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Dietary supplement

Horse Chestnut Extract Ingredients & Drug Interactions

by Integrative Therapeutics

Horse Chestnut Extract label
See full label image
Capsule Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Horse Chestnut Extract 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 Extract is a dietary supplement by Integrative Therapeutics 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 (Aesculus hippocastanum) seed extract. 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 Extract by Integrative Therapeutics

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

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HelloPharmacist Scorecard of Horse Chestnut Extract by Integrative Therapeutics

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: horse chestnut seed extract from Aesculus hippocastanum. The extract has been processed to remove esculin, a toxic compound found in the raw plant.

The capsule itself is made from vegetable polysaccharide, with cellulose, magnesium stearate, and silicon dioxide 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: support circulation of the legs and vascular system.
  • We looked for evidence on: Chronic venous insufficiency (CVI), Postoperative swelling, varicose veins, leg edema.
  • 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 Postoperative swelling.

Horse chestnut extract is possibly effective for chronic venous insufficiency (CVI)—a condition where veins in the legs have trouble returning blood to the heart. The evidence is still limited, which is why the rating is "possibly" rather than "definitely." For other uses listed—hemorrhoids, irritable bowel syndrome, and kidney stones—there isn't enough reliable evidence yet to know 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.

Properly processed horse chestnut seed extract (with the toxic esculin removed) is generally well tolerated when taken by mouth. The most common side effects reported are dizziness, stomach upset, headache, and itching.

Raw plant parts are toxic and should be avoided. There's one case report of heart inflammation (pericardial tamponade) in someone who consumed large amounts of horse chestnut paste over several weeks, though a direct cause wasn't certain.

Calf spasms have also been reported in people taking the extract for venous insufficiency. Pregnancy and breastfeeding: The safety data advises against using this supplement during pregnancy or while breastfeeding.

There isn't enough information to know whether it's safe in these situations.

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.

Before you start this product, double-check with your doctor or pharmacist if you take any blood thinners or antiplatelet drugs—these include medications like warfarin, apixaban, dabigatran, rivaroxaban, clopidogrel, prasugrel, ticagrelor, or aspirin. The interaction is Moderate severity, and the combination could raise your bleeding risk.

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.

If you have chronic venous insufficiency and are not on blood thinners, horse chestnut extract may be worth discussing with your doctor. If you take any anticoagulant or antiplatelet medication—whether prescription or over-the-counter—you'll need to check with your own doctor or pharmacist before adding this supplement, because it could increase your bleeding risk.

Pregnant or breastfeeding? This one isn't recommended.

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 Jul 25, 2013.

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 Extract, straight from the product label.

Brand Integrative Therapeutics
Barcode (UPC) 871791004078
Net contents 60 Veg Capsule(s)
Market status On market
Date entered into DSLD Jul 25, 2013
DSLD ID 24086
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegetarian, Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar 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 Extract by Integrative Therapeutics, 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:
1 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
UPC/BARCODE
871791004078
IngredientAmount% DV
Horse Chestnut (Aesculus hippocastanum) seed extract250 mg--

Other ingredients: Vegetable Polysaccharide Capsule, Cellulose, Magnesium Stearate, Silicon Dioxide

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

Horse chestnut extract is widely used to support circulatory health and is standardized to contain 20% triterpene glycosides calculated as escin, just like the extracts used in the European clinical studies. Escin has been shown to decrease capillary permeability by reducing the number and size of the pores, which improves tone. Horse Chestnut Extract also includes a number of other valuable compounds for vascular health, such as flavonoids amd sterols.

EVIDENCE-BASED

Supports circulation of the legs and vascular system

This product contains natural ingredients; color variations are normal.

Seals/Symbols

VEGETARIAN

General

LI79906.A02

FDA Disclaimer Statement

THIS STATEMENT HAS NOT BEEN EVALUATED BY THE FOOD AND DRUG ADMINISTRATION. THIS PRODUCT IS NOT INTENDED TO DIAGNOSE, TREAT, CURE, OR PREVENT ANY DISEASE.

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Recommendations: Take 1 capsule in the morning and evening.

Precautions

If pregnant, nursing, or taking prescription drugs, consult your healthcare practitioner prior to use.

Formulation

Contains no sugar, salt, yeast, wheat, gluten, corn, soy, dairy products, artificial coloring, artificial flavoring, preservatives, or ingredients of animal origin.

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

See for yourself

Horse Chestnut Extract by Integrative Therapeutics label

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

Horse Chestnut Extract 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 Extract by Integrative Therapeutics

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

Serving size1 Capsule(s) Dosage formCapsule Amounts shown are per serving.

Horse Chestnut (Aesculus hippocastanum) seed extract

Interacts with
122 drugs
250 mg per serving Form: Triterpene Glycosides

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 (Aesculus hippocastanum) seed extract monograph & interactions

Other (inactive) ingredients: Vegetable Polysaccharide Capsule, Cellulose, Magnesium Stearate, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.

Interaction report

Horse Chestnut Extract by Integrative Therapeutics Drug Interactions

Want to check YOUR meds against Horse Chestnut Extract?

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.

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122Drugs
122 Moderate

Ingredients driving the most interactions

Horse Chestnut (Aesculus hippocastanum) seed extract 122

Individual Drug Interactions

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

1 of the 1 ingredient in Horse Chestnut Extract interact with drugs. Each result below shows which ingredient is responsible. Horse Chestnut (Aesculus hippocastanum) seed extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Horse Chestnut Extract 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 (Aesculus hippocastanum) seed extract1 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 (Aesculus hippocastanum) seed extract full monograph & interactions
The maker

Brand information

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

Integrative Therapeutics

See all Integrative Therapeutics products
Name
Integrative Therapeutics, Inc.
City
Green Bay
State
WI
ZipCode
54311
Phone Number
1.800.931.1709
Web Address
www.integrativeinc.com
Pharmacist Counseling Corner

Horse Chestnut Extract by Integrative Therapeutics: Common Questions

Does Horse Chestnut Extract by Integrative Therapeutics interact with any medications?
Yes. Based on its ingredients, Horse Chestnut Extract 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 Extract 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.
What is horse chestnut extract used for?
Horse chestnut extract is possibly effective for chronic venous insufficiency (CVI), a condition where the veins in your legs have trouble returning blood to your heart. For other uses like hemorrhoids or irritable bowel syndrome, there isn't enough evidence yet to know if it works.
Are there any common side effects I should know about?
The most common side effects from the processed seed extract are dizziness, stomach upset, headache, and itching. These tend to be mild, though a thorough safety study hasn't been done. Raw horse chestnut plant parts are toxic and should never be used.
Is this safe during pregnancy or while breastfeeding?
No. The safety data advises against using horse chestnut extract during pregnancy or while breastfeeding. There isn't enough information to know whether it's safe in these situations, so talk with your doctor or pharmacist for personalized advice.
Why do I need to be careful if I'm on a blood thinner?
Horse chestnut contains a compound called esculin that can thin the blood slightly. If you're already taking a blood thinner or antiplatelet drug, adding horse chestnut could increase your bleeding risk. Always check with your doctor or pharmacist before combining them.
What makes this supplement different from raw horse chestnut?
This product uses a processed seed extract that has had esculin, a toxic compound, removed. Raw horse chestnut plant parts are toxic and can cause serious stomach and kidney damage—that's why only the properly processed extract should be used.

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 Extract label
Go deeper

The Full Monographs Behind Horse Chestnut Extract’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 Extract'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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