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1000mg MPFF daily (900mg diosmin + 100mg hesperidin); acute hemorrhoid protocols use higher short-term doses

With meals · with food

MPFF (micronized diosmin + hesperidin)

Prescription topical: a pea-sized amount of 0.025%-0.1% cream or gel applied to clean, dry skin once nightly. Start low-strength and every-other-night to build tolerance. A prescription drug used under clinician direction — not a supplement regimen.

Before bed

Topical cream or gel, 0.025%-0.1% (prescription)

• Pregnancy/breastfeeding (limited data)
• Allergy to citrus flavonoids

• None well established

• Pregnancy and planning pregnancy (topical retinoid — avoid)
• Breastfeeding (avoid application near areas of infant contact)
• Eczema / rosacea-prone or broken/sunburned skin (irritation)

• Benzoyl peroxide
• Other topical exfoliants (AHAs / BHAs, abrasives)
• Photosensitizing drugs