Usage
This combination medication is primarily prescribed for:
- Chronic Venous Insufficiency (CVI): Improves blood flow and reduces symptoms like swelling, pain, and leg heaviness.
- Hemorrhoids (Piles): Reduces inflammation, pain, and bleeding.
- Varicose Veins: Improves venous tone and reduces their appearance.
- Diabetic Retinopathy: Improves microcirculation in the retina.
Pharmacological Classification: Vasoprotective agent, Venotonic, Phlebotonic.
Mechanism of Action: Calcium dobesilate stabilizes capillary walls, reduces capillary permeability and fragility, improves microcirculation, and decreases blood viscosity. Citrus bioflavonoids have antioxidant and anti-inflammatory properties, enhancing the effects of vitamin C and supporting vascular health. Vitamin C is essential for collagen synthesis, strengthens blood vessel walls, and acts as an antioxidant.
Alternate Names
- Venorich
- Dobelon
- Veinosil Forte
- Dobipile Plus (when combined with Troxerutin)
How It Works
Pharmacodynamics: Calcium dobesilate improves microcirculation by decreasing capillary permeability and fragility, reducing blood viscosity, and acting as an antagonist to histamine, serotonin, and bradykinin. Citrus bioflavonoids and vitamin C exert antioxidant and anti-inflammatory effects, further supporting vascular health.
Pharmacokinetics: Calcium dobesilate is well-absorbed after oral administration. It is metabolized in the liver and excreted primarily through the kidneys. Citrus bioflavonoids are metabolized in the gut and liver. Vitamin C is readily absorbed and distributed throughout the body, with excess excreted in urine.
Mode of Action: Calcium dobesilate acts on the vascular endothelium, reducing capillary permeability and improving microcirculation. Citrus bioflavonoids and vitamin C scavenge free radicals, reducing oxidative stress and inflammation.
Dosage
Standard Dosage
Adults: 500mg Calcium Dobesilate + 500mg Citrus Bioflavonoids + 100mg Vitamin C twice daily (BID) with meals. Treatment duration varies depending on the condition and severity.
Children: Safety and efficacy not established in children; use is generally not recommended.
Special Cases:
- Elderly Patients: Dosage adjustments may be necessary based on renal function; close monitoring is advised.
- Patients with Renal Impairment: Dose reduction may be required in patients with severe renal disease.
- Patients with Hepatic Dysfunction: Caution is advised, and dose adjustments may be necessary.
- Patients with Comorbid Conditions: Individualized dosing based on specific conditions (e.g., diabetes, cardiovascular disease) may be necessary.
Side Effects
Common Side Effects:
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Headache
- Skin rash
- Fever
Rare but Serious Side Effects:
- Allergic reactions
- Agranulocytosis
- Liver dysfunction
- Kidney problems
Contraindications
- Hypersensitivity to any component of the medication.
- Pregnancy.
- Breastfeeding.
- Severe renal insufficiency.
Drug Interactions
- Warfarin: Bioflavonoids may interact with warfarin, increasing bleeding risk. Close INR monitoring is recommended.
- Alcohol: Avoid alcohol as it may potentiate drowsiness caused by Calcium Dobesilate.
- Medications affecting liver or kidney function: Use with caution.
Pregnancy and Breastfeeding
Contraindicated in both pregnancy and breastfeeding.
Drug Profile Summary
- Mechanism of Action: Vasoprotective, venotonic, anti-inflammatory, antioxidant
- Side Effects: Nausea, vomiting, diarrhea, abdominal pain, headache, skin rash, fever. Rarely: allergic reactions, agranulocytosis, liver dysfunction, kidney problems.
- Contraindications: Hypersensitivity, pregnancy, breastfeeding, severe renal insufficiency.
- Drug Interactions: Warfarin, alcohol, medications affecting liver/kidney function.
- Pregnancy & Breastfeeding: Contraindicated.
- Dosage: 500mg Calcium Dobesilate + 500mg Citrus Bioflavonoids + 100mg Vitamin C BID with meals. Adjust for renal/hepatic impairment.
- Monitoring Parameters: Liver function tests, renal function tests, complete blood count (especially during prolonged therapy).
Popular Combinations
This combination is typically used as standalone therapy. However, it may be combined with other medications for specific conditions under the guidance of a healthcare professional.
Precautions
- General Precautions: Assess for allergies, renal/hepatic function, and concomitant medications.
- Pregnant Women: Contraindicated.
- Breastfeeding Mothers: Contraindicated.
- Children & Elderly: Not recommended for children. Caution and dose adjustment necessary in elderly patients.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Calcium Dobesilate + Citrus Bioflavonoid + Vitamin C?
A: The standard adult dosage is 500mg Calcium Dobesilate + 500mg Citrus Bioflavonoids + 100mg Vitamin C twice daily with meals. Dose adjustments may be necessary for elderly patients and those with renal or hepatic impairment.
Q2: What are the common side effects?
A: Common side effects include nausea, vomiting, diarrhea, abdominal pain, headache, skin rash, and fever.
Q3: Is this medication safe during pregnancy or breastfeeding?
A: No, this medication is contraindicated during pregnancy and breastfeeding.
Q4: What are the serious side effects to watch out for?
A: Rare but serious side effects include allergic reactions, agranulocytosis, liver dysfunction, and kidney problems.
Q5: Are there any drug interactions I should be aware of?
A: Yes, this medication can interact with warfarin, alcohol, and medications affecting liver or kidney function.
Q6: Can children take this medication?
A: The safety and efficacy in children haven’t been established, so it’s generally not recommended.
Q7: How does Calcium Dobesilate work in this combination?
A: Calcium Dobesilate improves microcirculation by decreasing capillary permeability and fragility and reducing blood viscosity.
Q8: What is the role of Citrus Bioflavonoids and Vitamin C?
A: Citrus bioflavonoids and Vitamin C exert antioxidant and anti-inflammatory effects, enhancing vascular health.
Q9: What should I monitor in patients taking this medication long-term?
A: Monitor liver function tests, renal function tests, and complete blood count, especially during prolonged therapy.
