Objective: To review the drugs used in the treatment of chronic venous
diseases of the lower limb. Data sources: Published papers referring
to the pharmacology of drugs used in the management of chronic venous
insufficiency and varicose veins of the lower limb. Study selection: S
ixty-four papers referring to the use of horse chestnut extract (aesci
n), flavonoids, tribnoside and calcium dobesilate have been included.
Data extraction: Papers were examined to establish the mechanism of ac
tion of 'oedema protective' drugs. Data synthesis: Oedema protective d
rugs modify the permeability of the microcirculatory endothelium in an
imal models of oedema and probably in patients with venous disease to
reduce transcapillary loss of fluid into the tissues. The exact mechan
isms of action remain unclear. Conclusion: Animal and clinical studies
demonstrate that drugs of the four types included in this review mode
rate the development of tissue oedema.