Pregnancy Use

Safety in pregnancy and lactation has not been well established. PRACTICE POINTS/PATIENT COUNSELLING

• Horse chestnut extract has been extensively researched for its beneficial effects and is commonly used by general practitioners in Germany for the treatment of CVI. There is strong evidence to support its use for this indication.

• In practice, a dry extract is used (HCSE standardised to contain 16-21 % triterpene glycosides (anhydrous escin)).

• HSCE is also used for venous leg ulceration because it increases venous tone while reducing venous fragility and capillary permeability, and possesses anti-oedema-tous and anti-inflammatory properties.

• HSCE is also used in the treatment of haemorrhoids. Although it has not been investigated for this indication, escin has been shown to significantly improve signs and symptoms under double-blind study conditions.

• HSCE is well tolerated with only mild, infrequent reports of adverse reactions including gastric irritation, skin irritation, dizziness, nausea, headache and pruritis.

• Horse chestnut can cause hypersensitivity reactions, which occur more commonly in people who are allergic to latex.

ANSWERS TO PATIENTS' FREQUENTLY ASKED QUESTIONS

What will this herb do for me?

Horse chestnut standardised extract (HSCE) will relieve signs and symptoms of chronic venous insufficiency such as pain, pruritis and oedema. It may also be of benefit in

alleviating signs and symptoms in people with haemorrhoids and has been used in venous leg ulceration. When will it start to work?

Beneficial effects in chronic venous insufficiency have been reported within 3-6 weeks; however, 12 weeks may be required in some cases. Escin provided symptom relief in haemorrhoids after 6 days of treatment. Are there any safety issues?

HSCE is well tolerated with only mild, infrequent reports of adverse reactions including gastric irritation, skin irritation, dizziness, nausea, headache and pruritis. It can cause hypersensitivity reactions, which occur more commonly in people who are allergic to latex.

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