Aesculus

(pINNM)

💊 Chemical information

Aesculus hippocastanum; Castaño de indias; Hippocastani semen; Horse-chestnut; Marron d’Inde; Rosskastaniensamen.
CAS — 6805-41-0 (aescin); 11072-93-8 ( -aescin); 53175-9 (anhydrous esculoside).

Pharmacopoeias.

In Fr., Ger., It., and US. US also includes the powdered form and powdered extract. Ger. also includes esculoside in the sesquihydrate form.

USP 31

(Horse Chestnut). The dried seeds of Aesculus hippocastanum (Hippocastanaceae), harvested in the autumn. It contains not less than 3.0% of triterpene glycosides, calculated on the dried basis as aescin. Protect from light and moisture.

💊 Profile

The seeds (conkers) and other parts of the horse-chestnut, Aesculus hippocastanum, contain several active principles including esculoside (aesculin or esculin; 6β-D-glucopyranosyloxy-7-hydroxycoumarin, C15H16O9= 340.3) and aescin (escin), which is a mixture of saponins. Ingestion of aesculus may cause nausea, vomiting, diarrhoea, abdominal colic, delirium, and with large doses respiratory arrest. Aescin and esculoside, the major active principles of aesculus, have been used in the prevention and treatment of various peripheral vascular disorders, including haemorrhoids. They have been given by mouth, 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. The maximum intravenous dose in adults for such conditions has been stated to be 20 mg daily; acute renal failure has been reported in patients given higher doses, sometimes with other nephrotoxic drugs. 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 cortex; Aesculus hippocastanum ex cortice; Aesc. hip. Esculoside has been used in homoeopathic medicines under the following names: Aesculinum; Aescul.

Adverse effects.

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.1In 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.
1. Hellberg K, et al. Medikamentös bedingtes post-operatives Nierenversagen nach herzchirurgischen Eingriffen. Thoraxchirurgie 1975; 23: 396–400.
EFFECTS ON THE RESPIRATORY TRACT. Bronchial asthma associated with aescin inhalation has been reported in a worker in the pharmaceutical industry.1
1. Muñoz X, et al. Occupational asthma related to aescin inhalation. Ann Allergy Asthma Immunol 2006; 96: 494–6.
EFFECTS ON THE SKIN. Contact dermatitis1 to aesculin 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.
1. Comaish JS, Kersey PJ. Contact dermatitis to extract of horse chestnut (esculin). Contact Dermatitis 1980; 6: 150–1
2. Escribano MM, et al. Contact urticaria due to aescin. Contact Dermatitis 1997; 37: 233.
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.
1. Nagy M. Human poisoning from horse chestnuts. JAMA 1973; 226: 213.

Uses.

The use of aesculus has been reviewed;1,2 although there is some evidence suggesting benefit in chronic venous insufficiency, more rigorous studies are needed.2
1. Sirtori CR. Aescin: pharmacology, pharmacokinetics and therapeutic profile. Pharmacol Res 2001; 44: 183–93
2. Pittler MH, Ernst E. Horse chestnut seed extract for chronic venous insufficiency. Available in The Cochrane Database of Systematic Reviews; Issu
1. Chichester: John Wiley; 2006 (accessed 31/03/06).

💊 Preparations

Proprietary Preparations

Arg.: Grafic Retard; Herbaccion Venotonico; Nadem; Venastat; Venostasin; Austria: Aesculaforce; Provenen; Reparil; Venosin; Venostasin; Belg.: Reparil; Veinofytol; Venoplant; Braz.: Phytovein; Reparil; Varilise; Venafort; Venostasin†; Zarv; Chile: Venastat; Cz.: Reparil; Traumaril†; Venitan; Yellon; Fr.: Flogencyl; Ger.: Aescorin Forte; Aescorin N†; Aescusan; Aescuven; Concentrin; Essaven; Essaven Neu; Hamos-Tropfen-S†; Heweven Phyto; Hoevenol; Noricaven; Opino; opino N; Perivar Rosskaven†; Plissamur; Proveno N†; Reparil; Rexiluven S†; Sklerovenol N†; Vasoforte N†; Vasotonin†; Venalot novo†; Venen-Dragees†; Venen-Fluid; Venen-Tabletten; Venen-Tropfen N; Venentabs; veno-biomo; Venodura; Venoplant; Venopyronum; Venopyronum N†; Venostasin; Hong Kong: Reparil; Hung.: Venastat; Ital.: Curaven†; Edeven; Flebostasin; Reparil; Mex.: Alevarin; Venastat; Verisan†; Pol.: Aescuven; Esceven; Reparil; Sapoven; Venastat; Venitan; Venoplant; Venotonin; Port.: Varison; Venoparil†; Rus.: Venitan (Венитан); Venoplant (Веноплант); Spain: Flebostasin; Plantivenol; Provenen†; Varicid; Switz.: Aesculaforce; AesculaMed; Phlebostasin; Reparil†; Venavit N; Venostasin; Thai.: Reparil; Turk.: Reparil N; UK: Venaforce; Venez.: Vasoplant. Multi-ingredient: Arg.: Escina Forte; Escina Omega; Esculeol P; Feparil†; Flaval; Grafic Forte; Ixana; Troxeven†; Tubarine; Venoful; Venostasin; VNS 45; Austral.: Bioglan Cirflo†; Bioglan Zellulean with Escin; Extralife LegCare; Herbal Capillary Care†; Proflo†; Austria: Amphodyn; Augentropfen Stulln; Dilaescol; Heparin Comp; Opino; Reparil; Urelium Neu; Venostasin compositum; Belg.: Mictasol-P; Rectovasol; Reparil; Braz.: Castanha de India Composta†; Digestron†; Hemorroidex†; Mirorroidin†; Novarrutina; Proctosan; Reparil; Supositorio Hamamelis Composto†; Traumed†; Varizol†; Venocur Triplex; Venofortan†; Venostasin†; Canad.: Proctol; Proctomyxin HC; Proctosedyl; ratio-Proctosone; Chile: Hemorrol†; Proctoplex; Repariven; Varicare†; Cz.: Anavenol; Evercil†; Heparin-Gel†; OphthalmoEvercil; Reparil-Gel N; Denm.: Proctosedyl; Fin.: Proctosedyl; Fr.: Aphloine P; Arterase; Climaxol; Creme Rap; Escinogel†; Evarose; Hemorrogel; HistoFluine P; Intrait de Marron d’Inde P; Mediflor Tisane Circulation du Sang No 12; Opo-Veinogene; Phlebogel; Phlebosedol†; Phytomelis; Preparation H; Reparil; Sedorrhoide; Veinophytum†; Veinostase; Veinotonyl; Vivene†; Ger.: Aescusan; Amphodyn†; Apoplectal N†; Augentropfen Stulln Mono; Cefasabal; Cycloven Forte N; Diu Venostasin; Essaven N†; Essaven ultra†; Essaven†; Fagorutin Rosskastanien-Balsam N; Hametum-N†; Hamos N†; Heparin Comp†; Heparin Kombi-Gel†; Heusin†; Intradermi; Lindigoa S†; opino N spezial†; PC 30 V; Posti N†; Reparil-Gel N; Revicain comp plus†; Revicain comp†; Salhumin Teilbad N†; Salus Venen Krauter Dragees N†; Solum Ol; Sportupac M; Trauma-cyl; Varicylum-S; Venacton†; Venen Krauter NT; Venen-Salbe N†; Venengel†; Veno-Kattwiga N†; Venoplant AHS†; Weleda Hamorrhoidalzapfchen; Gr.: Opino-jel; Hong Kong: Proctosedyl†; Proctosone†; Reparil; Hung.: Reparil N; India: Proctosedyl; Indon.: Lanaven; Lanaven Plus; Opino; Irl.: Proctosedyl; Ital.: Algorex; Altadrine; Angiovein; Bres†; Capill; Capill Venogel; Centella Complex; Centeril H; Dermocinetic; Dermoprolyn†; Edeven; Essaven; Flavion; Flebo-Si; Flebolider; Flodolor; Flogofort; Flogovis IdroGel; Hirudex†; Inflamase; Inflamase IdroGel; Levital Plus; Muscoril Trauma; Osmogel; Pik Gel; Proctonet†; Proctopure; Proctosedyl; Recto-Reparil; Reparil; RepaVen†; Sedalen Cort†; Sedilene Procto†; Signum; Snell Cell; Somatoline; Varicogel†; Venactive; Venalta; Venoplus†; Venoton; Venotrauma†; Malaysia: Proctosedyl; Proctosone†; Mex.: Almodin; Mon.: Fluon; Norw.: Proctosedyl; Philipp.: Proctosedyl; Pol.: Aesculan; Anavenol; Arcalen; Arnisol; Emorect; Escalar; Fitoven; Hemorol; Neo-Aesculan; Proctosone; Reparil N; Sapoven AT; Sapoven T; Savarix; Venacorn; Venescin; Venoforton; Venozel; Port.: Relmus Compositum†; Synchrocell; Venoparil; Rus.: Aescusan (Эскузан); Anavenol (Анавенол); S.Afr.: Essaven†; Proctosedyl; Reparil; Stibium Comp; Singapore: Erase; Proctosedyl; Spain: Caprofides Hemostatico; Contusin; Essavenon; Feparil; Hemodren Compuesto†; Roidhemo†; Ruscimel†; Urgenin; Venacol; Swed.: Proctosedyl†; Switz.: Augentonicum; Demoven N; Dolo-Veniten†; Flavovenyl; Flogecyl; Ipasin; Lapidar 4; Phlebostasin compositum†; Reparil; Strath Gouttes pour les veines; Suppositoires contre les hemorroides†; Veino-Gouttes-N†; Venoplant comp; Venoplant-N†; Thai.: Essaven; Proctosedyl; Reparil; Veno Gel; Turk.: Prepagel; Venez.: Gelsem.
Published November 14, 2018.