepine and Fexofenadine.

Interaction cautions also extend to specific herbal products (e.g., Ginger, Ginkgo), which may have additive blood-thinning effects.

Mechanism of Action

The mechanism of Alvenor (MPFF) involves three complementary domains influencing the functional parameters of the veno-lymphatic system.

Modulating Venous Smooth Muscle Tone

The drug’s action as a phlebotonic agent targets the venous smooth muscle cells. Active metabolites modulate noradrenergic signaling in the perivenous tissue, prolonging the presence of norepinephrine. This interaction increases the intrinsic contractile force of the vein walls, leading to increased venous tone and reduced venous distensibility, which mechanically reduces the conditions conducive to venous stasis.

Microcirculatory and Capillary Wall Stabilization

Alvenor exerts a vascular protecting action by inhibiting the pathological interaction between leukocytes and the capillary endothelium. By stabilizing the microvascular barrier and suppressing the local release of inflammatory mediators (like prostaglandins), the mechanism actively reduces capillary hyperpermeability. This core action influences the rate of fluid and protein extravasation into the surrounding interstitial space.

Modulation of Lymphatic Motility and Fluid Transport

The combined action on capillaries and veins is linked to the drug's influence on the lymphatic system. The active ingredients increase the frequency and force of lymphatic contractions. This increases the physiological capacity for lymphatic drainage, accelerating the clearance of accumulated interstitial fluid and macromolecules. The three domains operate concurrently, influencing the core physiological parameters of the entire circulatory system.

Dosage and Administration Information

Administration Route and Timing

Alvenor, which contains the Micronized Purified Flavonoid Fraction (MPFF), is intended exclusively for oral administration as a film-coated tablet. The tablets are taken at mealtimes (with food). For dosing that is split throughout the day, this typically means taking one portion at midday and the other in the evening.

Standard Dosing Regimens

The following regimens are used based on the specific condition:

Condition Total Daily Dose (MPFF) Frequency & Duration
Chronic Venous Insufficiency 1000 mg Taken once daily or in two divided doses. Usage is typically long-term (several months).
Acute Hemorrhoidal Attack 3000 mg (Days 1–4), then 2000 mg (Days 5–7) Taken in divided doses daily over a strictly 7-day course.

Administration Guidance

For the higher-strength tablets, such as the 1000 mg dose, a score line may be present. This score line is provided to facilitate breaking the tablet for ease of swallowing, and is not intended to divide the tablet into two equal doses.

Use in Specific Populations

Usage is restricted in certain populations. The drug is not recommended for use in children. As a precautionary measure, use is also not recommended during pregnancy or breastfeeding due to a lack of sufficient clinical data. The intensive, short-term treatment for acute hemorrhoids requires review by a professional if symptoms do not subside rapidly after the 7-day course.

Recent Clinical Evidence

Research evidence / Overview of Studies for Alvenor

The research base for Alvenor, which contains the Micronized Purified Flavonoid Fraction (MPFF), consists of randomized controlled trials, meta-analyses, and large observational studies. The evidence focuses on specific conditions and outcomes related to venous health.


Evidence for Use in Chronic Venous Insufficiency (CVI) Symptoms

The research focused on outcomes related to physical discomfort in individuals dealing with conditions characterized by fluctuating or episodic manifestations of CVI, such as leg heaviness, pain, and cramping. Studies monitored how symptoms evolved in the observed populations, and research describes observed symptom patterns. Research highlights the types of changes measured during the study period for these specific outcomes. The research provides context for observed symptom patterns when Alvenor is studied alongside standard care.

It is important to understand that the results apply only to the populations studied within these trials. Evidence quality varies across studies, and some secondary outcomes have had findings were mixed. Furthermore, long-term effects are not fully established beyond the initial assessment periods of the trials.


Evidence for Use in Hemorrhoidal Disease

Alvenor was evaluated in studies focused on hemorrhoidal disease, including episodes where symptoms become more noticeable. The studies exploring how symptoms change over time often focused on outcomes describing episodic or acute changes, such as the intensity of pain or the duration of bleeding. Studies report how symptoms evolved in the observed populations, in which patterns related to changes in the duration and severity of the acute episodes were observed in the short term. The follow-up durations were limited in many of the trials focused on acute episodes, meaning data are still emerging regarding the medication's potential influence on long-term recurrence of symptoms.


Research in Specific Populations and Conditions

The research base includes studies that have explored the use of Alvenor in various subgroups, such as older adults or those with more advanced stages of CVI (e.g., C4 disease). However, the sample sizes were modest, and subgroup findings were mixed across analyses due to small sample sizes. Certainty remains low for many of these specialized areas of research, and data for certain groups remain insufficient.

Key Studies & References

  1. Micronized Purified Flavonoid Fraction (MPFF 500 mg) at the very heart of Chronic Venous Insufficiency: results from the meta-analysis presented at the UIP congress, San Diego 2003

Frequently Asked Questions (FAQ)

Common questions about Alvenor (FAQ)


Q: Is Alvenor the same as other medicines for the same condition?

Alvenor contains a specific Micronized Purified Flavonoid Fraction (MPFF), which is a unique formulation of diosmin and hesperidin. Regulatory documents highlight that the micronization process is crucial because it is associated with improved absorption and bioavailability of the active ingredients. This manufacturing detail distinguishes it from conventional, non-micronized forms of the same substances.


Q: How long does it typically take for Alvenor to start working?

Studies indicate that patients may begin to experience relief from subjective symptoms within 1 to 2 weeks of starting treatment. For optimal benefits, particularly in managing chronic venous issues, optimal benefits are often observed after consistent use for a period of 4 to 8 weeks, as described in clinical information.


Q: If I miss a day of Alvenor, what happens?

Official product information states that if a dose is missed, the recommended guidance is to take it as soon as it is remembered. However, if the next scheduled dose is close, the guidance is to skip the missed dose and continue with the regular schedule. Guidance also states that a double dose should not be taken.


Q: Can I take Alvenor with common pain relievers like ibuprofen?

The official safety profile notes a theoretical risk of additive effects with antiplatelet agents, such as aspirin. This caution is generally extended to other medications that may affect blood clotting, including non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. Information regarding all concurrent medications and supplements should be reviewed by a healthcare professional.


Q: Is Alvenor a controlled substance?

No. Regulatory context indicates that the active ingredients, diosmin and hesperidin, are flavonoids derived from natural sources. These substances are not listed or classified as controlled substances in official regulatory frameworks.


Q: What happens if I accidentally take Alvenor twice in one day?

While no official cases of severe overdose have been reported, taking more than the prescribed amount may lead to increased common side effects. If you accidentally take too many tablets or suspect a severe reaction, official patient information states that medical attention should be sought immediately in the event of suspected severe overdose.


Q: Why does Alvenor require a prescription?

The requirement for a prescription often depends on the region's specific regulatory classification. In some areas, Alvenor is classified as a prescribed drug due to its specific pharmaceutical formulation (MPFF) and intended uses. However, in other regions, similar formulations may be regulated and sold as over-the-counter medicines or medical foods.


Q: Does Alvenor interact with commonly used over-the-counter supplements?

Official regulatory information specifically warns about potential interactions with certain herbal products. Additionally, there are cautions regarding pharmacokinetic interactions with other medicines that are metabolized by certain liver enzymes (CYP3A4) or transport systems (P-gp), which may include some non-herbal supplements.


Q: Can Alvenor be crushed or broken in half?

Official prescribing information states that any score line on the tablet is provided only to facilitate swallowing, not to divide the tablet into two equal doses. Furthermore, some patient information sheets include guidance that chewing, crushing, or breaking the tablet is not recommended to maintain its intended formulation.


Q: Are there any warnings about driving or operating machinery while taking Alvenor?

Official documents list dizziness, headache, and general malaise as potential rare side effects. Regulatory documents generally include a caution that if dizziness or malaise occurs, driving or operating machinery may be impaired.


Q: Is Alvenor a high-risk medication?

Regulatory classification of adverse reactions shows that the most frequently reported effects (such as diarrhea and nausea) are considered common and primarily involve the gastrointestinal system. The overall safety profile, as described in clinical trials, is often described as well-tolerated based on clinical data.


Q: What is the difference between Alvenor and generic versions, if available?

The key difference is the Micronized Purified Flavonoid Fraction (MPFF) formulation specified in regulatory documents. This micronized process is associated with enhanced absorption and subsequent bioavailability of the active ingredients compared to non-micronized forms of diosmin that may be sold as a generic supplement.


Q: How is Alvenor removed from the body?

According to the Pharmacokinetics section of regulatory documents, diosmin is metabolized by intestinal bacteria into its active form, diosmetin, which is then absorbed. This active metabolite is removed from the body with an elimination half-life generally ranging from 26 to 43 hours.


Q: Does Alvenor have a risk of dependence or addiction?

Official patient information explicitly states that the product is not known to be habit-forming. Therefore, there is no identified risk of developing dependence or addiction associated with the use of this medication.


Q: What are the reported success rates of Alvenor in clinical trials?

Clinical trials and regulatory summaries describe success in terms of observed improvements in subjective symptoms, such as the reduction of leg pain and heaviness. Efficacy is also measured through objective outcomes like reductions in ankle circumference or improvements in ulcer healing rates, rather than a single numerical 'success rate.'


Q: Why do some people say Alvenor did not work for them?

Research and clinical summaries explain that results apply only to the specific populations studied in trials. Furthermore, evidence quality and subgroup findings were sometimes mixed across different clinical analyses. Studies have noted varied outcomes across different subgroups of patients, which accounts for varied patient outcomes in real-world use.


Q: Is Alvenor a new or established medication?

Official regulatory context confirms that the active ingredient, the Micronized Purified Flavonoid Fraction (MPFF), is a well-established product. It is supported by an extensive history of clinical trials and has been in use across multiple countries for over two decades.

How should Alvenor be stored and disposed of?

How to Store and Dispose of Alvenor (Diosmin/Hesperidin)

The storage and disposal instructions for Alvenor are defined by official regulatory documentation to ensure product integrity and safety.

Required Storage Conditions

Alvenor tablets must be stored at a temperature not exceeding 30 C and should not be frozen. To maintain the product's stability and protect it from moisture, the tablets must be kept in the original package and the container must remain tightly closed.

As a safety requirement, the medicine must be stored out of the sight and reach of children. The product must not be used after the expiry date indicated on the packaging.

Disposal Instructions

Unused or expired Alvenor must be disposed of according to specific procedures. Official instructions prohibit disposing of this medicine via wastewater or household waste. Guidance on the correct method for disposal should be obtained from a pharmacist.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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