horse chestnut

What is the most important information I should know about horse chestnut?

Follow all directions on the product label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

What is horse chestnut?

Horse chestnut is a plant also known as Aescin, Aesculus hippocastanum, Buckeye, Castaño de Indias, Châtaignier de Mer, Châtaignier des Chevaux, Escine, Faux-Châtaignier, Hippocastani, Hippocastanum Vulgare Gaertn, Marron Europeen, Marronnier, Spanish Chestnut, Venostasin Retard, Venostat, White Chestnut, and other names.

Horse chestnut has been used in alternative medicine and is likely effective in treating some symptoms of chronic venous insufficiency (decreased blood flow return from the feet and legs back to the heart). These symptoms include leg pain or tenderness, varicose veins, itching or swelling in the legs, and fluid retention (puffy or swollen ankles or feet).

Other uses not proven with research have included fever, cough, diarrhea, hemorrhoids, enlarged prostate, menstrual cramps, and swelling caused by arthritis, sprains, or bone fractures.

Horse chestnut is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be 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 be used for purposes not listed in this product guide.

What should I discuss with my healthcare provider before using horse chestnut?

• a bleeding or blood clotting disorder (horse chestnut can thin your blood);
• diabetes (horse chestnut may cause low blood sugar);
• kidney disease;
• liver disease;
• a stomach or intestinal disorder;
• congestive heart disease;
• epilepsy;
• asthma;
• migraine headaches; or
• if you are allergic to latex.

How should I use horse chestnut?

When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.

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. Do not use more of this product than is recommended on the label.

The usual dose of horse chestnut in capsule form is 1 capsule every 12 hours before a meal.

It is best to use a horse chestnut product that contains an exact amount of the labeled chemical. Check the label to be sure your product does not contain a toxic substance called "esculin."

What happens if I miss a dose?

Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra horse chestnut to make up the missed dose.

What happens if I overdose?

Signs of horse chestnut poisoning may include weakness, depressed mood, loss of coordination, dilated pupils, vomiting, diarrhea, little or no urinating, muscle twitching, or loss of movement in any part of the body.

What should I avoid while taking horse chestnut?

Avoid using horse chestnut together with other herbal/health supplements that can lower blood sugar, such as alpha-lipoic acid, chromium, devil's claw, fenugreek, garlic, guar gum, Panax ginseng, psyllium, Siberian ginseng, and others.

Avoid using horse chestnut together with herbal/health supplements that can also affect blood-clotting. This includes angelica (dong quai), capsicum, clove, danshen, garlic, ginger, ginkgo, panax ginseng, poplar, red clover, turmeric, and willow.

What are the possible side effects of horse chestnut?

Although not all side effects are known, horse chestnut is thought to be possibly safe when taken for a short period of time.

• severe skin redness, swelling, itching, or rash.

Common side effects may include:

• upset stomach;
• headache, dizziness; or
• itching

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect horse chestnut?

Do not take horse chestnut without medical advice if you are using any of the following medications:

• insulin or oral diabetes medicine;
• medicines to prevent blood clots--clopidogrel (Plavix), dalteparin, enoxaparin, heparin, warfarin (Coumadin, Jantoven), and others; or
• an NSAID (nonsteroidal anti-inflammatory drug)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with horse chestnut, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this product guide.

Where can I get more information?

Consult with a licensed healthcare professional before using any herbal/health supplement. Whether you are treated by a medical doctor or a practitioner trained in the use of natural medicines/supplements, make sure all your healthcare providers know about all of your medical conditions and treatments.