What is horse chestnut?
The use of horse chestnut in cultural and traditional settings may differ from concepts accepted
by current Western medicine. When considering the use of herbal supplements, consultation with a
primary health care professional is advisable. Additionally, consultation with a practitioner trained in the
uses of herbal/health supplements may be beneficial, and coordination of treatment among all health
care providers involved may be advantageous.
Horse chestnut is also known as Aesculus hippocastanum, Cellu-Var, Variclear, Reparil,
Varicare, Varicosin, VeinAway, Venastat, and others.
Horse chestnut has been used topically to cosmetically improve the appearance of varicose
veins. It has also been promoted for relief of swelling or inflammation of joints, tendons, and muscles
and hemorrhoids. Horse chestnut has been used orally to improve symptoms of fatigue, and pain,
nighttime cramping, itching and swelling in the legs.
Horse chestnut has not been evaluated by the FDA for safety, effectiveness, or purity. All
potential risks and/or advantages of horse chestnut may not be known. Additionally, there are no
regulated manufacturing standards in place for these compounds. There have been instances where
herbal/health supplements have been sold which were contaminated with toxic metals or other drugs.
Herbal/health supplements should be purchased from a reliable source to minimize the risk of
contamination.
Horse chestnut may also have uses other than those listed in this medication guide.
What should I discuss with my healthcare provider before taking horse chestnut?
Do not use horse chestnut without first talking to your doctor if you have
-
a history of blood clots;
-
colitis or other stomach or intestine related illnesses;
-
diabetes;
-
vitamin K deficiency;
-
a bleeding or blood clotting disorder;
-
are taking a blood thinner such as warfarin (Coumadin);
-
heart disease;
-
low blood pressure;
-
poor blood circulation;
-
liver disease; or
-
kidney disease.
Horse chestnut may not be safe for use if you have any of the conditions
listed above.
Before using horse chestnut, talk to your doctor, pharmacist, or health care professional if you
have allergies (especially to plants, foods, medicines, dyes, or preservatives), have any medical
condition, or if you take other medicines or other herbal/health supplements. Horse chestnut may not
be recommended in some situations.
Do not
use horse chestnut without first talking to your doctor if you are
pregnant or could become pregnant. Horse chestnut may be harmful to an unborn baby.
Do not
use horse chestnut without first talking to your doctor if you are
breast-feeding a baby. It is also not known whether horse chestnut will be harmful to a nursing infant.
Horse chestnut is generally not recommended for use by children. Do not give any
herbal/health supplement to a child without first talking to the child's doctor.
How should I take horse chestnut?
The use of horse chestnut in cultural and traditional settings may differ from concepts accepted
by current Western medicine. When considering the use of herbal supplements, consultation with a
primary health care professional is advisable. Additionally, consultation with a practitioner trained in the
uses of herbal/health supplements may be beneficial, and coordination of treatment among all health
care providers involved may be advantageous.
If you choose to use horse chestnut, use it as directed on the package or as directed by your
doctor, pharmacist, or other healthcare provider.
Horse chestnut cream and gel is intended for external use only. Do not take it my mouth. Wash
your hands before and after application of the topical product. Apply a thin layer of the medication to
the affected area and rub it gently into the skin. Do not apply the product to the eyes, nose, mucous
membranes, or broken skin.
Take the oral forms of horse chestnut with a full glass of water.
Take oral horse chestnut after a meal to reduce the chance of stomach upset.
Standardized extracts, tinctures, and solid formulations of herbal/health supplements may
provide a more reliable dose of the product.
Do not use different formulations (e.g., tablets, topical formulations, and others) of horse
chestnut at the same time, unless specifically directed to do so by a health care professional. Using
different formulations together increases the risk of an overdose of horse chestnut.
Store horse chestnut as directed on the package. In general, horse chestnut should be protected
from light, heat, and moisture.
What happens if I miss a dose of horse chestnut?
If you miss a dose of horse chestnut, skip the missed dose and take the next regularly scheduled
dose as directed.
Do not
take a double dose of the product.
Where can I get more information about horse chestnut?
Your pharmacist has information about horse chestnut written for health professionals that you may read.
What are the possible side effects of horse chestnut?
Although uncommon, allergic reactions to horse chestnut have been reported. Stop taking
horse chestnut and seek emergency medical attention if you experience:
-
an allergic reaction (difficulty breathing; closing of the throat;
swelling of the lips, tongue, or face; or hives);
-
bleeding (gums, nose, skin, stool, urine);
-
decreased amounts of urine;
-
joint or muscle pain;
-
skin rash; or
-
unusual bruising.
Other less serious side effects have also been reported. Talk to your doctor
or pharmacist if you experience
Side effects other than those listed here may also occur. Talk to your doctor
about any side effect that seems unusual or that is especially bothersome.
What is the most important information I should know about horse chestnut?
Do not use horse chestnut without first talking to your doctor if you have a history of blood
clots, colitis or other stomach or intestine related illnesses, diabetes, heart disease, low blood pressure,
kidney disease, liver disease, or poor blood circulation.
Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
(Motrin, Advil, others), naproxen (Aleve, others), or ketoprofen (Orudis KT, others) while using horse
chestnut. These drugs may increase the risk of bleeding while using horse chestnut.
Horse chestnut has not been evaluated by the FDA for safety, effectiveness, or purity. All
potential risks and/or advantages of horse chestnut may not be known. Additionally, there are no
regulated manufacturing standards in place for these compounds. There have been instances where
herbal/health supplements have been sold which were contaminated with toxic metals or other drugs.
Herbal/health supplements should be purchased from a reliable source to minimize the risk of
contamination.
What should I avoid while taking horse chestnut?
Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
(Motrin, Advil, others), naproxen (Aleve, others), or ketoprofen (Orudis KT, others) while using horse
chestnut. These drugs may increase the risk of bleeding while using horse chestnut.
What other drugs will affect horse chestnut?
Do not take horse chestnut with any of the following medications or herbal supplements:
-
aspirin;
-
a nonsteroidal anti-inflammatory drug (NSAID) such as
ibuprofen (Advil, Motrin, others), naproxen (Aleve, Anaprox, Naprosyn, others), ketoprofen
(Orudis, Orudis KT), diclofenac (Cataflam, Voltaren), nabumetone (Relafen), etodolac (Lodine),
indomethacin (Indocin), piroxicam (Feldene), oxaprozin (Daypro), and others;
-
clopidogrel (Plavix);
-
cilostazol (Pletal);
-
dipyridamole (Persantine, Aggrenox);
-
warfarin (Coumadin);
-
heparin, dalteparin (Fragmin), danaparoid (Orgaran),
enoxaparin (Lovenox), or tinzaparin (Innohep);
-
feverfew;
-
danshen;
-
garlic; or
-
ginger.
You may not be able to take horse chestnut, or you may require a dosage
adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
Drugs other than those listed here may also interact with horse chestnut. Talk to your doctor,
pharmacist, or health care professional before taking any prescription or over-the-counter medicines or
other herbal/health supplements.
What happens if I have an overdose of horse chestnut?
