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

It is not certain whether horse chestnut is effective in treating any medical condition. The FDA has not approved this product for medicinal use. Horse chestnut should not be used instead of medication prescribed for you by your doctor.

Horse chestnut is often sold as an herbal supplement. There are no regulated manufacturing standards for many herbal products, and some supplements on the market have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to reduce the risk of contamination.

Horse chestnut may also be used for purposes not listed in this product guide.

When thinking about using herbal supplements, talk to your doctor. You might also want to consult a practitioner who is trained in herbal/health supplements.

If you decide to use horse chestnut, follow the instructions on the package or those given by your doctor, pharmacist, or other healthcare provider. Do not take more than what is recommended on the label.

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

Take the capsule with a full glass of water.

Do not crush, chew, break, or open a horse chestnut capsule. Swallow it whole.

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

It may take up to 4 weeks before your symptoms improve. Call your doctor if your symptoms do not improve or if they get worse while using horse chestnut.

Store at room temperature away from moisture, heat, and light.

Follow all instructions on the product label and package. Inform all your healthcare providers about all your medical conditions, allergies, and all medicines you are taking.

Before using horse chestnut, talk to your healthcare provider. You may not be able to use horse chestnut if you have certain medical conditions, such as:

• 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.

It is not known whether horse chestnut will harm an unborn baby. Do not use this product if you are pregnant.

Horse chestnut may pass into breast milk and may harm a nursing baby. Do not use this product if you are breast-feeding a baby.

Do not give any herbal/health supplement to a child without medical advice.

Get emergency medical help if you notice any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Although not all side effects are known, horse chestnut is believed to be possibly safe when used for a short time.

Stop using horse chestnut and contact your healthcare provider immediately if you experience:

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

Common side effects of horse chestnut may include:

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

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

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.

Seek emergency medical help or call the Poison Help line at 1-800-222-1222. Using raw horse chestnut (seeds, flowers, stems, leaves) can lead to fatal poisoning.

Signs of horse chestnut poisoning may include weakness, feeling very sad, losing coordination, dilated pupils, vomiting, diarrhea, little or no urination, muscle twitching, or losing movement in any part of the body.

Do not use raw horse chestnut seed, bark, flower, or leaves. These parts are not safe to take by mouth and may cause fatal side effects.

Do not use horse chestnut with other herbal or 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.

Do not use horse chestnut with herbal or 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.

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.