Red vine leaf
Three placebo-controlled trials of the AS 195 extract found smaller leg volume or circumference in chronic venous insufficiency. Volume fell by about 20 to 100 mL more than placebo over 12 weeks. A systematic review of five trials found improvements in only some of them. In the largest trial, only leg pain changed among symptoms, and tolerability matched placebo.
- Status
- Dietary supplement in the US. Not FDA-approved for any condition.
- Also called
- AS 195, Antistax, red vine leaf extract, Vitis vinifera leaf, folia vitis viniferae, grape leaf extract
- Taken for
- chronic venous insufficiency, varicose veins, leg swelling, swelling, edema, heavy legs, leg pain
Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on
Shown to help2
Reported risks0
No risks sourced yet.
What people take it for, and what was found
Shown to help2
Leg swelling in chronic venous insufficiency
Shown to reduce leg volume and swelling in adults with chronic venous insufficiency over 6 to 12 weeks, all with one branded extract.
The numbers and sources
- Effect
- In 248 patients, 720 mg a day for 12 weeks reduced lower limb volume by 19.9 mL more than placebo (95% CI -37.5 to -2.3) [1]. In 257 patients, 360 mg and 720 mg once a day for 12 weeks gave lower leg volumes 75.9 g (95% CI -106.1 to -45.8) and 99.9 g (95% CI -130.3 to -69.6) below placebo, measured as displaced water, with smaller calf circumference [2]. In a crossover trial of 71 patients, 360 mg a day for 6 weeks reduced ankle circumference by 0.39 cm while it rose 0.29 cm on placebo, and calf circumference by 0.54 cm against a rise of 0.14 cm [3]. A systematic review of 5 trials found that leg volume and circumference improved in only some trials [4].
- Population
- Adults with chronic venous insufficiency, CEAP grades 3 to 4a [1], stages I to II [2][3].
- Sources
- [1], [2], [3], [4]
- Caveats
- All trials tested one branded extract. The review authors call for higher-quality trials [4].
Leg pain, heaviness and tension
Limited evidence: leg pain fell slightly more than on placebo, while trials disagreed on heaviness, tingling and tension.
The numbers and sources
- Effect
- In the 248-patient trial, leg pain fell by 6.6 mm more than placebo on a 100 mm scale (95% CI -13.1 to -0.1). Other symptoms did not change significantly [1]. In the 257-patient trial, key venous symptoms improved more in both extract groups than on placebo at 12 weeks (p < 0.001) [2]. The systematic review found heavy and tired legs, tingling, pain and tension improved in only some trials [4].
- Population
- Adults with chronic venous insufficiency [1][2][4].
- Sources
- [1], [2], [4]
- Caveats
- The two largest trials disagree on symptoms other than pain [1][2]. In the 248-patient trial, patients' overall rating of efficacy did not track measured volume change [1].
Doses studied
Trials used 360 mg or 720 mg of AS 195 once a day for 6 to 12 weeks [1][2][3].
Risks
Checked, no increase found1
Adverse events in trials
Limited evidence: tolerability was similar to placebo in trials of 12 weeks or less.
The numbers and sources
Sources
- Rabe E, Stücker M, Esperester A, et al. Efficacy and tolerability of a red-vine-leaf extract in patients suffering from chronic venous insufficiency, results of a double-blind placebo-controlled study. European Journal of Vascular and Endovascular Surgery. 2011. https://doi.org/10.1016/j.ejvs.2010.12.003
- Kiesewetter H, Koscielny J, Kalus U, et al. Efficacy of orally administered extract of red vine leaf AS 195 (folia vitis viniferae) in chronic venous insufficiency (stages I-II). A randomized, double-blind, placebo-controlled trial. Arzneimittelforschung. 2000. https://pubmed.ncbi.nlm.nih.gov/10719612/
- Kalus U, Koscielny J, Grigorov A, et al. Improvement of cutaneous microcirculation and oxygen supply in patients with chronic venous insufficiency by orally administered extract of red vine leaves AS 195: a randomised, double-blind, placebo-controlled, crossover study. Drugs in R&D. 2004. https://doi.org/10.2165/00126839-200405020-00001
- Azhdari M, Zilaee M, Karandish M, et al. Red vine leaf extract (AS 195) can improve some signs and symptoms of chronic venous insufficiency, a systematic review. Phytotherapy Research. 2020. https://doi.org/10.1002/ptr.6705