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Horse chestnut (Aesculushippocastanum L.)



Interactions

Horse chestnut/Drug Interactions:
  • Antiangiogenic drugsAntiangiogenic drugs: Horse chestnut may interact with antiangiogenic drugs because HCSE has been shown to increase venous tone, improve venous return, and reduce vascular permeability (38; 39; 40; 41; 42; 43).
  • Anticoagulants, antiplatelet agents, NSAIDsAnticoagulants, antiplatelet agents, NSAIDs: Due to its esculin constituents, horse chestnut (but not horse chestnut seed extract [HCSE], which when properly prepared does not contain esculin) may theoretically increase the risk of bleeding when taken with anticoagulants (warfarin, heparin) or antiplatelet drugs (aspirin, clopidogrel, ticlopidine, non-steroidal anti-inflammatory drugs) (30; 31; 32). Clinical cases are lacking in the available literature.
  • Antidiabetic agents Antidiabetic agents : HCSE has been noted to inhibit the normal increase of serum glucose levels in glucose-loaded rats (12). Thus, HCSE may theoretically have an additive effect when taken with drugs that cause hypoglycemia, including sulfonylureas, insulin, or metformin.
  • Anti inflammatory agentsAnti inflammatory agents: Purified escin has been shown to decrease chemically-induced inflammation in rats (42; 43; 39).
  • Hepatotoxic agentsHepatotoxic agents: A 69 year-old woman who was taking Venocapsan®, which contained horse chestnut leaf, experienced hepatotoxicity that resolved after discontinuing the product (22).
  • Highly protein bound drugHighly protein bound drug: 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.
  • Neurologic agentsNeurologic agents: Theoretically, horse chestnut may interact with neurologic herbs and supplements.

Horse chestnut/Herb/Supplement Interactions:
  • Antiangiogenic herbsAntiangiogenic herbs: Horse chestnut may interact with antiangiogenic herbs or supplements because HCSE has been shown to increase venous tone, improve venous return, and reduce vascular permeability (38; 39; 40; 41; 42; 43).
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: Due to its esculin constituents, horse chestnut (but not HCSE, which when properly prepared does not contain esculin) may have additive effects with herbs that cause bleeding via effects on platelets, bleeding time, or the coagulation cascade.
  • Anti inflammatory herbs and supplementsAnti inflammatory herbs and supplements: Purified escin has been shown to decrease chemically-induced inflammation in rats (42; 43; 39).
  • AntioxidantsAntioxidants: HCSE extract has been reported to have antioxidant effects (39; 44).
  • Hepatotoxic herbs and supplementsHepatotoxic herbs and supplements: A 69 year-old woman who was taking Venocapsan®, which contained horse chestnut leaf, experienced hepatotoxicity that resolved after discontinuing the product (22).
  • HyperglycemicsHyperglycemics: Herbs that may increase blood sugar should be used cautiously with horse chestnut seed extract (HCSE), due to a theoretical diminished effect. Cases in humans are lacking in the available literature.
  • HypoglycemicsHypoglycemics: Herbs that may lower blood sugar, such as bitter melon, Panax ginseng, and American ginseng (Panax quinquefolius), should be used cautiously with horse chestnut seed extract (HCSE), due to a theoretical additive effect. Cases in humans are lacking in the available literature.
  • Neurologic herbs and supplementsNeurologic herbs and supplements: Theoretically, horse chestnut may interact with neurologic herbs and supplements.

Horse chestnut/Food Interactions:
  • Insufficient available evidence.

Horse chestnut/Lab Interactions:
  • Serum glucoseSerum glucose: HCSE has been noted to inhibit the normal increase of serum glucose levels in glucose-loaded rats (12).

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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.