Calcium Dobesilate

• Chronic Venous Insufficiency (CVI): Management of symptoms such as leg swelling, heaviness, pain, and cramps related to venous disorders.
• Diabetic Retinopathy: Adjunct therapy to reduce microvascular complications and improve retinal microcirculation.
• Hemorrhoidal Disease: Used to alleviate symptoms associated with hemorrhoids including bleeding and pain.
• Capillary Fragility and Microangiopathy: To strengthen capillary walls and reduce permeability in various microvascular disorders.
• Peripheral Vascular Diseases: Management of symptoms related to peripheral microcirculatory disorders.
• Off-label Uses:
• Prevention and treatment of retinopathy in hypertension.
• Adjunct in radiation-induced proctitis and vascular complications.

Adults:

• Oral administration is typical.
• Standard dose: 500 mg two to three times daily (total 1000–1500 mg/day).
• Dose may be adjusted according to clinical response and tolerability.

Elderly:

• Use usual adult dosing unless renal impairment is present; monitor closely.

Pediatrics:

• Limited data; use only if benefits outweigh risks and under specialist supervision.

Special Populations:

• Renal Impairment: Use with caution; no specific dose adjustment guidelines but monitoring recommended.
• Hepatic Impairment: Use cautiously; no dose adjustment established.

Administration Route:

• Oral tablets with water, preferably after meals to reduce gastrointestinal discomfort.

Duration:

• Treatment duration varies depending on indication, often weeks to months for chronic conditions.

Calcium Dobesilate acts primarily by protecting and stabilizing the capillary endothelium. It reduces capillary permeability and fragility by reinforcing basement membranes and inhibiting the release of inflammatory mediators. It also improves microcirculatory blood flow by reducing blood viscosity and platelet aggregation, thus enhancing tissue oxygenation and reducing edema. These effects contribute to the alleviation of symptoms related to venous insufficiency, diabetic microangiopathy, and hemorrhoidal disease.

• Absorption: Well absorbed orally with peak plasma concentration reached within 1–2 hours.
• Distribution: Widely distributed in body tissues, including the vascular endothelium.
• Metabolism: Undergoes hepatic metabolism; metabolic pathways not fully elucidated.
• Half-life: Approximately 4–6 hours.
• Excretion: Primarily eliminated via renal excretion, both unchanged and as metabolites.

• Pregnancy: Limited data available; use only if clearly needed and after risk-benefit assessment. Not classified by FDA.
• Lactation: Unknown if excreted in human milk; caution advised. Breastfeeding should be avoided or discontinued during treatment unless benefits outweigh risks.

• Therapeutic Class: Vascular Protective Agent
• Subclass: Capillary Stabilizer / Microcirculation Modifier

• Hypersensitivity to Calcium Dobesilate or any formulation components.
• Severe renal impairment.
• Known bleeding disorders or active hemorrhagic conditions.
• Pregnancy and lactation unless under strict medical supervision.

• Use cautiously in patients with renal impairment; monitor renal function periodically.
• May affect platelet function; caution in patients on anticoagulants or with bleeding risk.
• Discontinue if signs of hypersensitivity or severe adverse reactions occur.
• Not recommended in children unless under specialist guidance.
• Monitor for gastrointestinal adverse effects during prolonged use.

Common:

• Gastrointestinal disturbances: nausea, diarrhea, abdominal discomfort.
• Headache and dizziness.
• Mild allergic reactions: rash, pruritus.

Uncommon/Rare:

• Hypersensitivity reactions including angioedema or urticaria.
• Rare hematological effects such as thrombocytopenia.
• Very rare: severe skin reactions or anaphylaxis.

• May potentiate the effects of anticoagulants and antiplatelet drugs, increasing bleeding risk.
• No significant interactions reported with common cardiovascular or diabetic medications.
• No known interactions with food or alcohol, but caution advised with alcohol due to potential additive vascular effects.
• CYP450 involvement not well characterized; no major enzyme induction or inhibition expected.

• Recent clinical guidelines have emphasized Calcium Dobesilate as an effective adjunct in managing diabetic retinopathy microvascular changes.
• Updated recommendations support its use in chronic venous insufficiency to improve patient quality of life.
• Safety profile has been reaffirmed with no new major warnings issued by regulatory bodies.
• Ongoing studies continue to evaluate its role in microangiopathies beyond diabetic complications.

• Store at controlled room temperature: 20°C to 25°C (68°F to 77°F).
• Protect from moisture and light.
• Keep tablets in original packaging until use.
• Keep out of reach of children.
• No special refrigeration or reconstitution needed.