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

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

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Suggested Uses

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

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Interactions

Interaction Checker

and Horse Chestnut Seed

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      Serious - Use Alternative

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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.

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                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

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                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

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                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

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