Epistaxis is a common ENT emergency and most cases are idiopathic. Flavonoids are natural substances with variable phenolic structures that are found in fruit and vegetables and take effect on blood vessels. Daflon is proposed to control epistaxis by “improving venous tone, lymphatic drainage and reducing capillary hyperpermeability by protecting the microcirculation from inflammatory processes.” This is a fairly well-designed study which enrolled 450 patients and randomised them into three groups: Daflon 500mg twice daily for one month; Daflon 500mg twice daily for three months; or no specific treatment other than local emergency measures. Patients were thoroughly assessed before inclusion on the study to ensure truly idiopathic epistaxis rather than any underlying cause, and then the number of visits to A&E and number of cauterisations required were recorded for each patient. The results suggest an excellent effect from the Daflon with a statistically significant reduction in the number of visits to A&E and number of cauterisations required in both Daflon groups when compared to the control group at both one and three months. Side-effects were relatively rare (5.3% in group one and 6.7 % in group two) and minor (GI upset only). The results also suggest that a longer period of treatment of three months provides a modest improvement in epistaxis outcomes one year following treatment when compared with one month of treatment, although both have a very good benefit. This seems to be a very interesting and potentially beneficial new treatment option for patients with recurrent nosebleeds.

Efficacy and safety of Daflon in the treatment of idiopathic epistaxis.
Attila T.
Joanna Stephens

United Lincolnshire Hospitals NHS Trust, UK.

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