Horse Chestnut

Results from pharmacological studies and controlled clinical trials support the use of standardized horse chestnut seed extracts as an alternative therapy for the sympto- matic treatment of chronic venous insufficiency (CVI). In clinical trials, oral admin- istration of a standardized horse chestnut seed extract was more effective than placebo and as effective as compression stockings and reference medications in alle- viating the symptoms of CVI. Horse chestnut seed extract exerts its effects through tonic actions on the veins, thereby decreasing their permeability and reducing the associated peripheral edema. The recommended daily dosage is 300 mg of a stan- dardized horse chestnut seed extract (corresponding to 50 mg/day of aescin) twice daily. Treatment for 1 to 3 months may be required before the full therapeutic effects are apparent. Two cases of nephrotoxicity have been reported due to the ingestion of high doses of pure aescin, one of the active constituents of horse chestnut seed extract. Therefore, the extract should not be administered to patients with preexist- ing renal disease or in combination with other drugs known to cause nephrotoxicity. Adverse reactions, such as pruritis, nausea, vomiting, headaches and dizziness, have been reported in clinical trials. Due to a lack of safety data, the administration of horse chestnut seed extract during pregnancy and nursing, and to children under the age of 18 years old is not recommended.