Phlebotonics are broadly characterized as a group of venoactive compounds that are used to treat varicose veins and other chronic venous disorders. They include natural flavonoids extracted from plants and synthetic compounds with flavonoid-like properties. Many work by increasing venous tone, decreasing the permeability of capillaries, fighting inflammation, improving lymphatic drainage, or making blood less viscous. Some examples are aminaftone, calcium dobesilate, Gotu Kola (Centella asiatica), diosmin, hidrosmin, French pine bark extract (Pycnogenol), grape seed extract, and rutosides. A systematic review from 2020 concluded that there was low to moderate-certainty evidence that phlebotonics may reduce edema, pain, cramps, restless legs, and lower-leg swelling.[1] The evidence for most phlebotonics is limited, but horse chestnut seed extract[2] and French pine bark extract[3] are two phlebotonics that may be effective for treating signs and symptoms of varicose veins.
