Interactions on record — worth a quick check against your medications. Check your meds →
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 certified organic Horse Chestnut. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

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.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
Prefer a human? Send your question to our licensed pharmacists — free, answered by email within 24 hours.

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 Aug 6, 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: certified organic horse chestnut seed extract in liquid form. The extract has been processed to remove esculin, the toxic compound found in raw plant parts, which makes the supplement safer for oral use.

The liquid is made with vegetable palm glycerin, pharmaceutical-grade alcohol, and artesian Hawaiian purified water as inactive ingredients.

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: leg circulation and vein health.
  • 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 is possibly effective for chronic venous insufficiency (CVI) — the condition where veins have trouble returning blood from the legs, causing swelling and discomfort. The evidence isn't strong enough yet to rate it effective, but human studies suggest it may help.

For hemorrhoids, irritable bowel syndrome, and kidney stones, we don't have enough reliable evidence to say whether it works or not.

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.

When the extract is properly processed (with esculin removed), it's generally well tolerated by mouth. The most common side effects from the extract are dizziness, upset stomach, headache, and itching.

Raw or unprocessed horse chestnut parts are toxic and should never be used. Because there isn't enough safety data, horse chestnut should be avoided during pregnancy and while breastfeeding — talk to your doctor or pharmacist if you're pregnant, trying to become pregnant, or nursing.

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 your medications against this product if you take any anticoagulant or antiplatelet drug — blood thinners like warfarin, apixaban, rivaroxaban, or dabigatran, and antiplatelet drugs like aspirin, clopidogrel, or ticlopidine. The risk of increased bleeding is Moderate.

Use the medication checker on this page and confirm with your own doctor or pharmacist before combining.

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 leg swelling from chronic venous insufficiency, but it's not a first-line choice and the evidence is modest. If you take any blood thinner or antiplatelet medication, check with your doctor or pharmacist before starting — the bleeding risk is real, even if uncommon.

Pregnant or breastfeeding? Skip it.

Anyone else should confirm their medications are clear first.

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 Oct 23, 2020.

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) 650905460012
Net contents 4 Fluid Ounce(s); 120 mL
Market status On market
Date entered into DSLD Oct 23, 2020
DSLD ID 237279
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
650905460012
IngredientAmount% DV
certified organic Horse Chestnut970 mg--

Other ingredients: Vegetable Palm Glycerin, pharmaceutical grade Alcohol, artesian Hawaiian purified Water

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.
General Statements

Hawaii Pharm Herbal Extract Highest quality since 2008

Made with Aloha!

Formulation

Contains no GMO, gluten, artificial colors, heavy metals, preservatives, pesticides, fertilizers.

Super concentrated liquid herbal extract. Dry herb/menstruum ratio: 1:3.

Manufactured in an FDA registered facility.

Non GMO Gluten free

Made in USA, Hawaii

Suggested/Recommended/Usage/Directions

Directions for use: Shake well before using. Take about 20-30 drops (0.7-1 ml, one full squeeze of the dropper bulb) to 2-4 oz of juice or water up to 4 times per day.

Precautions

Warning: Keep out of the reach of children.

May have contraindications. We recommend to seek expert medical advice before taking.

Do not use if you are allergic to any ingredients.

Consult a physician before using during pregnancy, if nursing or taking any medications.

Do not use if seal is broken or missing.

Storage

Store in a cool dry place.

Formula

(Aesculus hippocastanum)

FDA Statement of Identity

Herbal Dietary Supplement

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Seals/Symbols

FDA Registered Facility Made in United States of America USA

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.

Certified organic Horse Chestnut

Interacts with
122 drugs
970 mg per serving

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

Certified organic Horse Chestnut monograph & interactions

Other (inactive) ingredients: Vegetable Palm Glycerin, Pharmaceutical grade Alcohol, Artesian Hawaiian purified Water. 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

certified organic Horse Chestnut 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. certified organic Horse Chestnut

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.

certified organic Horse Chestnut1 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
certified organic Horse Chestnut 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
City
Honolulu
State
HI
ZipCode
96815
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.
Can I take horse chestnut if I'm pregnant or breastfeeding?
No. There isn't enough safety data to know if it's safe during pregnancy, so it should be avoided. The same goes for breastfeeding. If you're pregnant, trying to conceive, or nursing, talk to your doctor or pharmacist before taking any new supplement.
What are the side effects?
The most common ones from the extract are dizziness, stomach upset, headache, and itching. Serious side effects are rare with properly processed extract, but raw or unprocessed horse chestnut can be toxic and cause severe stomach problems and kidney damage.
What does horse chestnut actually do?
The evidence shows it may help with chronic venous insufficiency — the swelling and discomfort that happens when leg veins struggle to pump blood back up. For other uses like hemorrhoids or IBS, we don't have enough reliable evidence to say it works.
Why does this product interact with blood thinners?
Horse chestnut contains a compound called esculin that can thin blood or reduce clotting in lab tests. If you're already on a blood thinner, the combination might raise your bleeding risk. It hasn't been proven in human studies, but the caution is warranted.
Is this extract safe compared to raw horse chestnut?
Yes — this product's extract has been processed to remove esculin, the toxic part of the plant. Raw or unprocessed horse chestnut is toxic and should never be taken by mouth. The processed extract is much safer, though side effects and interactions are still possible.
How do I know if my blood thinner will interact with this?
Use the medication checker on this page with your exact medication name. Common blood thinners and antiplatelet drugs do interact with horse chestnut. If you're unsure, ask your pharmacist or doctor — don't start the supplement without checking first.

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

Not sure if Horse Chestnut is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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

Keep exploring
Supplement interaction checker › Check any supplement or product against your medications Drug–drug interactions › Check two or more of your medications against each other Browse medications A–Z › Every drug we've checked against herbs & supplements NDC & pricing lookup › Find a drug’s NDCs, packaging and costs Ask a pharmacist › Free, personal answer from our licensed team