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
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

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.
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
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
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