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Aesculus hippocastanum
Horse chestnut is a large tree native to southeastern Europe whose seed extract is one of the best-studied herbal remedies for chronic venous insufficiency. Its primary compound, aescin, has demonstrated anti-inflammatory and venotonic properties. Raw horse chestnuts are toxic; only standardized, processed extracts should be used.
| Drug | Severity | Description |
|---|---|---|
| Warfarin (Coumadin) | moderate | Horse chestnut may have mild anticoagulant properties that increase bleeding risk with warfarin. |
| Lithium | moderate | Horse chestnut's diuretic effects may reduce lithium excretion and increase serum levels. |