PDR for Herbal Medicines

HERBAL MONOGRAPHS HORSE CHESTNUT/405

OVERDOSAGE

HORSE CHESTNUT SEEDS

The intake of larger quantities of Horse Chestnut seeds (in

one case of a child with 5 seeds) can bring about vomiting,

diarrhea, severe thirst, reddening of the face, enlargement of

pupils, vision and consciousness disorders. Following stom-

ach and intestinal emptying (gastric lavage, sodium sulfate)

and the administration of activated charcoal, therapy for

poisonings consists of diazepam for spasms, atropine for

colic, electrolyte replenishment and sodium bicarbonate

infusions for any acidosis that may arise. Intubation and

oxygen respiration may also be necessary.

Daily Dosage:

Infusion (as a tea)—Pour boiling water over 1 tsp. of finely

cut drug and strain after 5 to 10 minutes (ltsp = 1 gm drug).

Intravenously—1 to 2 ampules daily.

Intramuscularly—1 ampule daily.

How Supplied:

Ampules

Capsules — 250 mg, 300 mg, 485 mg

Coated tablets

Drops

Ointment/Gels

Tablets
Tincture
Preparation: Stabilized extract of Horse Chestnut (5:1) is
standardized for aescin; tincture of Horse Chestnut 1:1 with
75% ethanol; isolated aescin.
Daily Dosage:
Intravenous—Doses of 5 mg once or twice daily of aescin as
the sodium salt has been used for treatment or prevention of
post-traumatic edema and potoperative edema. The maxi-
mum daily dose is 20 mg (Brandt, 1992/1993).

Oral—Aescin from encapsulated standardized extracts are

initially given at doses of 10 mg (Chandler, 1993). The

encapsulated standardized extract has been used for the

treatment of postoperative or traumatic edema, hemorrhoids

or symptoms due to varicose veins in doses providing 40 to

120 mg of aescin per day (Schlesser, 1991). Aescin (escin)

100 mg corresponding to 250-312.5 mg extract may be

administered twice daily in delayed-release form.

Tincture—For the treatment of painful hemorrhoids, a dose

of 1:10 tincture is 0.6 ml (Reynolds, 1977).

Topical—A 1 to 2% gel is applied topically several times

daily for soft tissue injuries, bruises and symptomatic relief

of varicose veins (Fachinfo Reparil (R)- Sportgel 1994;

Fachino Opijo (R) N gel, 1991; Calabrese & Preston 1993).

Homeopathic Dosage: 5 drops, 1 tablet or 10 globules every

30 to 60 minutes (acute) and 1 to 3 times daily (chronic);

parenterally: 1 to 2 ml 3 times daily sc; ointment 1 to 2 times

daily (HAB1).

Storage: The herb should be stored in a dry and dark place.

LITERATURE

Aizavva X, Fukui. Yamada K, Kogo H, Aescin,

antiinflammatory action of Aescin (1, intravenous injection). In:

Pharmacometrics (Tokyo) 8:211. 1974.

Alter H, (1973) Zur medikamentbsen Therapie der Varikosis. Z

AUg Med 49(17): 1301-1304.

Annoni F, Mauri A, Marincola Resele LF. (1979) Venotonic

activity of Escin on the human saphenous vein. Arzneim

Forsch/Drug Res 29:672.

Arnold M, Przerwa M, Die therapeutische Beeinflufibarkeit

experimentell erzeugter Odeme. In: Arzneim Forsch 26:402-409.

1976.

Auster F, Wirkung eines RoPkastanienpraparates auf die

Resistenz der Hautkapillaren. In: Pharmazie 11:726-730. 1956.

Bisler H, Pfeifer R, Kluken N, Pauschinger P, (1986) Wirkung

von Ropkastaniensamenextrakt auf die transkapillare Filtration

bei chronischer venoser Insuffizien. Z Dtsch Med Wschr 111:

1321-1328.

Brandt D (ed.): Reparil (R) -Ampoules. In: MDR, MIMS Desk

Reference Vol 28. MIMS, Pretoria, 1992/93.

Buechi S, Antivirale Saponine, pharmakologische und klinische

Untersuchungen. In: DAZ 136(2):89-98. 1996.

Calabrese C, Preston P, Report of the results of a double-blind,

randomized, single-dose trial of a topical 2% escon gel versus

placebo in the acute treatment of experimentally-induced

hematoma volunteers. Planta Med 59:394-397. 1993.

Chandler RF, Herbal Medicine: Horse Chestnut. Can Pharm J

1993; 126:297-306.

Comaish JS, Kersey PJ, Contact dermatitis to extract of horse

chestnut (esculin). Contact Dermatitis 1980 Jan;6(2): 150-1.

DOSAGE

HORSE CHESTNUT LEAF

Mode of Administration: Extracts of the drug are contained

in "vein teas" or "hemorrhoid teas," as well as in

pharmaceutical preparations for the treatment of venous

symptoms.

Preparation: One ampule corresponds to 4 mg flavones in

0.9% NaCl.

HORSE CHESTNUT SEEDS

Mode of Administration: Available in liquid and solid

preparations for internal use; semi-solid preparations for

external use; and parenterally for homeopathic use.