Horse chestnut (aescin)
Cochrane-reviewed seed extract for chronic venous insufficiency, comparable to compression stockings for leg oedema and aching.
Why
Horse chestnut (Aesculus hippocastanum) seed extract, standardised to aescin (escin), holds an EMA Well-Established Use monograph for symptomatic treatment of chronic venous insufficiency. The Cochrane review concluded that horse chestnut seed extract is an effective short-term treatment for symptoms of CVI, with effects on leg pain and oedema comparable to compression stockings.
How it works
Aescin inhibits hyaluronidase and elastase activity, sealing venous endothelial pores and reducing transcapillary leakage. Modulates inflammatory cytokine release and has venotonic effect, increasing venous tone. The standardised extract has a sustained-release form that improves tolerability.
Expected onset · Leg pain and heaviness within 2–4 weeks; oedema within 4–8 weeks
How to take
Dosage
Standardised seed extract: 50 mg aescin twice daily (300–600 mg extract twice daily). Sustained-release forms once daily where available.
Timing
Twice daily with food
On the label
Standardised to '50 mg aescin per dose' or '~16% triterpene glycosides'. Named preparations: Venoplant, Venostasin, Aesculaforce.
Ideal for
Adults with chronic venous insufficiency (heavy, aching legs; ankle oedema; nocturnal cramps; varicose vein discomfort).
Safety
Evidence
Cochrane 2012 SR (17 RCTs, n=1,575): horse chestnut seed extract significantly reduced leg pain, leg volume and leg oedema in chronic venous insufficiency vs placebo, with effects comparable to compression stockings in head-to-head trials. EMA classifies the seed extract as Well-Established Use, the highest regulatory tier for a botanical.
- Pittler & Ernst, Cochrane Database Syst Rev 2012, horse chestnut seed extract for chronic venous insufficiency
- EMA HMPC monograph, Aesculus hippocastanum L., semen (Well-Established Use + Traditional Use)
- Ottillinger & Greeske, BMC Cardiovasc Disord 2001, Aesculus hippocastanum extract vs compression therapy in CVI (RCT)
Where to get it
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