Aescin

Uses and Administration

The seeds ( conkers ) and other parts of the horse-chestnut,Aesculus hippocastanum, contain several active principles including esculoside ( aesculin or esculin ; 6-β- D -glucopyranosyloxy-7-hydroxycoumarin , C15H16O9 = 340.3) and aescin ( escin ), which is a mixture of saponins.

Aescin and esculoside, the major active principles of aesculus, have been used in the prevention and treatment of various peripheral vascular disorders, including haemorrhoids ( Refer to ). They have been given orally, by intravenous injection (in the form of sodium aescinate ), by rectal suppository, and applied topically. Aescin has also been given intravenously in the prevention and treatment of postoperative oedema.

Other derivatives such as sodium aescin polysulfate have also been used.

Homoeopathy

Aesculus has been used in homoeopathic medicines under the following names: Aesculus hippocastanum ; Aesculus hipp ; Aesculus cortex ; Aesculus hippocastanum ex cortice ; Aesc. hip. ; Aesculus hippocastanum, flos ; Aesculus hipp, flos .

Related plants are also used in homoeopathic medicines under the following names: Aesculus carnea, flos ; Aesculus glabra ; Aesculus glab .

Esculoside has been used in homoeopathic medicines under the following names: Aesculinum ; Aescul.

(last reviewed 2010-09-02; last modified 2012-02-08)

General references.

(last reviewed 2010-09-02; last modified 2010-05-10)

References

1. WHO. Semen Hippocastani.WHO Monographs on Selected Medicinal Plants, volume 2. Geneva: WHO, 2004. Also available at: Link (accessed 04/02/10)

The use of aesculus has been reviewed;1-3although there is some evidence suggesting benefit in chronic venous insufficiency, more rigorous studies are needed.2

(last reviewed 2010-09-02; last modified 2010-05-10)

References

1. Sirtori CR. Aescin: pharmacology, pharmacokinetics and therapeutic profile.Pharmacol Res. 2001; 44: 183–93. PubMed

2. Pittler MH, Ernst E. Horse chestnut seed extract for chronic venous insufficiency. Available in The Cochrane Database of Systematic Reviews; Issue 1. Chichester: John Wiley; 2006 (accessed 31/03/06). PubMed

3. Anonymous. Aesculus hippocastanum (Horse chestnut).Altern Med Rev. 2009; 14: 278–83. PubMed

Adverse Reactions

Ingestion of aesculus may cause nausea, vomiting, diarrhoea, abdominal colic, delirium, and with large doses respiratory arrest (but see under Poisoning, Refer to ).

(last reviewed 2010-09-02; last modified 2010-05-10)

Effects on the kidneys

A report of the incidence of acute renal failure in patients after cardiac surgery and implicating high-dose intravenous aescin therapy.1 In 70 patients given a mean maximum daily dose of 340 micrograms/kg, no alteration of renal function was seen; in 16 receiving 360 micrograms/kg, mild renal impairment occurred; and in 40 given 510 micrograms/kg, acute renal failure developed.

(last reviewed 2010-09-02; last modified 2010-05-26)

References

1. Hellberg K, et al.. Medikamentös bedingtes post-operatives Nierenversagen nach herzchirurgischen Eingriffen.Thoraxchirurgie. 1975; 23: 396–400. PubMed

Effects on the respiratory tract

Bronchial asthma associated with aescin inhalation has been reported in a worker in the pharmaceutical industry.1

(last reviewed 2010-09-02; last modified 2010-05-10)

References

1. Muñoz X, et al.. Occupational asthma related to aescin inhalation.Ann Allergy Asthma Immunol. 2006; 96: 494–6. PubMed

Effects on the skin

Contact dermatitis1 to esculoside and contact urticaria2 to aescin have been reported after the use of topical preparations that contained these extracts. Both reactions were confirmed by positive skin tests.

(last reviewed 2010-09-02; last modified 2010-05-10)

References

1. Comaish JS, Kersey PJ. Contact dermatitis to extract of horse chestnut (esculin).Contact Dermatitis. 1980; 6: 150–1. PubMed

2. Escribano MM, et al.. Contact urticaria due to aescin.Contact Dermatitis. 1997; 37: 233. PubMed

Poisoning

There have been reports of poisoning in children from eating the seeds, or drinking infusions made from the leaves and twigs of horse-chestnut trees.1 The toxic substance is considered to be esculoside. Symptoms of poisoning were muscle twitching, weakness, lack of coordination, dilated pupils, vomiting, diarrhoea, paralysis, and stupor.

The UK National Poisons Information Service considers, however, that given the bitterness of the seeds and the poor gastrointestinal absorption of esculoside, significant poisoning is unlikely.

(last reviewed 2010-09-02; last modified 2011-01-02)

References

1. Nagy M. Human poisoning from horse chestnuts.JAMA. 1973; 226: 213.

Preparations: Single-Ingredient

The following preparations list represents a compilation of all available salt forms or related substances for this drug product.

The symbol ¤ denotes a preparation which is discontinued or no longer actively marketed.

ARGENTINA: Grafic Retard; Herbaccion Venotonico; Nadem; Venastat; Venostasin;AUSTRALIA: Tecura¤;AUSTRIA: Aesculaforce¤; Provenen¤; Reparil¤; Reparil; Traumaparil¤; Venoplant¤; Venosin¤; Venosin; Venostasin;BELGIUM: Reparil¤; Reparil; Traumatil¤; Veinofytol; Venoplant¤;BRAZIL: Phytovein¤; Reparil; Reparil; Varilise; Venafort¤; Venocaps; Venocur Fit; Venostasin¤; Venotac¤; Zarv¤;CANADA: Venaforce;CHILE: Venastat¤;CHINA: Ai Xin Ke (艾辛可); Mai Tong Na (麦通纳); Ou Kai (欧开);CZECH REPUBLIC: Reparil; Traumaril¤; Venitan¤; Yellon¤;FINLAND: Venaforce¤;FRANCE: Flogencyl; Hemorrogel¤; Reparil¤;GERMANY: Aescorin Forte; Aescorin N¤; Aescusan; Aescuven; Concentrin¤; Essaven Mono¤; Essaven Neu¤; Essaven¤; Hamos-Tropfen-S¤; Heweven Phyto¤; Hoevenol¤; Noricaven¤; opino N¤; Opino¤; Perivar Rosskaven¤; Plissamur; Proveno N¤; Reparil¤; Reparil; Rexiluven S¤; Sanaven Venentabletten¤; Sklerovenol N¤; Vasoforte N¤; Vasotonin¤; Venalot¤; Venen-Dragees¤; Venen-Fluid¤; Venen-Tabletten¤; Venen-Tropfen N¤; Venen-Tropfen¤; Venentabs¤; veno-biomo¤; Venodura¤; Venogal¤; Venoplant plus¤; Venoplant¤; Venoplant; Venopyronum N¤; Venopyronum¤; Venorutin retard Rosskastanie¤; Venostasin¤; Venotrulan N¤;HONG KONG: Reparil; Venatan;HUNGARY: Venastat;IRELAND: Venaforce;ITALY: Curaven¤; Edeven¤; Edevexin; Flebostasin; Ginoven; Reparil¤; Reparilexin; Venoplant¤;MALAYSIA: Reparil;MEXICO: Alevarin; Flebo Vich; Flebocaps; Fluxine¤; Venastat; Verisan¤;NORWAY: Venastat¤;POLAND: Aescuven¤; Esceven; Hiposem; Reparil; Sapoven; Venastat¤; Venitan; Venoplant¤; Venotonin;PORTUGAL: Varison¤; Venoparil¤; Venotop;RUSSIAN FEDERATION: Escizane (Эсцизан); Rectaktiv (Ректактив); Venitan (Венитан); Venoplant (Веноплант);SOUTH AFRICA: Reparil¤;SPAIN: Fepalitan¤; Feparil¤; Flebostasin; Plantivenol¤; Provenen¤; Thrombescina; Varicid¤;SWEDEN: Venastat;SWITZERLAND: Aesculaforce; AesculaMed; Bio-Venaphyt¤; Phlebostasin; Phytopharma Vennen; Reparil¤; Sanhelios Venen¤; Venastat¤; Venavit N; Venostasin;THAILAND: Reparil¤; Reparil;TURKEY: Reparil; Venotrex;UNITED KINGDOM: Venaforce;UKRAINE: Aescusan (Эскузан); Aescuven (Эскувен); Aesplant (Эсплант); Eskuvit (Эскувит); Venitan (Венитан); Venoplant (Веноплант);VENEZUELA: Vasoplant; Venastat;

Preparations: Multi-Ingredient

The following preparations list represents a compilation of all available salt forms or related substances for this drug product.

The symbol ¤ denotes a preparation which is discontinued or no longer actively marketed.

ARGENTINA: CVP Cellulite¤; Escina Forte; Escina Omega; Esculeol P; Feparil¤; Flaval Duo; Flaval; Gel Fitotonico; Grafic Forte; Troxeven; Tubarine; Venofix¤; Venoful; Venostasin; Venostasin; VNS 45;AUSTRALIA: Aesculus & Ruscus Compound¤; Bioglan Fingers & Toes¤; Cirflo¤; Extralife Leg-Care¤; Herbal Capillary Care¤; Horsechestnut Complex; Proflo¤; Sleep Remedy; Vein Relief¤; Zellulean with Escin¤;AUSTRIA: Aesrutan¤; Alpha-Apoplectal¤; Amphodyn¤; Apoplectal¤; Augentropfen Stulln¤; Dilaescol¤; Heparin Comp¤; Opino¤; Reparil; Sandoven¤; Urelium Neu¤; Venosin¤; Venostasin compositum¤;BELGIUM: Hemocoavit¤; Mictasol-P¤; Paracodine¤; Rectovasol¤; Reparil;BRAZIL: Castanha de India Composta¤; Digestron¤; Geloril¤; Hematon; Hemoaenus¤; Hemorroidex¤; Hemorrol¤; Hemosan¤; Hemovirtus; Mirorroidin¤; Novaboin¤; Novarrutina; Proctosan; Reparil; Reparil; Supositorio Hamamelis Composto¤; Traumed¤; Varizin¤; Varizol¤; Venocur Triplex; Venofortan¤; Venostasin Composto¤; Venostasin¤;CANADA: Cir; Circulate-Me; Circulex; Freedhem; Marro-Dausse¤; Pommade Midy¤; Proctol; Proctomyxin HC; Proctosedyl; Teva-Proctosone; Varicare; Varicomfort; Varicose Vein Comfort; Varicosin; Varivein;CHILE: Hemorrol¤; Proctoplex; Repariven; Varicare¤; Venoscool;CHINA: Ou Lai (欧莱); Reparil-Gel N (利百素凝胶); Stulln (施图伦);CZECH REPUBLIC: Anavenol¤; Evercil¤; Heparin-Gel¤; Ophthalmo-Evercil; Reparil-Gel N;DENMARK: Proctosedyl;FINLAND: Proctosedyl;FRANCE: Actisane Hemorroides, Jambes Lourdes¤; Anti-Hemorroidaires¤; Aphloine P¤; Arterase¤; Bioveinal¤; Cepevit¤; Circularine¤; Climaxol; Curoveinyl¤; Escino¤; Escinogel¤; Essavene¤; Evarose¤; Fluxival¤; Fragonal¤; Hemoluol¤; Hemorrogel¤; Histo-Fluine P; Hyalurectal¤; Intrait de Marron d'Inde P; Iodone Robin¤; Ondascora¤; Opo-Veinogene¤; P. Veinos¤; Pelvimag; Phlebocreme; Phlebogel¤; Phlebosedol¤; Phlebosup; Phytomelis; Pommade Midy¤; Preparation H¤; Rap Phyto; Rap Phyto; Reparil; Sedorrhoide; Suppositoires Midy¤; Veinophytum¤; Veinostase; Veinotonyl¤; Vivene¤;GERMANY: Aescorin N¤; Aescorin¤; Aescosulf N-percutan¤; Aescusan¤; Alpha-Apoplectal¤; Amphodyn¤; Apoplectal N¤; Arnika plus¤; Augentropfen Stulln Mono; Bayrovas¤; Bryonia-Strath¤; Carito¤; Cefadysbasin N¤; Cefadysbasin¤; Cefasabal¤; Clemenzil¤; Comforte¤; Cycloven Forte N¤; Demoplas comp¤; Demoplas¤; Diu Venostasin¤; Dr. Grandel's Venen Tonikum¤; Duoform¤; Enziagil-Plus¤; Essaven 50 000¤; Essaven N¤; Essaven ultra¤; Essaven¤; Fagorutin Rosskastanien-Balsam N¤; Fortivenat¤; Galleb forte¤; Ger N in der Ophtiole¤; Hametum-N¤; Hamoagil¤; Hamos N¤; Haven¤; Heparin Comp¤; Heparin Kombi-Gel¤; Heusin¤; Heweven P 3¤; Heweven P 7¤; Hoevenol A¤; Hoevenol¤; Intradermi Fluid N¤; Intradermi¤; Jatamansin¤; Jossathromb¤; JuPhlebon S¤; Lindigoa S¤; Localithromb¤; Mastu NH¤; Maudor¤; Medivarsin¤; Neuro-Demoplas¤; Nicoplectal¤; Oculoton¤; opino heparinoid¤; opino N spezial¤; Ostochont¤; Panturon-Extern¤; Pascovenol novo¤; Pascovenol S¤; PC 30 V; Pe-Ce Ven N¤; Pentavenon¤; Phlebex¤; Phlogase¤; Posti N¤; Praecivenin¤; Prostavigol¤; Protitis¤; Proveno¤; Ratanhia comp¤; Rectosellan¤; Reparil-Gel N; Rephastasan¤; Revicain comp plus¤; Revicain comp¤; Rheumex¤; RR-plus¤; Salhumin Teilbad N¤; Salus Venen Krauter Dragees N¤; Schnupfencreme; Solum Ol; Spondylon B¤; Spondylon¤; Sportupac M¤; Tamposit¤; Trauma-cyl¤; Urol¤; varico sanol Beincreme¤; varico sanol forte¤; Varicylum-S¤; Varicylum¤; Vascleran¤; Vasesana-Vasoregulans¤; Vasoforte¤; Vasotonin forte-Serol¤; Vasotonin forte¤; Vasotonin S¤; Vasotonin Serol¤; Venacton¤; Venalitan¤; Venen Krauter NT¤; Venen-Salbe N¤; Venen-Salbe¤; Venengel¤; Veno-Kattwiga N¤; Venocux¤; Venodrag¤; Venoplant AHS¤; Venoplant¤; Venopyronum N triplex¤; Venopyronum¤; Venothromb¤; Venotrulan Compositum¤; Weleda Hamorrhoidalzapfchen;GREECE: Opino¤;HONG KONG: Bentpla; Chiau Son Hemo; Cycloven; Essaven¤; Fip Hemo; Lonaderm; Pohepil; Proctosedyl¤; Proctosone¤; Protozone¤; Redema; Reparil; Roidhemo¤; Signature Hemo Ointment; Thrombosin; Trodakin;HUNGARY: Aranyer Elleni¤; Carvasculini; Reparil; Venen;INDIA: Proctosedyl;INDONESIA: Cebelia LCE Balm; Lanaven Plus¤; Lanaven; Opino¤;IRELAND: Proctosedyl;ITALY: Algorex; Altadrine; Angiovein; Binfolipase¤; Binfonorm¤; Blogofort¤; Bres¤; Capill Venogel; Capill; Castindia¤; Centella Complex; Centella Complex; Centeril H; Centeril H; Clebolider¤; Criotonal; Dermocinetic; Dermoprolyn¤; Edeven; Elisir Depurativo Ambrosiano¤; Enatus; Essaven; Flavion; Flavion; Flebo-Si¤; Flebolider; Flebovis materna; Flebozin; Flodolor; Flogofort Cremagel; Flogofort; Flogovis IdroGel; Flogovis; Gefion; Ginkgo Plus¤; Hirudex¤; Inflamase IdroGel; Inflamase; Levital Plus; Lik-Gel¤; Linfonorm Cremagel; Liotontrauma; Muscoril Trauma; Nitesco Smagliature¤; Opino¤; Osmogel; Osteolip Crema; Pik Gel; Plogovis¤; Pomata Midy HC¤; Pomata Midy¤; Premium¤; Proctena¤; Proctonet¤; Proctopure; Proctosedyl; Proctosedyl; Recto-Reparil; Reparil CM; Reparil¤; RepaVen¤; Sandoven¤; Sedalen Cort¤; Sedilene Procto¤; Sidenol; Signum; Snell Cell¤; Somatoline; Supposte Midy¤; Tioscina¤; Tractoven¤; Varicogel¤; Vasotonal; Venactive¤; Venalta; Venoplant¤; Venoplant; Venoplus¤; Venoton; Venotrauma¤; Venovit¤; Wasotonal¤; Zeta-Bat¤;MALAYSIA: Cefasabal; Proctosedyl; Proctosone¤; Reparil-N;MEXICO: Almodin; Goicotabs; Hemoflam; Varicyl; Variflam; Verisan Triplex;MONACO: Fluon+; Fluon¤; Phytospray;NETHERLANDS: Hametum¤; Venoplant¤;NORWAY: Proctosedyl;PHILIPPINES: Proctosedyl; Reparil N;POLAND: Aesculan; Anavenol¤; Arcalen; Arnisol¤; Emorect¤; Escalar; Esceven; Fitoven¤; Hemorol; Neo-Aesculan¤; Niverosin; Proctosone¤; Proktosedon; Rektovit¤; Reparil N; Sapoven AT¤; Sapoven T; Savarix; Venacorn¤; Venescin Forte¤; Venescin¤; Venoforton; Venozel;PORTUGAL: Bio-Strath No 1¤; Emopads¤; Relmus Compositum¤; Synchrocell¤; Venoparil;RUSSIAN FEDERATION: Aescusan (Эскузан); Anavenol (Анавенол)¤; Angionorm (Анигонорм); Dr Theiss Venen (Доктор Тайсс Венен); Evalar (Эвалар); Herbion Aesculus (Гербион Эскулюс); Proctosedyl (Проктоседил); Proctosedyl M (Проктоседил М); Reparil-Gel N (Репарил-Гель Н); Venabos (Венабос); Venitan Forte (Венитан Форте);SOUTH AFRICA: Essaven¤; Proctosedyl¤; Reparil; Sandovene¤; Stibium Comp¤;SINGAPORE: Erase; Proctosedyl; Reparil-Gel N; Vendep Emulgel; Vendep;SPAIN: Blanc Tonico¤; Caprofides Hemostatico¤; Circovenil Fuerte¤; Circovenil¤; Contusin¤; Essavenon¤; Feparil; Flebo Stop¤; Hemodren Compuesto¤; Hemorroidina¤; Killpan¤; Liviane Compuesto¤; Prever¤; Roidhemo¤; Ruscimel¤; Urgenin¤; Venacol¤; Venoplant¤;SWEDEN: Proctosedyl¤; Reparil N;SWITZERLAND: Amphodyn special¤; Augentonicum; Demoven N¤; Dolo-Veniten¤; DUL-X cool Wallwurz comp; Flavovenyl¤; Flavovenyl; Flogecyl¤; Hametum-N¤; Ipasin¤; Lapidar 4¤; Optazine¤; PC 30 V; Phlebostasin compositum¤; Proctosedyl¤; Reparil N; Reparil¤; Ruvenas¤; Sandovene f¤; Strath Gouttes pour les veines¤; Veino-Gouttes-N¤; Venaphyt N¤; Venoplant comp¤; Venoplant-N¤; Venostasin comp¤; Weleda Hamorrhoidal-Suppositorien;THAILAND: Essaven; Reparil; Veno-Gel¤;TURKEY: Prepagel;UKRAINE: Aescusan (Эскузан); Cardiophit (Кардиофит); Eskuvit (Эскувит); Fitoval Lotion (Фитовал Лосьон)¤; Herbion Aesculus (Гербион Эскулус)¤; Proctosedyl (Проктоседил); Ravisol (Рависол); Reparil-Gel N (Репарил-Гель Н); Venen Theiss (Венен Тайсс); Venitan Forte (Венитан); Venoda (Венода); Venosan (Веносан); Venoton (Венотон);UNITED STATES: Bioflex; Flexgen;VENEZUELA: Gelsem;

Last Updated 1/21/20