Home Ingredients Mirtoselect® (Standardized Bilberry Extract — Indena)
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Mirtoselect® (Standardized Bilberry Extract — Indena)

Vaccinium myrtillus
Evidence Level
Limited
3 Clinical Trials
4 Documented Benefits
2/5 Evidence Score

Mirtoselect is Indena's standardized extract of bilberry (Vaccinium myrtillus) fruit, made from frozen ripe berries and standardized to 36% anthocyanins by HPLC. It also keeps the fruit's other polyphenols. Human research on Mirtoselect itself is small. In a 4-week placebo-controlled trial run by Indena in 21 adults with dry eye symptoms, 160 mg a day increased tear volume, but the gain beat placebo only in the right eye. A single 470 mg dose lowered the blood sugar rise after a carbohydrate drink in 8 men with diet-controlled type 2 diabetes, while gut hormones and plasma antioxidant capacity did not change. Eye pressure studies used Mirtogenol, a blend with Pycnogenol, without a placebo, and leg vein and retina studies were open registries in which patients chose their own product. Rigorous placebo-controlled trials of bilberry do not support the night vision story.

Studied Dose 160 mg/day (two 80 mg tablets) for 4 weeks for dry eye symptoms; a single 470 mg dose before a carbohydrate drink for post-meal blood sugar. Mirtogenol, a blend with Pycnogenol, supplied 160 mg Mirtoselect plus 80 mg Pycnogenol a day in one study and one tablet (80 mg plus 40 mg) a day in another.
Active Compound Standardized Vaccinium myrtillus fruit extract, 36% anthocyanins by HPLC (glycosides of delphinidin, cyanidin, petunidin, peonidin and malvidin)

Benefits

Tear production and eye moisture

In a 4-week randomized, placebo-controlled trial run by Indena, 21 adults with dry eye symptoms took 160 mg a day or placebo. Tear volume on the Schirmer test rose in the bilberry group but not the placebo group. Compared directly with placebo, the gain was significant only for the right eye and was larger in people with more severe dryness. A measure of eye strain (pupil constriction) did not change.

Supported by Trial 1

Eye blood flow and eye pressure (Mirtogenol blend with Pycnogenol)

These results come from Mirtogenol, a blend of Mirtoselect and Pycnogenol pine bark extract. In an open study funded by Indena and Horphag, 38 adults with raised eye pressure took the blend or nothing, and after 3 months eye pressure was lower and eye blood flow better than in untreated controls. A later randomized study by the same group also had no placebo. The bilberry share of any effect cannot be separated.

Supported by Trial 2

Post-meal blood sugar response

In a double-blind crossover study, 8 men with type 2 diabetes managed by diet took a single 470 mg capsule of Mirtoselect or placebo before a carbohydrate drink. The rise in blood glucose and insulin was lower than with placebo, but gut hormones, glucagon, amylin, an inflammation marker and plasma antioxidant capacity did not differ. This tested one dose in a very small group.

Supported by Trial 3

Blood antioxidant measures

In the dry eye trial, blood antioxidant potential (the BAP test) rose within the Mirtoselect group over 4 weeks, but the paper reports no comparison with placebo for this measure, and an oxidative stress marker did not change. In the single-dose blood sugar study, plasma antioxidant capacity did not differ from placebo.

Supported by Trial 1, Trial 3

Mechanism of action

1

Small blood vessel and microcirculation support

Bilberry anthocyanins are proposed to support small blood vessels and local blood flow. In people this has been measured only as eye blood flow in studies of the Mirtogenol blend and in open registries without a placebo, so it has not been confirmed in controlled trials of Mirtoselect alone.

2

Slower carbohydrate digestion and absorption

The authors of the single-dose glucose study suggest that bilberry polyphenols slow the digestion or absorption of carbohydrate, because gut hormones such as GLP-1 and GIP did not change. This is a proposed explanation rather than a measured one.

3

Antioxidant activity

Anthocyanins are described as antioxidants. In people taking Mirtoselect, blood antioxidant potential rose within the treated group of one small trial, with no comparison against placebo reported, and plasma antioxidant capacity did not differ from placebo in another.

4

Whole-extract matrix and absorption (animal data)

In rats, blood anthocyanin exposure was higher after Mirtoselect than after a purified anthocyanin extract given at a higher anthocyanin dose. Indena's authors credit the non-anthocyanin part of the fruit extract. This is animal data only and has not been tested in people.

Clinical trials

1
Mirtoselect and tear production in dry eye symptoms
PubMed

Randomized, double-blind, placebo-controlled, 4 weeks; five of the seven authors list Indena affiliations and another is an Indena consultant (Riva et al. 2017, European Review for Medical and Pharmacological Sciences)

22 adults in Japan with dry eye symptoms were enrolled and 21 finished (11 bilberry, 10 placebo); 160 mg Mirtoselect a day as two 80 mg tablets

Tear volume on the Schirmer test improved within the bilberry group in the right eye and in both eyes combined, with no significant change in the placebo group. Compared with placebo, the improvement rate was significantly greater only for the right eye, and mainly in people with more severe dryness. Pupil constriction, a measure of eye strain, did not change. Blood antioxidant potential rose within the bilberry group, with no comparison against placebo reported, while an oxidative stress marker did not change.

2
Mirtogenol blend (Mirtoselect plus Pycnogenol) and eye pressure
PubMed

Open controlled study with an untreated control group, no placebo, not described as randomized; supported by grants from Indena and Horphag (Steigerwalt et al. 2008, Molecular Vision)

38 adults with raised eye pressure and no glaucoma symptoms; 20 took Mirtogenol (160 mg Mirtoselect plus 80 mg Pycnogenol a day) for 6 months and 18 were untreated

Mean eye pressure fell from 25.2 to 22.2 mmHg after 2 months and was 22.0 mmHg at 3 months, significantly lower than in controls, with no further change by 6 months. 19 of 20 users had lower pressure at 3 months, and eye blood flow improved. Because bilberry was combined with Pycnogenol, its own effect cannot be isolated.

3
Single dose of Mirtoselect and blood sugar after a carbohydrate drink
PubMed

Randomized, double-blind, placebo-controlled crossover with a 2-week washout; funded by the Scottish Government (RESAS); Indena supplied the extract and the authors reported no conflicts of interest (Hoggard et al. 2013, Journal of Nutritional Science)

8 men with type 2 diabetes managed by diet and lifestyle; one 470 mg capsule before a drink equal to 75 g of glucose

Compared with placebo, Mirtoselect lowered the rise in blood glucose and insulin after the drink. Gut hormones, glucagon and plasma antioxidant capacity did not change. This tested one dose in a very small group.

Side effects and drug interactions

Common Potential side effects

No side effects were reported with Mirtoselect in the single-dose blood sugar study or the venous registry, or with the Mirtogenol blend in the eye pressure studies, but these studies were small, short or uncontrolled.
NCCIH says bilberry fruit extracts have been used in research at doses up to 160 mg a day for up to 6 months and "appear to be well tolerated"; it also cautions that bilberry leaves may be unsafe in high doses or over long periods.

Important Drug interactions

Blood thinners (such as warfarin): a review of supplements and bleeding lists bilberry among supplements associated with bleeding risk in people taking anticoagulants, so ask your doctor before combining them.
Blood-sugar-lowering medicines: a single dose of Mirtoselect lowered the post-meal blood sugar rise, so monitor blood sugar and tell your doctor.
Pregnancy and breastfeeding: NCCIH says little is known about the safety of bilberry in amounts greater than those found in foods during pregnancy or breastfeeding, so ask your doctor first.

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Frequently asked questions about Mirtoselect® (Standardized Bilberry Extract — Indena)

What is Mirtoselect used for?

Mirtoselect is Indena's standardized bilberry fruit extract, used mainly for eye comfort. In one small placebo-controlled trial run by Indena, 160 mg a day for 4 weeks increased tear volume in adults with dry eye symptoms, but the gain beat placebo only in the right eye. Rigorous placebo-controlled trials of bilberry do not support the popular night vision claim.

What is the recommended dosage of Mirtoselect?

There is no established recommended dose. Placebo-controlled studies of Mirtoselect used 160 mg a day for 4 weeks for dry eye symptoms and a single 470 mg dose in a blood sugar study. The Mirtogenol blend supplied 160 mg of Mirtoselect a day in one study and 80 mg in another. Follow the product label.

Is Mirtoselect safe, and does it have side effects?

No side effects were reported in the Mirtoselect blood sugar study, the registries or the Mirtogenol studies cited here, and the dry eye trial did not report on them. NCCIH says bilberry fruit extracts used in research at up to 160 mg a day for up to 6 months "appear to be well tolerated." Little is known about amounts above food levels in pregnancy or breastfeeding. Because one dose lowered the post-meal blood sugar rise and a review links bilberry to bleeding risk with anticoagulants, ask your doctor if you take diabetes medicines or blood thinners.

What is Mirtoselect?

Mirtoselect is Indena's standardized extract of bilberry (Vaccinium myrtillus) fruit, made from frozen ripe berries and standardized to 36% anthocyanins by HPLC. It also keeps the fruit's other polyphenols. Human research on Mirtoselect itself is small.

Does Mirtoselect interact with any medications?

Possible interactions include: Blood thinners (such as warfarin): a review of supplements and bleeding lists bilberry among supplements associated with bleeding risk in people taking anticoagulants, so ask your doctor before combining them. If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Mirtoselect?

NutraSmarts rates the evidence for Mirtoselect as Limited (2 out of 5). It is backed by 3 study summaries and 9 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(9 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Riva A, Togni S, Franceschi F, Kawada S, Inaba Y, Eggenhoffner R, Giacomelli L. The effect of a natural, standardized bilberry extract (Mirtoselect®) in dry eye: a randomized, double blinded, placebo-controlled trial. Eur Rev Med Pharmacol Sci. 2017;21(10):2518-2525..PubMedUsed to support: A 4-week randomized, double-blind trial in 22 adults with dry eye symptoms (21 finished). 160 mg/day of Mirtoselect improved tear volume on the Schirmer test within the bilberry group, with no significant change on placebo; versus placebo, the mean improvement rate was significantly greater only for the right eye (p = 0.049) and was larger in people with more severe dryness. Blood antioxidant potential (BAP) rose within the bilberry group (p = 0.003), with no between-group test reported; d-ROMs and the BAP/d-ROMs ratio did not change significantly, and pupil constriction did not change. A rat arm found higher blood anthocyanin exposure with Mirtoselect than with a purified anthocyanin extract. Five of the seven authors list Indena affiliations and another is an Indena consultant.
  2. Steigerwalt RD, Gianni B, Paolo M, Bombardelli E, Burki C, Schönlau F. Effects of Mirtogenol on ocular blood flow and intraocular hypertension in asymptomatic subjects. Mol Vis. 2008;14:1288-92..PubMedUsed to support: An open study in 38 adults with raised eye pressure: 20 took Mirtogenol (160 mg Mirtoselect plus 80 mg Pycnogenol a day) and 18 were untreated, with no placebo. Eye pressure fell from 25.2 to 22.0 mmHg by 3 months, significantly lower than controls, with no further change at 6 months, and eye blood flow improved. Funded by Indena and Horphag; the bilberry effect cannot be separated from Pycnogenol.
  3. Hoggard N, Cruickshank M, Moar KM, Bestwick C, Holst JJ, Russell W, Horgan G. A single supplement of a standardised bilberry (Vaccinium myrtillus L.) extract (36 % wet weight anthocyanins) modifies glycaemic response in individuals with type 2 diabetes controlled by diet and lifestyle. J Nutr Sci. 2013;2:e22. doi: 10.1017/jns.2013.16.PubMedUsed to support: A double-blind, placebo-controlled crossover in 8 men with type 2 diabetes managed by diet and lifestyle. One 470 mg capsule of Mirtoselect (36% anthocyanins) before a glucose drink lowered the rise in blood glucose and insulin versus placebo. Gut hormones and plasma antioxidant capacity did not change. Funded by the Scottish Government (RESAS); Indena supplied the extract; the authors reported no conflicts of interest.
  4. Belcaro G, Dugall M, Luzzi R, Corsi M, Ledda A, Ricci A, Pellegrini L, Cesarone MR, Hosoi M, Errichi BM, Cornelli U, Cotellese R, Agus G, Feragalli B. Management of Varicose Veins and Chronic Venous Insufficiency in a Comparative Registry with Nine Venoactive Products in Comparison with Stockings. Int J Angiol. 2017;26(3):170-178. doi: 10.1055/s-0036-1597756.PubMedUsed to support: An open, non-randomized registry in which 1,051 people with chronic venous insufficiency chose their own product, with no placebo. One group of 77 patients took about 600 mg/day of Mirtoselect. The authors report no commercial sponsorship and no conflicts of interest. Pycnogenol, Venoruton and their combination gave the best results; the authors describe Mirtoselect as having activity on leg microcirculation and swelling, but it was not among the top performers.
  5. Canter PH, Ernst E. Anthocyanosides of Vaccinium myrtillus (bilberry) for night vision--a systematic review of placebo-controlled trials. Surv Ophthalmol. 2004;49(1):38-50. doi: 10.1016/j.survophthal.2003.10.006.PubMedUsed to support: A systematic review of 12 placebo-controlled trials of bilberry anthocyanosides for night vision. The 4 most recent randomized trials were all negative; positive results came from one other randomized trial and weaker non-randomized studies. The authors conclude the evidence does not support bilberry for improving normal night vision.
  6. Steigerwalt RD Jr, Belcaro G, Morazzoni P, Bombardelli E, Burki C, Schönlau F. Mirtogenol potentiates latanoprost in lowering intraocular pressure and improves ocular blood flow in asymptomatic subjects. Clin Ophthalmol. 2010;4:471-6. doi: 10.2147/opth.s9899.PubMedUsed to support: 79 adults with raised eye pressure and no symptoms were randomly assigned to Mirtogenol (one tablet a day of 80 mg Mirtoselect plus 40 mg Pycnogenol), prescription eye drops, or both, for 24 weeks, with no placebo group. Eye pressure fell with Mirtogenol alone over 16 weeks, and retinal blood flow rose in all groups. No side effects occurred in the Mirtogenol-only group. Supported by a grant from Indena and Horphag Research; two authors are from Indena and two from Horphag. Because the blend includes Pycnogenol, the bilberry share of any effect cannot be separated.
  7. Gizzi C, Belcaro G, Gizzi G, Feragalli B, Dugall M, Luzzi R, Cornelli U. Bilberry extracts are not created equal: the role of non anthocyanin fraction. Discovering the "dark side of the force" in a preliminary study. Eur Rev Med Pharmacol Sci. 2016;20(11):2418-24..PubMedUsed to support: An open registry in 140 patients with various retinal blood vessel conditions who chose their own group: standard care alone (38), standard care plus 160 mg/day of Mirtoselect (47), or standard care plus 160 mg/day of a generic bilberry extract (55), for 6 months, with no placebo and no randomization. Retinal blood flow measures improved more in the Mirtoselect group than in the other groups, and no side effects were reported. Medical writing was supported by Indena; the authors declared no conflicts of interest.
  8. Hatfield J, Saad S, Housewright C. Dietary supplements and bleeding. Proc (Bayl Univ Med Cent). 2022;35(6):802-807. doi: 10.1080/08998280.2022.2121575.PubMedUsed to support: A literature review of bleeding risk with popular herbal and dietary supplements. It lists bilberry among supplements associated with bleeding risk in people taking anticoagulants and found no evidence of bleeding with these supplements independent of anticoagulants.
  9. National Center for Complementary and Integrative Health (NCCIH). Bilberry. NCCIH, National Institutes of Health. 2024;Last updated November 2024; accessed 2026..SourceUsed to support: Not PubMed-indexed (US government fact sheet). States that the most rigorous studies have not found bilberry to improve night vision in healthy people, that bilberry fruit is considered safe in amounts typically found in foods, that fruit extracts have been used in research at doses up to 160 mg a day for up to 6 months and appear to be well tolerated, that bilberry leaves may be unsafe in high doses or over long periods, and that little is known about amounts greater than food amounts during pregnancy or breastfeeding.