Journal of Pharmacovigilance

Uncommon serum creatine phosphokinase and lactic dehydrogenase increase during diosmin therapy: Two case reports

4^th International Conference and Exhibition on Pharmacovigilance & Clinical Trials

August 10-12, 2015 London, UK

Giulia Milano

Posters-Accepted Abstracts: J Pharmacovigilance

Abstract:

Diosmin is a natural bioflavonoid isolated from various plants or derived from the flavonoid hesperidin. It is used to relieve symptoms of venous insufficiency and hemorrhoidal syndrome. Short-term administration of diosmin is usually considered safe, with only minor side effects occasionally observed. During a period of about 4 years, a general practitioner noticed 17 cases of mild diosmin-induced side effects, two of which showed particular interest. The first case is about a 55-yearold Caucasian woman with chronic leg venous insufficiency. Five days after starting diosmin treatment, the patient complained of diffuse leg pain, and, for this reason, she stopped diosmin therapy and her myalgias disappeared. She made a rechallenge and her myalgias reappeared. So the physician prescribed her some blood tests: Serum creatine phosphokinase (CPK) dosage was the only out-of-range biochemical value. The second case concerns a 79-year-old Caucasian man, who was diagnosed with acute hemorrhoidal syndrome. After 21 days of continuous diosmin treatment, increased levels of serum lactic dehydrogenase (LDH) were observed. After 1 month, blood tests showed a normalization of LDH values. In this case, rechallenge was not performed. In both cases a comprehensive analysis of all possible causes for enzyme elevation was made. We ascribe these reported ADRs to a concurrence of events: An individual predisposition and the presence of severe comorbidities that may have enhanced noradrenaline tone on microcirculation, leading to an excessive peripheral vasoconstriction and subsequent ischemic damage.

Biography :

Giulia Milano received a Bachelor?s degree from Genoa University School of Medicine. She is currently pursuing her specialization in Medical Toxicology at the Department of Internal Medicine, Clinical Pharmacology and Toxicology Unit at the University of Genoa. She has published several papers and is speaker in different conferences.