Horse Chestnut, Aesculus hippocastanum skin cream or gel

What is horse chestnut skin cream or gel?

HORSE CHESTNUT, also called Aesculus hippocastanum, is a herbal remedy that is being promoted to cosmetically improve the appearance of varicose veins. It is also promoted for relief of swelling or inflammation of joints, tendons, or muscles. At this time, there is no FDA approved use of this herb. Topical creams or gels containing horse chestnut in combination with other herbs (Cellu-Var™) or medicines (Reparil® Gel) are available.

What should my health care professional know before I use horse chestnut?

It is important for you to tell your prescriber or other health care professional that you are using horse chestnut. Some herbs exert potent effects and may interact with other drugs you are taking.

You should discuss horse chestnut with your health care professional BEFORE taking it if you have any of these conditions:

• blood clots

• colitis or other stomach or intestine related illness

• diabetes mellitus

• heart disease or high or low blood pressure

• kidney disease

• liver disease

• poor blood circulation

• an unusual or allergic reaction to horse chestnut, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

How should I use this medicine?

Horse chestnut skin cream or skin gel is for external use only; do not take by mouth. Follow the directions on the label. Wash your hands before and after use. Apply a thin layer of cream to the affected area and rub in gently. Do not use your medicine more often than directed.

Contact your pediatrician or health care professional regarding the use of this herb in children. Special care may be needed. This herb is generally not used in children.

What if I miss a dose?

Missing a dose is probably not harmful. If you miss a dose, simply resume taking it on your previous schedule. Do not take double doses to catch up, however.

What drug(s) may interact with horse chestnut?

While herbs applied to the skin are less likely to interact with other medications, you should talk to your prescriber before using this gel or cream if you take any of the following medicines:

• aspirin

• clopidogrel

• cilostazol

• danshen

• dipyridamole

• enoxaparin or other injectable blood thinners

• feverfew

• garlic

• ginger

• ginkgo biloba

• medications used to treat high blood sugar or diabetes

• ticlopidine

• warfarin

• willow bark

For many herbs, interactions with other medications are unknown. That is why you should always be careful when mixing herbal remedies with traditional medications. If you take any other medications, consult with your health care professional prior to taking horse chestnut.

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking horse chestnut?

Since horse chestnut is derived from a plant, allergic reactions are possible. Stop using this herb if you develop a rash. You may want to see your health care professional, or inform them that this occurred.

If you are scheduled to have surgery, let your surgeon know you are using horse chestnut.

What side effects may I notice from using horse chestnut?

Side effects that you should report to your prescriber or health care professional as soon as possible:

• bleeding (gums, nose, skin, stool, urine)

• decreased amounts of urine

• difficulty breathing or shortness of breath

• joint or muscle pain

• swelling of mouth or throat

• skin rash or itching

• unusual skin bruises

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

• mild stinging at the time of cream or gel application

Where can I keep my medicine?

Keep out of the reach of children.

Store at room temperature; do not freeze. Throw away any unused medicine after the expiration date.

GENERAL INFORMATION REGARDING DIETARY SUPPLEMENTS:

Dietary supplements include amino acids, vitamins, minerals, herbs, botanicals, and other plant-derived substances, and extracts of these substances. These products are easy to identify as they must state "Dietary Supplement" on the label. A "Supplement Facts" panel is provided on the label for most products. Supplements are not drugs and are not regulated like drugs. You should note that rigid quality control standards are not required for dietary supplements. Big differences in potency and purity of these products can occur. Scientific data to support the use of a dietary supplement for a certain disease or ailment may not be available. This product is not intended to diagnose, treat, cure or prevent any disease.

The Food and Drug Administration suggests the following to help consumers protect themselves:

• Always read product labels and follow directions.

• "Natural" doesn't mean a product is safe for humans to take.

• Look for products containing ingredients with the "USP" notation. This indicates the manufacturer followed the standards of the US Pharmacopoeia.

• Supplements produced or distributed by a nationally known food or drug company are more likely to be made under tight controls as these companies have standards in place for their other products. You can write to the company for more information about how the product was made.

Horse Chestnut, Aesculus hippocastanum tablets and capsules

What are horse chestnut tablets and capsules?

HORSE CHESTNUT, also called Aesculus hippocastanum, (Reparil®, Venastat® and others) is a herbal remedy that is being promoted to maintain healthy leg vein blood flow. At this time, there is no FDA approved use of this herb. Horse chestnut is being studied for chronic problems of leg vein blood circulation and for hemorrhoids, but it should be used under the prescription of a health care prescriber. Many products containing horse chestnut in combination with other herbs are available, including Leg Veins Formula™, Varicare™, Variclear™, Varicosin™, and VeinAway™.

What should my health care professional know before I use horse chestnut?

It is important for you to tell your prescriber or other health care professional that you are using horse chestnut. Some herbs exert potent effects and may interact with other drugs you are taking.

You should discuss horse chestnut with your health care professional BEFORE taking it if you have any of these conditions:

• blood clots

• colitis or other stomach or intestine related illness

• diabetes mellitus

• heart disease or high or low blood pressure

• kidney disease

• liver disease

• poor blood circulation

• an unusual or allergic reaction to horse chestnut, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

How should I use this medicine?

This herb should be taken orally (i.e., swallowed). Take the herb after a meal to avoid stomach discomfort. Follow the directions on the package labeling, or talk to your health care professional. Do not take more of this herb than is recommended.

Contact your pediatrician or health care professional regarding the use of this herb in children. Special care may be needed. This herb is generally not used in children.

What if I miss a dose?

Missing a dose is probably not harmful. If you miss a dose, simply resume taking it on your previous schedule. Do not take double doses to catch up, however.

What drug(s) may interact with horse chestnut?

• aspirin

• clopidogrel

• cilostazol

• danshen

• dipyridamole

• enoxaparin or other injectable blood thinners

• feverfew

• garlic

• ginger

• ginkgo biloba

• medications used to treat high blood sugar or diabetes

• ticlopidine

• warfarin

• willow bark

For many herbs, interactions with other medications are unknown. That is why you should always be careful when mixing herbal remedies with traditional medications. If you take any other medications, consult with your health care professional prior to taking horse chestnut.

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking horse chestnut?

Since horse chestnut is derived from a plant, allergic reactions are possible. Stop using this herb if you develop a rash. You may want to see your health care professional, or inform them that this occurred.

Different brands of horse chestnut might contain different amounts of active ingredient so be careful to use the same brand. A standardized product is more likely to contain the same amount of herb from dose to dose. Your health care professional or pharmacist can assist you in finding a standardized product.

If you are scheduled to have surgery, let your surgeon know you are taking horse chestnut.

What side effects may I notice from using horse chestnut?

Side effects that you should report to your prescriber or health care professional as soon as possible:

• bleeding (gums, nose, skin, stool, urine)

• decreased amounts of urine

• difficulty breathing or shortness of breath

• joint or muscle pain

• swelling of mouth or throat

• skin rash or itching

• unusual skin bruises

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

• mild stomach upset or heartburn

Where can I keep my medicine?

Keep out of the reach of children.

Store at room temperature; do not freeze. Throw away any unused medicine after the expiration date.

GENERAL INFORMATION REGARDING DIETARY SUPPLEMENTS:

Dietary supplements include amino acids, vitamins, minerals, herbs, botanicals, and other plant-derived substances, and extracts of these substances. These products are easy to identify as they must state "Dietary Supplement" on the label. A "Supplement Facts" panel is provided on the label for most products. Supplements are not drugs and are not regulated like drugs. You should note that rigid quality control standards are not required for dietary supplements. Big differences in potency and purity of these products can occur. Scientific data to support the use of a dietary supplement for a certain disease or ailment may not be available. This product is not intended to diagnose, treat, cure or prevent any disease.

The Food and Drug Administration suggests the following to help consumers protect themselves:

• Always read product labels and follow directions.

• "Natural" doesn't mean a product is safe for humans to take.

• Look for products containing ingredients with the "USP" notation. This indicates the manufacturer followed the standards of the US Pharmacopoeia.

• Supplements produced or distributed by a nationally known food or drug company are more likely to be made under tight controls as these companies have standards in place for their other products. You can write to the company for more information about how the product was made.