Diosmin Metronidazole

In 12 volunteers, diosmin 500 mg/day for 9 days significantly increased the AUC and C ax of metronidazole 800 mg without a change in this effect was attributed to inhibition of CYP3A4 (3). 

Rajnarayana K, Reddy MS, Krishna DR. Diosmin pretreatment affects bioavailability of metronidazole. Eur J Chn Pharmacol 2003 58(12) 803-7. 

Diosmin reduces the metabolism of metronidazole to some extent, but the clinical importance of this is probabfy smalL... 

A single 800-mg dose of metronidazole was given to 12 healthy subjects following 9 days of treatment with diosmin 500 mg daily. The metronidazole AUC and maximum plasma concentrations were raised by 27% and 25%, respectively. This interaction is thought to occur because of an inhibitory effect of diosmin on metronidazole metabolism by hepatic enzymes, and inhibition of P-glycoprotein. The increase in metronidazole levels is similar to that seen with other drugs (e.g. cimetidine (above)) that are not considered to be clinically significant. Therefore no clinically... 

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