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Horse chestnut (Aesculushippocastanum)



Interactions

Horse chestnut/Drug Interactions:
  • AntiangiogenicsAntiangiogenics: HCSE has been shown to increase venous tone, improve venous return, and reduce vascular permeability (48; 49; 50; 51; 52; 53).
  • Anticoagulants, antiplatelet agents, NSAIDsAnticoagulants, antiplatelet agents, NSAIDs: Horse chestnut theoretically may increase bleeding risk due to the hydroxycoumarin content of esculin (13; 14; 15). Properly extracted HCSE should not contain esculin and therefore, should not carry this risk. Life-threatening, acute hemorrhage from renal angiomyolipoma after use of HCSE for venous insufficiency has been noted in a case report (29). The authors suggested caution in patients taking anticoagulants concomitantly with HCSE due to potential HCSE-induced anticoagulation.
  • Antidiabetic agentsAntidiabetic agents: In animal research, HCSE inhibited the normal increase of serum glucose levels after glucose-loading (24).
  • Anti inflammatory agentsAnti inflammatory agents: Purified escin has been shown to decrease chemically-induced inflammation in rats (52; 53; 49).
  • Dermatologic agentsDermatologic agents: In human research, escin by mouth has caused pruritus (11), and when used topically, has caused contact dermatitis (25).
  • Fertility agentsFertility agents: In human research, escin supplementation improved sperm density and the diameter of the spermatic vein in males with varicocele-associated infertility (12).
  • Gastrointestinal agentsGastrointestinal agents: In human research, escin taken by mouth resulted in nausea, dyspepsia, vomiting, diarrhea, dry mouth, and constipation (10; 11; 12; 26; 12).
  • HepatotoxinsHepatotoxins: A 69 year-old woman who was taking Venocapsan®, which contained horse chestnut leaf, experienced hepatotoxicity that resolved after discontinuing the product (31).
  • Highly protein bound agentsHighly protein bound agents: Escin may theoretically interfere with highly protein-bound drugs, such as phenytoin, warfarin, or amiodarone, although there is a lack of reported cases in the available literature.
  • Musculoskeletal agentsMusculoskeletal agents: In human research, a small percentage of patients reported calf spasm after taking HCSE (28).
  • Neurologic agentsNeurologic agents: Theoretically, horse chestnut may interact with neurologic agents. In human research, headache, dizziness, and fatigue have been reported with HCSE (11; 10; 12).
  • Renal agentsRenal agents: In human research, high parenteral doses of escin resulted in nephrotoxicity (17; 18).
  • VasodilatorsVasodilators: HCSE has been shown to increase venous tone, improve venous return, and reduce vascular permeability (48; 49; 50; 51; 52; 53). HCSE has been found to dose-dependently contract canine (49) and human (50) isolated saphenous veins in vitro, possibly due to preferential formation of the vasoconstrictive eicosanoid, PGF 2-alpha (51). In human research, escin increased relaxation in the endothelium of varicose veins (54).

Horse chestnut/Herb/Supplement Interactions:
  • AntiangiogenicsAntiangiogenics: HCSE has been shown to increase venous tone, improve venous return, and reduce vascular permeability (48; 49; 50; 51; 52; 53).
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: Horse chestnut theoretically may increase bleeding risk due to the hydroxycoumarin content of esculin (13; 14; 15). Properly extracted HCSE should not contain esculin and therefore, should not carry this risk. Life-threatening, acute hemorrhage from renal angiomyolipoma after use of HCSE for venous insufficiency has been noted in a case report (29). The authors suggested caution in patients taking anticoagulants concomitantly with HCSE due to potential HCSE-induced anticoagulation.
  • Anti inflammatoriesAnti inflammatories: Purified escin has been shown to decrease chemically-induced inflammation in rats (52; 53; 49).
  • AntioxidantsAntioxidants: HCSE extract has been reported to have antioxidant effects (49; 55).
  • Dermatologic agentsDermatologic agents: In human research, escin by mouth has caused pruritus (11), and when used topically, has caused contact dermatitis (25).
  • Fertility agentsFertility agents: In human research, escin supplementation improved sperm density and the diameter of the spermatic vein in males with varicocele-associated infertility (12).
  • Gastrointestinal agentsGastrointestinal agents: In human studies, escin taken by mouth resulted in nausea, dyspepsia, vomiting, diarrhea, dry mouth, and constipation (10; 11; 12; 26; 12).
  • HepatotoxinsHepatotoxins: A 69 year-old woman who was taking Venocapsan®, which contained horse chestnut leaf, experienced hepatotoxicity that resolved after discontinuing the product (31).
  • Highly protein bound agentsHighly protein bound agents: Escin may theoretically interfere with highly protein-bound agents, although there is a lack of reported cases in the available literature.
  • HypoglycemicsHypoglycemics: In animal research, HCSE inhibited the normal increase of serum glucose levels after glucose-loading (24).
  • Musculoskeletal agentsMusculoskeletal agents: In human research, a small percentage of patients reported calf spasm after taking HCSE (28).
  • Neurologic agentsNeurologic agents: Theoretically, horse chestnut may interact with neurologic herbs and supplements. In human research, headache, dizziness, and fatigue have been reported with HCSE (11; 10; 12).
  • Renal agentsRenal agents: In human research, high parenteral doses of escin resulted in nephrotoxicity (17; 18).
  • VasodilatorsVasodilators: HCSE has been shown to increase venous tone, improve venous return, and reduce vascular permeability (48; 49; 50; 51; 52; 53). HCSE has been found to dose-dependently contract canine (49) and human (50) isolated saphenous veins in vitro, possibly due to preferential formation of the vasoconstrictive eicosanoid, PGF 2-alpha (51). In human research, escin increased relaxation in the endothelium of varicose veins (54).

Horse chestnut/Food Interactions:
  • Insufficient available evidence.

Horse chestnut/Lab Interactions:
  • Coagulation panelCoagulation panel: Horse chestnut theoretically may increase bleeding risk due to the hydroxycoumarin content of esculin (13; 14; 15). Properly extracted HCSE should not contain esculin and therefore, should not carry this risk. Life-threatening, acute hemorrhage from renal angiomyolipoma after use of HCSE for venous insufficiency has been noted in a case report (29). The authors suggested caution in patients taking anticoagulants concomitantly with HCSE due to potential HCSE-induced anticoagulation.
  • Serum glucoseSerum glucose: HCSE has been noted to inhibit the normal increase of serum glucose levels in glucose-loaded rats (24).

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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