horse chestnut (generic name)

an herbal product - treats Chronic venous insufficiency
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Interactions

Interactions with Drugs

In theory, due to its esculin constituents, horse chestnut (but not horse chestnut seed extract, which when properly prepared does not contain esculin) may theoretically increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

In theory, and based on limited animal study, horse chestnut seed extract (HCSE) may have an additive effect when taken with drugs that cause hypoglycemia (low blood sugar levels). Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare provider. Medication adjustments may be necessary.

Escin in HCSE may theoretically interfere with protein-bound drugs such as phenytoin (Dilantin®), warfarin (Coumadin®), or amiodarone (Cordarone®), although human evidence is lacking.

HCSE has been demonstrated to have antiangiogenic activity, and may thus interact with antiangiogenic drugs.

Interactions with Herbs and Dietary Supplements

In theory, due to its esculin constituents, horse chestnut (but not horse chestnut seed extract, which when properly prepared does not contain esculin) may theoretically increase the risk of bleeding when taken with herbs or supplements that increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

In theory, and based on limited animal study, horse chestnut seed extract may have an additive effect when taken with other herbs or supplements that may lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

In theory, horse chestnut may interact with neurologic herbs and supplements.

Attribution

This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): E-P Barrette, MD (Harvard Medical School); Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Samuel Basch, MD (Mt. Sinai Medical Center, NY); Steve Bent, MD (University of California, San Francisco); Heather Boon, BScPhm, PhD (University of Toronto); Wendy Chao, PhD (Natural Standard Research Collaboration); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Cathi Dennehy, PharmD (University of California, San Francisco); Paul Hammerness, MD (Harvard Medical School); Michael Smith, MRPharmS, ND (Canadian College of Naturopathic Medicine); David Sollars, M.Ac, H.M.C. (New England School of Acupuncture); Philippe Szapary, MD (University of Pennsylvania School of Medicine); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Natasha Tiffany, MD (Harvard Medical School); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration).

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