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Dietary supplement

Horse Chestnut Ingredients & Drug Interactions

by Hawaii Pharm

Horse Chestnut label
See full label image
Liquid Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Horse Chestnut against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Moderate

Horse Chestnut is a dietary supplement by Hawaii Pharm with 1 active ingredient. Its ingredients are commonly taken for chronic venous insufficiency, leg swelling and heaviness, varicose veins.Based on those ingredients, 122 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Horse Chestnut Nut Extract, Dry. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Horse Chestnut by Hawaii Pharm

Ask about any prescription or over-the-counter medication and we check it for interactions with Horse Chestnut by Hawaii Pharm — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Horse Chestnut by Hawaii Pharm

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 1 of its 1 active ingredient.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains one active ingredient: horse chestnut nut extract. Horse chestnut has been studied for chronic venous insufficiency — a condition where veins in your legs don't return blood to your heart as well as they should — and the extract is prepared by processing the seed to remove a toxic component called esculin.

The liquid also contains alcohol, water, and glycerin as inactive ingredients to deliver the extract.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: circulatory health and leg vein support.
  • We looked for evidence on: Chronic venous insufficiency (CVI), Hemorrhoids, Postoperative swelling, varicose veins, leg edema, venous insufficiency.
  • The strongest evidence on file: Horse Chestnut is rated "Possibly Effective" for Chronic venous insufficiency (CVI) (Natural Medicines).
  • Also on file: Horse Chestnut is rated "Insufficient Reliable Evidence To Rate" for Hemorrhoids, Postoperative swelling.

Horse chestnut extract is possibly effective for chronic venous insufficiency based on available evidence. For other uses — hemorrhoids, irritable bowel syndrome, and kidney stones — there isn't enough reliable evidence yet to say whether it works.

The evidence, ingredient by ingredient Horse Chestnut

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 1 of the 1 matched ingredient.
  • Pregnancy & breastfeeding safety ratings cover 1 of 1.
  • General safety write-ups exist for 1 of 1.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

A properly processed seed extract is generally well tolerated when taken by mouth. The most common side effects are dizziness, gastrointestinal upset, headache, and itching.

One case report describes a serious heart condition (pericardial tamponade) in a man who consumed a large amount of horse chestnut paste over 6 weeks, though the link to the supplement isn't certain. Calf spasms have also been reported in people taking it for vein problems.

Horse chestnut is not safe in pregnancy or while breastfeeding — there isn't enough safety data, so it's best avoided during both.

Side effects, ingredient by ingredient Horse Chestnut

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 1 of the 1 matched ingredient can interact with medications — Horse Chestnut.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs.
  • For scale: 122 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check any anticoagulant or antiplatelet drugs you're on — blood thinners like warfarin, aspirin, clopidogrel, and others. Horse chestnut may increase bleeding risk when combined with these medications.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

Horse chestnut extract may help with chronic venous insufficiency if you're not on a blood thinner. If you take any anticoagulant or antiplatelet medication, talk to us before starting this product.

Pregnant or nursing? Skip it — the safety data just isn't there.

We can help you check your medications against this one.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated Jan 24, 2024.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Horse Chestnut, straight from the product label.

Brand Hawaii Pharm
Barcode (UPC) 840253627797
Net contents 4 Fluid Ounce(s); 120 mL
Market status On market
Date entered into DSLD Jan 24, 2024
DSLD ID 301682
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Gluten Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Horse Chestnut by Hawaii Pharm, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
0.7 mL
Maximum serving Sizes:
1 mL
Servings per container
120
UPC/BARCODE
840253627797
IngredientAmount% DV
Horse Chestnut Nut Extract, Dry983 mg--

Other ingredients: Alcohol, Water, Glycerin

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Brand IP Statement(s)

Hawaii Pharm Herbal Extract Highest quality since 2008

Suggested/Recommended/Usage/Directions

Suggested use: Shake well before using. For adults add about 20-30 drops (0.7-1 mL, one full squeeze of the dropper bulb) to some juice or water, up to 4 times a day.

Precautions

Warning: We recommend to seek expert medical advice before taking.

Do not use if you are allergic to any ingredients.

Consult your physician before giving to children under 18, during pregnancy, if nursing or taking medications.

Consult your physician before giving to children under 18, during pregnancy, if nursing or taking medications.

May affect the ability to drive and operate machinery. May have contraindications, can cause side effects and adverse reactions. Do not use if seal is broken or missing.

Keep out of the reach of children!

Storage

Store in a cool dry place.

Seals/Symbols

cGMP Made in compliance with cGMP 21 CFR 111 in an FDA registered and inspected facility.

Organic Alcohol Based USA Made in United States of America

FDA Disclaimer Statement

This product has not been evaluated by the FDA and is not intended to diagnose, treat, cure or prevent any disease.

General Statements

Scan this QR-code to get 15% discount on your next purchase. Limited time deal.

Formula

Aesculus hippocastanum

Organic Alcohol Based

Formulation

Only natural ingredients Purity is laboratory tested and verified

All the raw materials are gluten-free by their nature No artificial colors, flavors, or preservatives

Not tested on animals

Organic Alcohol Based

Made in USA, Hawaii

FDA Statement of Identity

Herbal Supplement

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Horse Chestnut by Hawaii Pharm label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Horse Chestnut label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Horse Chestnut by Hawaii Pharm

This is the 1 active ingredient this product is made of. Select it to open its full monograph.

Serving size0.7 mL Dosage formLiquid Servings per container120 Amounts shown are per serving.

Horse Chestnut Nut Extract, Dry

Interacts with
122 drugs
983 mg per serving Form: Aesculus hippocastanum Nut Extract, Dry

Horse chestnut seed extract is most often used for chronic venous insufficiency, where standardized products may help reduce leg swelling, pain, and h...

Horse Chestnut Nut Extract, Dry monograph & interactions

Other (inactive) ingredients: Alcohol, Water, Glycerin. These complete the product’s ingredient list but are not active constituents.

Interaction report

Horse Chestnut by Hawaii Pharm Drug Interactions

Want to check YOUR meds against Horse Chestnut?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
122Drugs
122 Moderate

Ingredients driving the most interactions

Horse Chestnut Nut Extract, Dry 122

Individual Drug Interactions

The ingredients in Horse Chestnut interact with 122 drugs. Click any drug to see the details.

1 of the 1 ingredient in Horse Chestnut interact with drugs. Each result below shows which ingredient is responsible. Horse Chestnut Nut Extract, Dry

Each ingredient & the kinds of drugs it affects

For each ingredient in Horse Chestnut with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.

Horse Chestnut Nut Extract, Dry1 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Horse chestnut may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Horse chestnut contains the constituent esculin which has been shown to have antithrombotic effects. Therefore, horse chestnut might have antiplatelet effects. This has not been shown in humans.

Likelihood Possible Evidence D
Horse Chestnut Nut Extract, Dry full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Horse Chestnut, from the product label.

Hawaii Pharm

See all Hawaii Pharm products
Name
Hawaii Pharm LLC
Street Address
510 Sumner St. Ste. 613
City
Honolulu
State
HI
ZipCode
96817
Phone Number
888-854-2924
Web Address
www.hawaiipharm.com
Pharmacist Counseling Corner

Horse Chestnut by Hawaii Pharm: Common Questions

Does Horse Chestnut by Hawaii Pharm interact with any medications?
Yes. Based on its ingredients, Horse Chestnut has a known interaction with 122 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Horse Chestnut contains a single active ingredient, and that one ingredient can interact with many different medications on its own. We check it against each medication and show the mechanism responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Is this safe if I'm pregnant or breastfeeding?
No. There isn't enough safety information, so horse chestnut is best avoided during pregnancy and is not recommended while breastfeeding. Talk to your OB or midwife if you're thinking about it.
What are the side effects?
The most common ones from the extract are dizziness, stomach upset, headache, and itching. A serious heart condition has been reported in one case, though it's unclear whether the supplement caused it. Calf spasms have also been reported in some people taking it.
Does horse chestnut actually work for leg veins?
For chronic venous insufficiency — poor blood flow in the legs — the extract is possibly effective based on current evidence. For other conditions like hemorrhoids or IBS, there's not enough reliable research yet.
What is horse chestnut extract?
It's an extract from the horse chestnut seed that's been processed to remove a toxic compound. It's been used in herbal medicine for vein and circulation issues.
Can I take this with blood thinners?
Not without talking to your pharmacist first. Horse chestnut may have blood-thinning effects itself, and combining it with anticoagulants or antiplatelets could increase bleeding risk. We can check your specific medications to see if it's safe.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Horse Chestnut label
Go deeper

The Full Monographs Behind Horse Chestnut’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Horse Chestnut

Interacts with 122 drugs

Horse chestnut seed extract is most often used for chronic venous insufficiency, where standardized products may help reduce leg swelling, pain, and heaviness. Raw, unprocessed horse chestnu...

Read the full Horse Chestnut monograph →
Sources

Sources & How We Checked

Horse Chestnut's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 21 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Horse Chestnut 21 references
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  3. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  4. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  5. Greeske K, Pohlmann BK. Horse chestnut seed extract-an effective therapy principle in general practice. Drug therapy of chronic venous insufficiency. Fortschr Med 1996;114:196-200.
  6. Robbers JE, Tyler VE. Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York, NY: The Haworth Herbal Press, 1999.
  7. Takegoshi K, Tohyama T, Okuda K, et al. A case of Venoplant-induced hepatic injury. Gastroenterol Jpn 1986;21:62-5.
  8. Jaspersen-Schib R, Theus L, Guirguis-Oeschger M, et al. [Serious plant poisonings in Switzerland 1966-1994. Case analysis from the Swiss Toxicology Information Center]. Schweiz Med Wochenschr 1996;126:1085-98.
  9. Popp W, Horak F, Jager S, et al. Horse chestnut (Aesculus hippocastanum) pollen: a frequent cause of allergic sensitization in urban children. Allergy 1992;47:380-3.
  10. Diaz-Perales A, Collada C, Blanco C, et al. Cross-reactions in the latex-fruit syndrome: A relevant role of chitinases but not of complex asparagine-linked glycans. J Allergy Clin Immunol 1999;104:681-7. PubMed
  11. Blanco C, Diaz-Perales A, Collada C, et al. Class I chitinases as potential panallergens involved in the latex-fruit syndrome. J Allergy Clin Immunol 1999;103:507-13. PubMed
  12. Comaish JS, Kersey PJ. Contact dermatitis to extract of horse chestnut (esculin). Contact Dermatitis 1980;6:150-1. PubMed
  13. Pittler MH, Ernst E. Horse chestnut seed extract for chronic venous insufficiency (Cochrane Review). In: The Cochrane Library, Issue 3, 2004. Chichester, UK: John Wiley & Sons, Ltd. PubMed
  14. Ottillinger, B. and Greeske, K. Rational therapy of chronic venous insufficiency--chances and limits of the therapeutic use of horse-chestnut seeds extract. BMC.Cardiovasc.Disord. 2001;1(1):5. PubMed
  15. Pittler, M. H. and Ernst, E. Horse chestnut seed extract for chronic venous insufficiency. Cochrane.Database.Syst.Rev. 2004;(2):CD003230. PubMed
  16. Fang, Y., Zhao, L., Yan, F., Xia, X., Xu, D., and Cui, X. Escin improves sperm quality in male patients with varicocele-associated infertility. Phytomedicine. 2010;17(3-4):192-196. PubMed
  17. De Smet, P. A., Van den Eertwegh, A. J., Lesterhuis, W., and Stricker, B. H. Hepatotoxicity associated with herbal tablets. BMJ 7-13-1996;313(7049):92.
  18. Rehn, D., Unkauf, M., Klein, P., Jost, V., and Lucker, P. W. Comparative clinical efficacy and tolerability of oxerutins and horse chestnut extract in patients with chronic venous insufficiency. Arzneimittelforschung 1996;46(5):483-487.
  19. Edem E, Kahyaoglu B, Çakar MA. Acute Effusive Pericarditis due to Horse Chestnut Consumption. Am J Case Rep. 2016;17:305-8. PubMed
  20. Costa Santos D, Lérias G, Madruga I. Drug-induced Liver Injury Due to a Horse Chestnut Dietary Supplement. Eur J Case Rep Intern Med 2021;8(3):002389. PubMed
  21. Yi HY, Lee JY. Poisoning due to consumption of horse chestnut seed. Clin Exp Emerg Med 2021;8(4):333-335. PubMed

See these in context on the Horse Chestnut monograph →

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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