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      News & Perspective Drugs & Diseases CME & Education Academy Video Decision Point
      Drugs & Diseases

      Horse Chestnut Seed (Herb/Suppl)

      Brand and Other Names:aescin, Aesculaforce, more...aesculus hippocastanum, chestnut, de marronier d'Inde, eschilo, escine, graine de marronier d'Inde, HCSE, hippocastani semen, marron europeen, marronier, rosskastanie, Spanish chestnut, venastat, venostat, venostatin, Venostasin
      • Print

      Suggested Dosing

      Seed Extract

      250-750 mg/d PO in div doses

      Tincture

      1-4 ml PO TID

      Other Information

      Extract standardized to 20-22% saponins

      Next:

      Suggested Uses

      Diarrhea, fever, hemorrhoids, phlebitis, prostate enlargement, varicose veins, venous insufficiency

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      Interactions

      Interaction Checker

      and Horse Chestnut Seed

      No Results

         activity indicator 
        No Interactions Found
        Interactions Found

        Contraindicated

          Serious - Use Alternative

            Significant - Monitor Closely

              Minor

                All Interactions Sort By:
                 activity indicator 

                Contraindicated (0)

                  Serious - Use Alternative (0)

                    Monitor Closely (69)

                    • aceclofenac

                      aceclofenac and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • acemetacin

                      acemetacin and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • agrimony

                      agrimony and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • alfalfa

                      alfalfa and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • alteplase

                      alteplase and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • American ginseng

                      American ginseng and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • antithrombin alfa

                      antithrombin alfa and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • antithrombin III

                      antithrombin III and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • argatroban

                      argatroban and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • aspirin

                      aspirin and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • aspirin rectal

                      aspirin rectal and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • aspirin/citric acid/sodium bicarbonate

                      aspirin/citric acid/sodium bicarbonate and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • bemiparin

                      bemiparin and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • bivalirudin

                      bivalirudin and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • celecoxib

                      celecoxib and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • choline magnesium trisalicylate

                      choline magnesium trisalicylate and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • cinnamon

                      cinnamon and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • cordyceps

                      cordyceps and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • dabigatran

                      dabigatran and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • dalteparin

                      dalteparin and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • diclofenac

                      diclofenac and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • diflunisal

                      diflunisal and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • dong quai

                      dong quai and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • enoxaparin

                      enoxaparin and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • epoprostenol

                      epoprostenol and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • etodolac

                      etodolac and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • fennel

                      fennel and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • fenoprofen

                      fenoprofen and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • feverfew

                      feverfew and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • flurbiprofen

                      flurbiprofen and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • fondaparinux

                      fondaparinux and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • forskolin

                      forskolin and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • garlic

                      garlic and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • ginger

                      ginger and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • ginkgo biloba

                      ginkgo biloba and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • heparin

                      heparin and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • ibuprofen

                      ibuprofen and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • ibuprofen IV

                      ibuprofen IV and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • indomethacin

                      indomethacin and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • ketoprofen

                      ketoprofen and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • ketorolac

                      ketorolac and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • ketorolac intranasal

                      ketorolac intranasal and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • lornoxicam

                      lornoxicam and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • meclofenamate

                      meclofenamate and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • mefenamic acid

                      mefenamic acid and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • meloxicam

                      meloxicam and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • mistletoe

                      horse chestnut seed increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                    • nabumetone

                      nabumetone and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • naproxen

                      naproxen and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • nettle

                      horse chestnut seed increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                    • oxaprozin

                      oxaprozin and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • panax ginseng

                      horse chestnut seed and panax ginseng both increase anticoagulation. Use Caution/Monitor.

                    • parecoxib

                      parecoxib and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • pau d'arco

                      horse chestnut seed and pau d'arco both increase anticoagulation. Use Caution/Monitor.

                    • phenindione

                      phenindione and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • phytoestrogens

                      horse chestnut seed and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • piroxicam

                      piroxicam and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • protamine

                      protamine and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • reishi

                      horse chestnut seed and reishi both increase anticoagulation. Use Caution/Monitor.

                    • reteplase

                      reteplase and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • salicylates (non-asa)

                      salicylates (non-asa) and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • salsalate

                      salsalate and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • Siberian ginseng

                      horse chestnut seed and Siberian ginseng both increase anticoagulation. Use Caution/Monitor.

                    • sulfasalazine

                      sulfasalazine and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • sulindac

                      sulindac and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • tenecteplase

                      tenecteplase and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • tolfenamic acid

                      tolfenamic acid and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • tolmetin

                      tolmetin and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

                    • vitamin K1 (phytonadione)

                      horse chestnut seed increases and vitamin K1 (phytonadione) decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                    Minor (35)

                    • abciximab

                      horse chestnut seed, abciximab. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.

                    • acarbose

                      horse chestnut seed increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

                    • anagrelide

                      horse chestnut seed, anagrelide. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.

                    • anamu

                      anamu and horse chestnut seed both increase anticoagulation. Minor/Significance Unknown.

                    • chlorpropamide

                      horse chestnut seed increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.

                    • cilostazol

                      horse chestnut seed, cilostazol. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.

                    • clopidogrel

                      horse chestnut seed, clopidogrel. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.

                    • danshen

                      danshen and horse chestnut seed both increase anticoagulation. Minor/Significance Unknown.

                    • devil's claw

                      devil's claw and horse chestnut seed both increase anticoagulation. Minor/Significance Unknown.

                    • dipyridamole

                      horse chestnut seed, dipyridamole. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.

                    • eptifibatide

                      horse chestnut seed, eptifibatide. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.

                    • glimepiride

                      horse chestnut seed increases effects of glimepiride by pharmacodynamic synergism. Minor/Significance Unknown.

                    • glipizide

                      horse chestnut seed increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

                    • glyburide

                      horse chestnut seed increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

                    • insulin aspart

                      horse chestnut seed increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown.

                    • insulin detemir

                      horse chestnut seed increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown.

                    • insulin glargine

                      horse chestnut seed increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

                    • insulin glulisine

                      horse chestnut seed increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown.

                    • insulin lispro

                      horse chestnut seed increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown.

                    • insulin NPH

                      horse chestnut seed increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown.

                    • insulin regular human

                      horse chestnut seed increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown.

                    • metformin

                      horse chestnut seed increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.

                    • miglitol

                      horse chestnut seed increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

                    • nateglinide

                      horse chestnut seed increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.

                    • pioglitazone

                      horse chestnut seed increases effects of pioglitazone by pharmacodynamic synergism. Minor/Significance Unknown.

                    • prasugrel

                      horse chestnut seed, prasugrel. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.

                    • repaglinide

                      horse chestnut seed increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown.

                    • rosiglitazone

                      horse chestnut seed increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown.

                    • saxagliptin

                      horse chestnut seed increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

                    • sitagliptin

                      horse chestnut seed increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

                    • ticlopidine

                      horse chestnut seed, ticlopidine. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.

                    • tirofiban

                      horse chestnut seed, tirofiban. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.

                    • tolazamide

                      horse chestnut seed increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.

                    • tolbutamide

                      horse chestnut seed increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown.

                    • vildagliptin

                      horse chestnut seed increases effects of vildagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

                    Previous
                    Next:

                    Adverse Effects

                    Frequency Not Defined

                    Anaphylaxis (IV)

                    GI irritation

                    Itching

                    Kidney toxicity (IV)

                    Liver toxicity (IV)

                    Toxic nephropathy

                    Depression

                    Diarrhea

                    Incoordination

                    Muscle twitching

                    Paralysis

                    Pupil dilation

                    Stupor

                    Vomiting

                    Weakness

                    Previous
                    Next:

                    Warnings

                    Contraindications

                    Hepatitic impairment, infectious GI conditions, inflammatory GI conditions, renal impairment

                    Cautions

                    Bleeding disorders, concurrent hypoglycemic agents, diabetes mellitus

                    WARNING: use only standardized seed extract; raw seed, leaf, bark, or flower possibly fatal

                    Previous
                    Next:

                    Pregnancy & Lactation

                    Pregnancy Category: raw seed unsafe; avoid use

                    Lactation: avoid use

                    Pregnancy Categories

                    A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                    B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                    C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                    D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                    X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                    NA: Information not available.

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                    Pharmacology

                    Metabolism: N/A

                    Excretion: N/A

                    Mechanism of Action

                    Saponins: aescin: vasoconstrictor; aesculin (a hydroxycoumarin)- antithrombin activity

                    Previous
                    Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.
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