Indication-specific dosing for aescin, Aesculaforce, aesculus hippocastanum horse chestnut seed in combination, frequency-based adverse effects, comprehensive interactions, contraindications, pregnancy & lactation schedules, and cost information.

Sections

Sections Horse Chestnut Seed
Suggested Dosing
Suggested Uses
Interactions
Adverse Effects
Warnings
Pregnancy
Pharmacology

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

Suggested Uses

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

Interaction Checker

Enter a drug name and Horse Chestnut Seed

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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.

abciximab
Minor (1)horse chestnut seed, abciximab. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.
acarbose
Minor (1)horse chestnut seed increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
aceclofenac
Monitor Closely (1)aceclofenac and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
acemetacin
Monitor Closely (1)acemetacin and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
agrimony
Monitor Closely (1)agrimony and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
alfalfa
Monitor Closely (1)alfalfa and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
alteplase
Monitor Closely (1)alteplase and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
American ginseng
Monitor Closely (1)American ginseng and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
anagrelide
Minor (1)horse chestnut seed, anagrelide. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.
anamu
Minor (1)anamu and horse chestnut seed both increase anticoagulation. Minor/Significance Unknown.
antithrombin alfa
Monitor Closely (1)antithrombin alfa and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
antithrombin III
Monitor Closely (1)antithrombin III and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
argatroban
Monitor Closely (1)argatroban and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
aspirin
Monitor Closely (1)aspirin and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
aspirin rectal
Monitor Closely (1)aspirin rectal and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate
Monitor Closely (1)aspirin/citric acid/sodium bicarbonate and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
bemiparin
Monitor Closely (1)bemiparin and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
bivalirudin
Monitor Closely (1)bivalirudin and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
celecoxib
Monitor Closely (1)celecoxib and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
chlorpropamide
Minor (1)horse chestnut seed increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.
choline magnesium trisalicylate
Monitor Closely (1)choline magnesium trisalicylate and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
cilostazol
Minor (1)horse chestnut seed, cilostazol. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.
cinnamon
Monitor Closely (1)cinnamon and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
clopidogrel
Minor (1)horse chestnut seed, clopidogrel. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.
cordyceps
Monitor Closely (1)cordyceps and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
dabigatran
Monitor Closely (1)dabigatran and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
dalteparin
Monitor Closely (1)dalteparin and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
danshen
Minor (1)danshen and horse chestnut seed both increase anticoagulation. Minor/Significance Unknown.
devil's claw
Minor (1)devil's claw and horse chestnut seed both increase anticoagulation. Minor/Significance Unknown.
diclofenac
Monitor Closely (1)diclofenac and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
diflunisal
Monitor Closely (1)diflunisal and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
dipyridamole
Minor (1)horse chestnut seed, dipyridamole. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.
dong quai
Monitor Closely (1)dong quai and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
enoxaparin
Monitor Closely (1)enoxaparin and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
epoprostenol
Monitor Closely (1)epoprostenol and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
eptifibatide
Minor (1)horse chestnut seed, eptifibatide. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.
etodolac
Monitor Closely (1)etodolac and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
fennel
Monitor Closely (1)fennel and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
fenoprofen
Monitor Closely (1)fenoprofen and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
feverfew
Monitor Closely (1)feverfew and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
flurbiprofen
Monitor Closely (1)flurbiprofen and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
fondaparinux
Monitor Closely (1)fondaparinux and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
forskolin
Monitor Closely (1)forskolin and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
garlic
Monitor Closely (1)garlic and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
ginger
Monitor Closely (1)ginger and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
ginkgo biloba
Monitor Closely (1)ginkgo biloba and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
glimepiride
Minor (1)horse chestnut seed increases effects of glimepiride by pharmacodynamic synergism. Minor/Significance Unknown.
glipizide
Minor (1)horse chestnut seed increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.
glyburide
Minor (1)horse chestnut seed increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.
heparin
Monitor Closely (1)heparin and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
ibuprofen
Monitor Closely (1)ibuprofen and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
ibuprofen IV
Monitor Closely (1)ibuprofen IV and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
indomethacin
Monitor Closely (1)indomethacin and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
insulin aspart
Minor (1)horse chestnut seed increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown.
insulin detemir
Minor (1)horse chestnut seed increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown.
insulin glargine
Minor (1)horse chestnut seed increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.
insulin glulisine
Minor (1)horse chestnut seed increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown.
insulin lispro
Minor (1)horse chestnut seed increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown.
insulin NPH
Minor (1)horse chestnut seed increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown.
insulin regular human
Minor (1)horse chestnut seed increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown.
ketoprofen
Monitor Closely (1)ketoprofen and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
ketorolac
Monitor Closely (1)ketorolac and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal
Monitor Closely (1)ketorolac intranasal and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
lornoxicam
Monitor Closely (1)lornoxicam and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
meclofenamate
Monitor Closely (1)meclofenamate and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
mefenamic acid
Monitor Closely (1)mefenamic acid and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
meloxicam
Monitor Closely (1)meloxicam and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
metformin
Minor (1)horse chestnut seed increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.
miglitol
Minor (1)horse chestnut seed increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.
mistletoe
Monitor Closely (1)horse chestnut seed increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nabumetone
Monitor Closely (1)nabumetone and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
naproxen
Monitor Closely (1)naproxen and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
nateglinide
Minor (1)horse chestnut seed increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.
nettle
Monitor Closely (1)horse chestnut seed increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
oxaprozin
Monitor Closely (1)oxaprozin and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
panax ginseng
Monitor Closely (1)horse chestnut seed and panax ginseng both increase anticoagulation. Use Caution/Monitor.
parecoxib
Monitor Closely (1)parecoxib and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
pau d'arco
Monitor Closely (1)horse chestnut seed and pau d'arco both increase anticoagulation. Use Caution/Monitor.
phenindione
Monitor Closely (1)phenindione and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
phytoestrogens
Monitor Closely (1)horse chestnut seed and phytoestrogens both increase anticoagulation. Use Caution/Monitor.
pioglitazone
Minor (1)horse chestnut seed increases effects of pioglitazone by pharmacodynamic synergism. Minor/Significance Unknown.
piroxicam
Monitor Closely (1)piroxicam and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
prasugrel
Minor (1)horse chestnut seed, prasugrel. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.
protamine
Monitor Closely (1)protamine and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
reishi
Monitor Closely (1)horse chestnut seed and reishi both increase anticoagulation. Use Caution/Monitor.
repaglinide
Minor (1)horse chestnut seed increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown.
reteplase
Monitor Closely (1)reteplase and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
rosiglitazone
Minor (1)horse chestnut seed increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown.
salicylates (non-asa)
Monitor Closely (1)salicylates (non-asa) and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
salsalate
Monitor Closely (1)salsalate and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
saxagliptin
Minor (1)horse chestnut seed increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown.
Siberian ginseng
Monitor Closely (1)horse chestnut seed and Siberian ginseng both increase anticoagulation. Use Caution/Monitor.
sitagliptin
Minor (1)horse chestnut seed increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown.
sulfasalazine
Monitor Closely (1)sulfasalazine and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
sulindac
Monitor Closely (1)sulindac and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
tenecteplase
Monitor Closely (1)tenecteplase and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
ticlopidine
Minor (1)horse chestnut seed, ticlopidine. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.
tirofiban
Minor (1)horse chestnut seed, tirofiban. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Theoretical. Use with caution.
tolazamide
Minor (1)horse chestnut seed increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
tolbutamide
Minor (1)horse chestnut seed increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown.
tolfenamic acid
Monitor Closely (1)tolfenamic acid and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
tolmetin
Monitor Closely (1)tolmetin and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
vildagliptin
Minor (1)horse chestnut seed increases effects of vildagliptin by pharmacodynamic synergism. Minor/Significance Unknown.
vitamin K1 (phytonadione)
Monitor Closely (1)horse chestnut seed increases and vitamin K1 (phytonadione) decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

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

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

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.

Pharmacology

Metabolism: N/A

Excretion: N/A

Mechanism of Action

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

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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