Casta?a de indias

Related Terms

Aescin, aescine, Aesculaforce?, aescule, aesculetin, Aesculushippocastanum L., buckeye, bongay, chestnut, conkers, Conquerors, coumarins, eschilo, escin, escina, escine, esculin, fatty acids, fish poison, flavonoids, graine de marronnier d'Inde (French), fraxetin glucoside, fraxin, H. vulgare Gaertn., hestekastanje (Danish, Norwegian), HCSE, Hippocastanaceae (family), Hippocastani folium, Hippocastani semen, horse chestnut seed extract, horsechestnut, lectin, linolenic acid, Marron Europeen, marronnier (French), NV-101, palmitic acid, quinines, Rokastaniensamen, Rosskastanie (German), scopoletin glucoside, scopolin, Spanish chestnut, steric acid, sterols, tannins, Venastat?, Venoplant?.
Combination product examples: Venostasin? (a German preparation containing 100 milligrams of escin).

Background

Horse chestnut seed extract (HCSE) comes from the buckeye tree. Its primary active ingredient is called escin. HCSE is widely used in Europe to treat pain, itching, skin disorders, and ulcers. Limited studies suggest that HCSE may be used for inflammation, infertility, and bowel blockage after surgery.
There is strong evidence supporting the use of HCSE for circulation problems in the legs. Studies suggest that HCSE may be cost-effective when combined with conventional therapy for this condition.
Horse chestnut flower, branch bark, or leaves that are not fully processed should be avoided, due to the risk of bleeding and poisoning. HCSE given through tube feeding should be avoided due to the risk of kidney problems, life-threatening allergic reactions, and infection.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


Horse chestnut has been used to treat chronic venous insufficiency (CVI), a circulation disorder in the legs. HCSE has been found to significantly decrease CVI symptoms such as leg pain, itching, and fatigue. Some studies suggest that HCSE may be as effective as compression stockings, which are often used for vein disorders.

 A


Horse chestnut has been used to treat chronic venous insufficiency (CVI), a circulation disorder in the legs. HCSE has been found to significantly decrease CVI symptoms such as leg pain, itching, and fatigue. Some studies suggest that HCSE may be as effective as compression stockings, which are often used for vein disorders.

 A


A study reports that escin injected into the veins, followed by danshen injected into the veins, may improve swelling of a fracture. More research is needed to confirm these findings.

 C


A study reports that escin injected into the veins, followed by danshen injected into the veins, may improve swelling of a fracture. More research is needed to confirm these findings.

 C


Early research suggests that supplementing with escin may improve sperm density in infertile men. Further research is needed before firm conclusions can be made.

 C


Early research suggests that supplementing with escin may improve sperm density in infertile men. Further research is needed before firm conclusions can be made.

 C


Early study suggests that injecting escin in the vein daily may improve bowel symptoms in people with colorectal cancer, compared to placebo. More research is needed in this area.

 C


Early study suggests that injecting escin in the vein daily may improve bowel symptoms in people with colorectal cancer, compared to placebo. More research is needed in this area.

 C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

Adults (18 years and older)
Studies suggest doses of 50-75 milligrams of escin taken by mouth every 12 hours, for a total dose of 300 milligrams twice daily.
To treat circulation problems, doses of 50-1,200 milligrams of horse chestnut have been taken by mouth twice daily for 2-16 weeks in the form of Venostasin?, ecsin, and HCSE or HCSE capsules.
To treat male infertility, 150 milligrams of Aescuven Forte? has been taken by mouth every 12 hours for two months (daily total of 300 milligrams daily, 60 milligrams of escin), along with 20 milligrams of vitamin E, 400 milligrams of pentoxifylline, and 50 milligrams of clomiphene daily for two months.
To treat bowel blockage after surgery, doses of 5-25 milligrams of escin diluted in 500 milliliters of five percent dextrose have been injected into the vein once daily for up to seven days or up to the first bowel movement. However, reliable evidence is lacking in support of injecting HCSE into the vein, and life-threatening allergic reactions have been reported.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Interactions

Interactions with Drugs
Horse chestnut (in the form of HCSE that is not properly extracted or unprocessed horse chestnut seeds, leaves, bark, and flowers) may 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, antiplatelet drugs such as clopidogrel (Plavix?), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin?, Advil?) or naproxen (Naprosyn?, Aleve?).
Horse chestnut may affect blood sugar levels. Caution is advised when using medications that may also affect blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Horse chestnut may also interact with agents that affect blood vessel width, agents that harm the liver, agents that prevent new blood vessel formation, anti-inflammatory agents, fertility agents, highly protein-bound agents, kidney agents, musculoskeletal agents, nervous system agents, skin agents, and stomach agents.

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

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