Rutin, also called rutoside, is the glycoside flavonoid found in a certain fruits and vegetables. Most rutine-rich foods are capers, olives, buckwheat (whole grain flour), asparagus, raspberry.In a clinical trial, rutin was found to aid control of intraocular pressure in patients with primary open angle glaucoma. As a component of dietary supplement Phlogenzym, rutin is used for treatment of osteoarthritis. Rutin is also used for treatment of post-surgical swelling of the arm after breast cancer surgery. Traditionally, rutin is used to prevent mucositis due to cancer treatment, to treat blood vessel disease such as varicose veins, bleeding, hemorrhoids.

Troxerutin (TXN) is a flavonoid present in tea, coffee, cereal grains, and a variety of fruits and vegetables. It inhibits the agglomeration of blood platelets and red blood cells; prevents thrombogenesis; protects endothelial cells; and enhances microcirculation. It possess anti-inflammatory and anti-apoptotic properties. Troxerutin protected different cell types (epithelial cells, fibroblasts and lymphocytes) against peroxyl radical-induced apoptosis, necrosis and mitotic death. It scavenged intracellular basal and inducible ROS levels and also restored depletion of intracellular GSH levels. Troxerutin might provide a safe and effective treatment for rhinorrhea in the common cold deserves systematic evaluation. The use of a mixture of troxerutin, diosmin and hesperidin is a safe and effective mean of managing symptoms of acute hemorrhoidal disease. Troxerutin is used for the treatment of chronic venous insufficiency.

Diosmin is a flavone indicated for the treatment of venous disease i.e., chronic venous insufficiency (CVI) including spider and varicose veins, leg swelling (edema), stasis dermatitis and venous ulcers. Diosmin is also used as a stand-alone or surgical adjunctive therapy in hemorrhoidal disease. There are extensive clinical trials that show diosmin improves all stages of venous disease including venous ulcers and improves quality of life. Diosmin prolongs the vasoconstrictor effect of norepinephrine on the vein wall, increasing venous tone, and therefore reducing venous capacitance, distensibility, and stasis. This increases the venous return and reduces venous hyperpressure present in patients suffering from CVI. Diosmin improves lymphatic drainage by increasing the frequency and intensity of lymphatic contractions, and by increasing the total number of functional lymphatic capillaries. Furthermore, diosmin with hesperidine decreases the diameter of lymphatic capillaries and the intralymphatic pressure. Diosmin reduces the expression of endothelial adhesion molecules (ICAM1, VCAM1), and inhibits the adhesion, migration, and activation of leukocytes at the capillary level. This leads to a reduction in the release of inflammatory mediators, principally oxygen free radicals, and prostaglandins (PGE2, PGF2a). Diosmin is currently a prescription medication in some European countries (under the Dio-PP, Venotec, Daflon etc. tradenames), and is sold as a nutritional supplement in the United States.

Monoxerutin is a flavonol, a type of flavonoid. Monoxerutin is the vasodilator and antihaemorrhagic agent. It is used for the treatment of varicose veins and chronic venous insufficiency.

Hidrosmin, a synthetic bioflavonoid, is a phlebotonic (capillary stabilising agent). It is marketed under the brand name Venosmil among others. Venosmil is a medicinal product indicated for: short-term (2-3 months) relief from oedema and symptoms related to chronic venous insufficiency in adults. Although the mechanism of action of hidrosmin has not been fully elucidated, it could be related toinhibition of the degradation of catecholamines, specifically inhibition of catechol-O-methyltransferase. Although the exact mechanism of action is unknown, hidrosmin has four main pharmacological actions: 1.It reduces the capillary permeability induced by various agents such as histamine, bradykinin, etc. and reduces the capillary fragility induced by a deficiency diet. 2.It increases the deformability of red blood cells and the viscosity of the blood. 3.It induces the contraction of smooth muscle in the vein wall in a gradual and sustained manner. 4.It produces dilation of the lymphatic collectors and increases the rate of lymphatic conduction, thereby improving lymphatic flow. The efficacy of Venosmil was evaluated in two clinical trials in a total of 70 patients with acute and chronic venous disease, who were treated with 200 mg hidrosmin orally three times per day and/or 2 g hidrosmin topically (gel) two or three times per day for one and two months Hidrosmin was effective at reducing oedema, ulcers and varicose eczema. Venosmil therefore possesses intrinsic activity against the consequences of venous stasis secondary to varicose dilation of the veins in the lower limbs, producing an improvement in the clinical symptoms of peripheral venous insufficiency (pain, heaviness, oedema, etc.) that is significantly different to that produced by placebo.