Horse Chestnut 
(Aesculus hippocastanum)

General Description:  The seeds from Aesculus hippocastanum, a member of the Hippocastanaceae family, are used to formulate horse chestnut extract.  The bark of young branches should be used.  Older bark is poisonous.

Part Used:  Seeds

Uses:  

                  chronic venous insufficiency including pain, swelling 
                        and cramps

                  arthritis

                  hemorrhoids

                  diarrhea

Action:  The active ingredient is aescin that reduces edema.  They also have anti-inflammatory properties and antioxidant properties.  

Dosage:  100-150 mg P.O. daily of aescin component in one or two divided doses has been clinically tested.

  Precautions/Adverse Effects:  Ingestion of whole seed can be toxic.  Has produced anaphylaxis and allergic responses.  GI upset, twitching, weakness and dilated pupils.

         Interactions with other Drugs: Anticoagulants, aspirin: increases the risk of bleeding.               

Contraindications:  Pregnancy/Lactation/Children.  Bleeding disorders and GI conditions.

Nursing Considerations:

    Tell patients it will not cure varicose veins.

    Warn patients of the difference of whole horse chestnut seed – toxic and classified unsafe by the FDA. Horse chestnut seed extract has the toxic constituents removed.

    Sweet chest nut is used for cooking, not the same as horse chestnut seed. 

    Venastat is an OTC that became available in 1998 for maintenance of leg health.  It does not contain the toxic component, aesculin.  It increases venous blood flow and may enhance venous tone.

    Monitor liver function tests and yellowing of skin or eyes.

    Warn patients that their urine may be red.

    Instruct patients to report unusual bleeding, fatigue, or fever.

    Tell patients to not use with OTC medications that may contain aspirin.