Products
Horse chestnut extracts are available in the form of topical preparations such as gels and ointments, and oral forms such as tablets, dragées, capsules, tinctures, and drops (e.g., Aesculaforce, Phlebostasin, Venostasin). Furthermore, numerous cosmetics and alternative medicine products such as homeopathics and anthroposophics are on the market. In addition to the extracts, the ingredient aescin is also processed into pharmaceuticals.
Stem plant
The common horse chestnut L. from the family Hippocastanaceae has spread as an ornamental plant in large parts of Europe. Originally, the tree, which grows up to 35 meters high, originates from the Balkans, the Caucasus and the Near East.
Medicinal drug
The fresh or dried horse chestnut seeds, Hippocastani semen, are mainly used as a medicinal drug. Less commonly used are the horse chestnut bark (Hippocastani cortex), horse chestnut leaves (Hippocastani folium), and horse chestnut flowers (Hippocastani flos). Ethanolic fluid or dry extracts are prepared from the drug for further processing into the medicinal products and are usually standardized for triterpene saponins and aescin.
Ingredients
The triterpene saponin mixture aescin is considered to be the most relevant ingredient. In addition, the seeds contain flavonoids, coumarins, tannins and nutrients, among others.
Effects
Studies with horse chestnut extracts have demonstrated antiexudative, vascular sealing, venous toning, edema-protective, anti-inflammatory, and antioxidant effects. We cannot comment on the actual efficacy. Pittler and Ernst concluded in their comprehensive review from 2006 that horse chestnut extracts are probably suitable for short-term treatment of chronic venous insufficiency.
Indications for use
Today, horse chestnut extracts are mainly used for the treatment of venous complaints, i.e., varicose veins, pain, itching, swelling, and tired legs. Other applications include calf cramps, bruising, sports injuries, hemorrhoids and skin disorders.
Dosage
According to the package leaflet. The external remedies are usually applied twice a day, some up to five times a day. The oral forms are usually taken in the morning and evening. Taking them with meals improves tolerability.
Contraindications
- Hypersensitivity
- Thrombosis
- Risk of embolism
- Open wounds
Full precautions can be found in the drug label.
Interactions
Drug-drug interactions have been described with anticoagulants such as phenprocoumon.
Adverse effects
Possible adverse effects include digestive discomfort with oral use due to the mucosal irritants in the ingredients. These may be reduced by taking with meals. If skin rashes occur, treatment should be discontinued as it may be a hypersensitivity reaction. Furthermore, headache and dizziness are listed as possible side effects in the literature.