MPFF – Micronized Purified Flavonoid Fraction

MPFF – is a shortage from Micronized Purified Flavonoid Fraction which is a combination of diosmin with hesperidin in ratio 9:1.


Diosmin is a molecule belonging to flavonoids. It is a natural substance extracted from citrus fruits, mainly from Citrus aurantium.

Diosmin increases venous tone through increasing in sensitivity to Ca2+ preventing blood stasis in venous system, mainly in lower limbs. Diosmin also acts antiedematously by improving lymphatic drainage and lymph flow.


Hesperidin in also one of flavonoids and similarily to diosmin comes from the nature and is extracted from citrus fruits.

Hesperidin is a strong anti-inflammatory molecule – it inhibits synthesis of prostanoids and has antioxidative action.

MPFF – mechanism of action

Mechanism of action of micronized purified flavonoid fraction can be devided into it’s action on micro- and macro- circulation. MPFF influences microcirculation through strong anti-inflammatory action (inhibition of COX-2) and reduction of permeability of capillaries. MPFF’s action on macrocirculation shows throughout increasing venous tone and normalization of venous valves function.

MPFF’s action on microcirculation

  • capillary resistance – increases resistance in capillaries and decreases its permeability
  • lymphatic drainage – stimulates outflow of lymph and capillaries proliferation
  • anti-inflammatory action – antioxidative action and inhibition of elastase and hialuranidase activity
  • rheological disorders – decreases blood viscosity and increases erithrocytes flow

MPFF’s action on macrocirculation

  • increases venous tone through extension of noradrenergic activity in smooth muscle cells
  • protection of endothelial cells in veins throughout inhibition of inflammatory mediators
  • counteraction of return flow throughout protection of venous valves funcion (inhibits adhesion of leukocytes on the surface of venous valves)


MPFF in patients with chronic venous insufficiency enhance benefictial effect of compression treatment and accelerates healing of leg ulcers.

International guidelines

During 13th the effectiveness of phlobetropic drugs in chronic venous insufficiency was presented International Consensus – a document concerning methods of treatment of chronic venous diseases of lover limbs developed under supervision of leading venous societies such as: European Hemorheological Society Conference in Italy in 2005 concerning

  • American Venous Forum
  • American College of Phlebology
  • European Venous Forum
  • International Union of Angiology

Consensus includes 3-grade classification of phlebotropic drugs used in treatment of chronic venous insufficiency based on efficacy confirmed with clinical trials and meta-analyses. Methodology of recommendation was based on EBM (Evidence Based Medicine) citeria.

Recommendations were divided into 3 grades on the basis of available clinical trials concerning certain medicines and their effectiveness in treatment chronic venous insufficiency.

  • grade A – RCT (Randomized Clinical Trials) with large groups of patients, metaanalysis of homogenic results
  • grade B – RCT with small groups of patients, single RCTs
  • grade C – other clinical trials with control groups, non-randomized clinical trials with control groups

Analysis of effectiveness includes alltogether 44 randomized clinical trials.


MPFF received the highest grade of recommendation – grade A – both because of the amount of quality of clinical trials and metaanalysis, as well as the effectiveness of healing every symptom of chronic venous insufficiency.


  1. Savineau JP, Marthan R. Diosmin-induced increase in sensitivity to Ca2+ of the smooth muscle contractile apparatus in the rat isolated femoral vein. Br J Pharmacol. 1994 Apr;111(4):978-80.
  2. A. N. Nicolaides, C. Allegra, J. Bergan et al. Leczenie przewlekłych chorób żył kończyn dolnych. Wytyczne opracowane na podstawie wynikow badań naukowych. Reprinted from: International Angiology, vol 27, No. 1., p. 1-58, February 2008