Oxerutins' therapeutic uses
Oxerutins, also known as hydroxyethylrutosides, are semisynthetic compounds derived from the natural bioflavonoid rutin and have been utilized in Europe since the mid-1960s for various therapeutic purposes. Their primary uses include treating venous insufficiency and varicose veins, where they help alleviate symptoms such as swelling, pain, and fatigue in the legs. Additionally, oxerutins have been explored for other conditions, including hemorrhoids, lower-leg edema in individuals with diabetes, lymphedema, postsurgical edema, and even vertigo related to Meniere's disease.
While evidence supports their effectiveness in managing symptoms of venous conditions and some edema-related issues, the cosmetic improvement of varicose veins remains unproven. Dosages for these treatments typically range from 600 to 3,000 mg daily, depending on the specific condition addressed. Generally well-tolerated, oxerutins may cause mild side effects, mostly gastrointestinal, and their safety during pregnancy has been studied but is not conclusively established. Overall, oxerutins represent a potentially beneficial option for individuals suffering from specific vascular and lymphatic conditions, although more research is necessary to fully understand their efficacy and safety across diverse populations.
Oxerutins' therapeutic uses
- PRINCIPAL PROPOSED USES: Hemorrhoids, venous insufficiency
- OTHER PROPOSED USES: Lower-leg edema in people with diabetes, lymphedema, postsurgical edema, vertigo
DEFINITION: Natural plant substance used to treat specific health conditions.
Overview
Oxerutins, also called hydroxyethylrutosides, are a group of semisynthetic chemicals derived from a naturally occurring bioflavonoid called rutin. This supplement has been widely used in Europe since the mid-1960s as a treatment for conditions in which blood or lymph vessels leak fluid. Considerable evidence suggests that oxerutins are effective. However, it is difficult to find this supplement in North America.
Requirements and Sources
Although they are closely related to a natural flavonoid, oxerutins are not found in food. They can be taken only in supplement form. The natural flavonoid rutin is found in grapefruit, other citrus fruits, buckwheat, apricots, cherries, grapes, and plums.
Therapeutic Dosages
For varicose veins/venous insufficiency, oxerutins are usually taken in dosages ranging from 600 to 1,200 milligrams (mg) daily. A typical schedule is 1,000 mg daily, taken in two separate 500 mg doses. For treating lymphedema and postsurgical edema, a typical dosage is a good deal higher at 3,000 mg daily.
One particular oxerutin, called troxerutin, may be taken alone in similar dosages as a treatment for varicose veins. There is evidence that rutin itself aids in blood pressure, varicose veins, cholesterol, and arthritis treatment.
Oxerutins are available most commonly in 250 mg tablets. These therapies have been safely used for up to twelve weeks.
Therapeutic Uses
“Varicose” means enlarged or distended. A varicose vein is abnormally enlarged, allowing blood to pool and stagnate instead of moving it efficiently toward the heart. The surface veins of the leg are those most vulnerable to becoming varicose. Venous insufficiency is a closely related condition affecting larger veins deep within the leg. In either case, blood pools within the vein and exerts pressure against the vein walls and capillaries, resulting in pain, aching, swelling, and feelings of heaviness and fatigue. In addition, varicose veins present a cosmetic problembulging, often ropy, blue or purple lines visible on the skin of the lower legs. Strong evidence shows that oxerutins can be helpful for venous insufficiency/varicose veins, improving aching, swelling, and fatigue in the legs.
Mixed evidence suggests oxerutins might also be helpful for the leg ulcers that can develop in venous insufficiency. There is no evidence that oxerutins can improve the cosmetic appearance of varicose veins. Oxerutins have also been found effective for treating varicose veins that occur during pregnancy. Hemorrhoids are a special type of varicose vein, and oxerutins may be helpful for treating them as well, although there have been some negative studies.
Some evidence suggests that oxerutins may be helpful for lymphedemachronic arm swelling caused by damage to the lymph drainage systemfollowing surgery for breast cancer, as well as for edema in the immediate postsurgical period. Preliminary evidence, including small double-blind trials, suggests that oxerutins might also be helpful for reducing lower extremity swelling in people with diabetes. In these trials, oxerutin therapy did not affect blood sugar control.
One small double-blind study suggests oxerutins may help reduce vertigo and other symptoms of Meniere’s disease. This use is based on a theory that Meniere’s disease is caused by excessive fluid leaking from capillaries in the inner ear.
A common cause of renal failure, renal ischemia-reperfusion injury, may be prevented with the use of oxerutins. A study in rats found positive results for oxerutins as a preventative and protective measure, but human trials are needed.
Scientific Evidence
Varicose veins/venous insufficiency. About twenty double-blind, placebo-controlled studies, enrolling more than two thousand participants, have examined oxerutins’ effectiveness for treating varicose veins and venous insufficiency. Virtually all found oxerutins significantly more effective than placebo, giving substantial relief from swelling, aching, leg pains, and other uncomfortable symptoms while causing no significant side effects.
For example, one large double-blind, placebo-controlled study published in 1983 enrolled 660 people with symptoms of venous insufficiency. Three out of four participants were randomly assigned to receive oxerutins (1,000 mg daily), while one in four received a placebo. After four weeks of treatment, those who took oxerutins reported less heaviness, aching, cramps, and restless leg or pins-and-needles symptoms than those who took placebo. According to the researchers’ calculations, oxerutins produced significantly better results than the placebo. This report has been criticized, however, for omitting key information, such as whether any participants also wore support stockings, and for failing to present data in a usable form.
A better-designed study supported these positive findings. This twelve-week, double-blind, placebo-controlled study enrolled 133 women with moderate chronic venous insufficiency. Half received 1,000 mg of oxerutins daily, and the rest took a matching placebo. All participants were also fitted with standard compression stockings and wore them for the duration of the study. The researchers measured subjective symptoms, such as aches and pains, as well as objective measures of edema in the leg.
Those who took oxerutins had significantly less lower-leg edema than those in the placebo group. Furthermore, these results lasted through a six-week follow-up period, even though participants were no longer taking oxerutins. Compression stockings, on the other hand, produced no lasting benefit after participants stopped wearing them. They gave symptomatic relief while they were worn, but they did not improve capillary circulation in a lasting way, as oxerutins apparently did. Regarding aching, sensations of heaviness, and other uncomfortable symptoms, however, there was little difference between the two groups. The authors theorized that the compression stockings gave both groups so much symptomatic relief that it was difficult to demonstrate a separate subjective benefit of oxerutin therapy. Many other double-blind, placebo-controlled studies have also found benefits with oxerutins for varicose veins and venous insufficiency.
As mentioned above, there is some evidence that troxerutin—one of the compounds in the standardized mixture sold as oxerutins—may be effective when taken alone. One study found it more effective than a placebo, but another (very small) study found it less effective than the standard oxerutin mixture.
Pregnant women are at especially high risk for varicose veins and venous insufficiency. A 1975 study examined sixty-nine pregnant women with varicose leg veins and found that oxerutins (900 mg daily) were significantly more effective than a placebo against pain and swelling. Another study also found positive results, but because it was neither placebo-controlled nor double-blind, its results mean little (other than to suggest that oxerutins are safe in pregnancy).
Skin ulcers sometimes form on the legs of people with varicose veins or venous insufficiency when capillary circulation has become too impaired to keep the skin healthy. A French study published in 1987 found that oxerutins combined with compression stockings were significantly more helpful for leg ulcers than the stockings alone. Other positive results have been reported as well. However, some experiments found oxerutins to have no benefit in treating or preventing leg ulcers. Until more research is done, the most that can be said is that oxerutins might be helpful for leg ulcers, especially if combined with compression stockings.
Hemorrhoids. Some evidence suggests oxerutins might be helpful for hemorrhoids, as well. A double-blind study enrolling ninety-seven pregnant women found oxerutins (1,000 mg daily) significantly better than a placebo in reducing the pain, bleeding, and inflammation of hemorrhoids.
Lymphedema. Women who have undergone surgery for breast cancer may experience a lasting and troublesome side effectswelling in the arm caused by damage to the lymph system. Along with the veins, the lymph system is responsible for returning fluid to the heart, but when the system is damaged, fluid can accumulate. Three double-blind, placebo-controlled studies enrolling more than one hundred people have examined the effectiveness of oxerutins in this condition.
In one trial, oxerutins worked significantly better than a placebo at reducing swelling, discomfort, immobility, and other measures of lymphedema over a six-month treatment period, with better results appearing each month–suggesting that, for women with this condition, the full effect of oxerutins might take months to be realized. Two smaller studies also found oxerutins to be more effective than a placebo, but the researchers were unsure that the improvement was large enough to make a real difference. In all these studies, the dosage was 3 grams (g) daily, about three times the typical dosage for venous insufficiency. Research continues to investigate oxerutin’s effectiveness in treating lymphedema and elephantiasis, primarily in Australia and India. However, most research indicates that physical therapy is a more effective, natural approach.
Post-surgical edema. Swelling often occurs in the recovery period following surgery. In one double-blind trial, researchers gave oxerutins or a placebo for five days to forty people recovering from minor surgery or other minor injuries, and they found oxerutins significantly helpful in reducing swelling and discomfort.
Chronic venous insufficiency (CVI). A proposed treatment for CIV is the combination of calcium dobesilate and oxerutin. In preliminary trials, the results were positive, but further research is required to fully understand the benefits and risks of this combination.
A common cause of renal failure, renal ischemia-reperfusion injury, may be prevented with the use of oxerutins. A study in rats found positive results for oxerutins as a preventative and protective measure, but human trials are needed.
Safety Issues
Oxerutins appear to be safe and well-tolerated. In most studies, oxerutins have produced no more side effects than the placebo. For example, in a study of 104 older adults with venous insufficiency, twenty-six participants taking oxerutins reported adverse events, compared with twenty-five in the placebo group. The most commonly observed side effects were gastrointestinal symptoms, headaches, and dizziness.
Oxerutins have been given to pregnant women in some studies with no apparent harmful effects. However, their safety for pregnant or nursing women cannot be regarded as absolutely proven. Some studies have found traces of oxerutins in breast milk after a supplement was ingested. In addition, the safety of oxerutins has not been established for people with severe liver or kidney disease.
Bibliography
Akbulut B., Calcium. "Dobesilate and Oxerutin: Effectiveness of Combination Therapy." Phlebology, vol. 25, no. 2, 2010, pp. 66-71. doi:10.1258/phleb.2009.008085.
Güzel, Ahmet, et al. “The Efficiency of Oxerutin on Apoptosis and Kidney Function in Rats with Renal Ischemia Reperfusion Injury.” Turkish Journal of Trauma & Emergency Surgery, vol. 28, no. 3, 2022, pp. 344-51. doi:10.14744/tjtes.2021.15740.
Incandela, L., et al. “HR (Paroven, Venoruton; 0-(beta-hydroxyethyl)-rutosides) in Venous Hypertensive Microangiopathy.” Journal of Cardiovascular Pharmacology and Therapeutics, vol. 7, 2002, pp. S7-S10.
Incandela, L., et al. “Treatment of Diabetic Microangiopathy and Edema with HR (Paroven, Venoruton; 0-(beta-hydroxyethyl)-rutosides).” Journal of Cardiovascular Pharmacology and Therapeutics, vol. 7, 2002, pp. S11-S15.
Petruzzellis, V., et al. “Oxerutins (Venoruton): Efficacy in Chronic Venous Insufficiency.” Angiology, vol. 53, 2002, pp. 257-63.