Adverse Reactions

According to clinical trials A. hippocastanum and HCSE appear to be well tolerated with only mild, infrequent reports of adverse reactions including gastric irritation, skin irritation, dizziness, nausea, headache and pruritus. Post marketing surveillance reports adverse effects of 0.7% (Micromedex 2003, NMCD 2006, PDRHealth 2006, Pittler & Ernst 2004, Siebert et al 2002).

Horse chestnut contains a toxic glycoside esculin (aesculin), a hydroxycoumarin that may increase bleeding time because of its antithrombin activity and may be lethal when the raw seeds, bark, flower or leaves are used orally. Poisoning has been reported from children drinking tea made with twigs and leaves (NMCD 2006).

Symptoms of overdose include diarrhoea, vomiting, reddening of the face, severe thirst, muscle twitching, weakness, loss of coordination, visual disturbances, enlarged pupils, depression, paralysis, stupor and loss of consciousness (NMCD 2006, PDRHealth 2006).

Horse chestnut can also cause hypersensitivity reactions, which occur more commonly in people who are allergic to latex (Diaz-Perales et al 1999).

Isolated cases of kidney and liver toxicity have occurred after intravenous and intramuscular administration (Micromedex 2003, Mills & Bone 2005, NMCD 2006).

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