Preparati

Currently, horse chestnut seed extract (HCSE) is widely used in Europe for chronic venous insufficiency, hemorrhoids, post-operative edema, and topically for clearing skin conditions. In the United States, HCSE is
gaining wider acceptance as an effective therapy for venous disorders and edema, based on the publication over the last two decades of numerous randomized controlled trials in prominent, peer-reviewed journals.

BILJNI PREPARATI DIVLJEG KESTENA: 

TINKTURA – hidroetanolni tečni ekstrakt sušenih delova biljke, DIVLJI KESTEN HSS, DER 1:5  i

MATIČNA TINKTURA – hidroetanolni tečni ekstrakt svežih delova biljke, DIVLJI KESTEN TM, DER 1:2. 

Tinctura Hippocastani DER 1:5

Hippocastani semen recentis extractum ethanolicum liquidum DER 1:2

Hippocastani floris recentis extractum ethanolicum liquidum  DER 1:1

 

ATC: 

C05BZ09 vazoprotektori, anivarikotici,

C05CA07 vazoprotektori, stabilizatori kapilara, bioflavonoidi

C05CX03 vazoprotektori, stabilizatori kapilara, Hippocastani semen,

 

U skladu sa:

1.) Eu. Ph. 01/2005 monografijom: 

2.) Based on Article 10a of Directive 2001/83/EC as amended (well-established use),

Based on Article 16d(1), Article 16f and Article 16h of Directive 2001/83/EC as amended (traditional use), DIRECTIVE 2004/24/EC OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL of 31 March 2004.

3.) EMA/HMPC/225319/2008 Committee on Herbal Medicinal Products (HMPC) od 16 jula 2009:
Community herbal monograph on Aesculus Hippocastanum, semen

4.) EMA/HMPC/225304/2008 Committee on Herbal Medicinal Products (HMPC) od 16 jula 2009:
Assessment report on Aesculus Hippocastanum, semen

5.) Fr. Ph. 2002 ANSM: Aesculus hippocastanum (semen) ad praeparationes homoeopathicas

6.) 22 May 2012 EMA/HMPC/354157/2011, Committee on Herbal Medicinal Products (HMPC):
Assessment report on Aesculus hippocastanum L., cortex
Based on Article 16d(1), Article 16f and Article 16h of Directive 2001/83/EC as amended (traditional use)

7.) Fr. Ph. 2004 ANSM:  Aesculi hippocastani flores ad praeparationes homoeopathicas (DEFINITION: Fresh inflorescence of Aesculus hippocastanum L. )

8.) 22 May 2012 EMA/HMPC/354156/2011, Committee on Herbal Medicinal Products (HMPC):
Community herbal monograph on Aesculus hippocastanum L., cortex

 

Biljni preparati u tečnom obliku (nerazblaženi ili razblaženi) za oralnu i lokalnu upotrebu.

a) Aesculus hippocastanum L., semen (Horse chestnut fresh seed),

b) Aesculus hippocastanum L., flores et inflorescentiae (Horse chestnut fresh flower/ inflorescence),

c) Aesculus hippocastanum L., folium (Horse chestnut fresh leaf).

 

Sastav:

a) tečni ekstrat (DER 1:2), ekstrakcioni rastvarač etanol 65% (v/v),

b) tečni ekstrat (DER 1:1), ekstrakcioni rastvarač etanol 51% (v/v).

Aesculus hippocastanum L., sadrži 207 hemijskih jedinjenja koja ispoljavaju 492 istraženih dejstava (* podaci ažurirani juna 2019).

 

Sadržaj:

a) minimum 0,25% ukupnih triterpen heterozida, izraženih kao escin (aescin) (Molecular Fornula: C₅₅H₈₆O₂₄: Molecular Weight: 1131,25694 g/mol⁻¹),

b) minimum 0,10% ukupnih flavonoida, izraženih kao kvircitrin (quercitrin) (Molecular Fornula: C₂₁H₂₀O₁₁: Molecular Weight: 448,3769 g/mol⁻¹),

c) u većoj koncentraciji sadrži α-pinen, benzaldehid, kamfen,nonanal,

d) više od svih biljaka sadrži aescin, aeskulin, hipokaeskulin, fenilglioksilnu kiselinu, 1-dekanol (decil alkohol), procijanidin A2, B2, B5 i C1 (proanthocyanidin A2, B2, B5 and C1), provitamin D, saponine, tridek-2-en-1-ol. 

Indikacije: biljni preparati divljeg kestena su namenjeni poboljšanju opšteg stanja organizma kroz razna naučno dokazana dejstva. Upotreba kod vaskularnih i kožnih  tegoba. 

Dr. Džems Djuk (Dr. James Duke) u Handbook of Medicinal Herbs, 2nd Ed. (2002). CRC Press, navodi sledeće: 

– ima jako dejstvo kod: hronične venske insuficijencije (CVI), koja se odlikuje otokom, proširenim venama, težinom, bolom, umorom, svrabom i grčevima u nogama, kod modrica, lokalnih edema, hematoma, kod hemoroida, tromboflebitisa, uvećane prostate, kod varikoznog ulcera, poboljšava renalnu prokrvljenost, povećava otpornost i smanjuje propustljivost kapilara, poboljšava vensku i limfnu cirkulaciju, kod gihta, inflamacija, varikoza, opekotina od sunca, neuralgija, sistrema – sindroma nemirnih nogu (grčeva nogu),  groznice, umanjuje sedimentaciju krvi, …

 – delotvoran kod: akni, artroza, modrica, kancera, slabosti kapilara (lomljivi kapilari), celulita, grčeva, sindroma karpalnog tunela, discitisa, dismenoreje, edema, gripa, glavobolje, hematoma, HTA i LTA (visokog i niskog krvnog pritiska), svraba, malarije, bolova, pareza, prostatitis, reumatizma, kožnih ulceracija, tumora, vertiga, virusnih infekcija, rana, bora, sportskih povreda, …

– u narodnoj medicini kod: astme, bola u leđima, nazeba, kongestije, kašlja, dijareje, dizenterije, dispepsije, ekcema, enteritisa, groznice, gastroenteritisa, gastritisa, hepatitisa, induracije, lupusa, mastitisa, neuralgije, pertusisa, flebitisa, tromboflebitisa, tromboze, uganuća, ulceracija, …

 – spoljašnja primena kod: akni, mastitisa, modrica, protiv bora i celulita, adstringent, slabosti kapiara, sternutator, vulnerar, … 

– upotrebljava se kao: jak antiedemik i antiinflamatik, anticelulitik, zatim ACTH-genik, analgetik, za slabost kapiara, antieksudativ, antihijaluronidaze, antiiritant, antitumorik, antivirotik, cirkulatonik, kortikogenik, citotoksik, hipertenziv, hipotenziv, natriuretik, piscicid, venotonik, u folk medicini narkotik, vazokonstriktor, …

Monografija nemačke E komisije (Commission E Monographs), terapijski vodič za biljne lekove, preporučuje Aesculus hippocastanum :

seme za tretman CVI hronične venske insuficijencije, …

list za tretman ekcema, varikoznih vena, flebitisa i tromboflebitisa, hemoroida, spastičkih bolova pred i za vreme menstruacije, …

cvet i koru za tretman loše cirkulacije, prevencije tromboza i tromboembolija, ….

Doziranje i način primene:
do 2 mL (80 kapi) podeljeno u 2 do 4 doze.
Biljni preparat DIVLJI KESTEN TM:
pojedinačna doza: 0,5-1 mL,
preporučena dnevna doza (PDD): 2 mL.
Oralna (15 -30 minuta pre obroka) i lokalna primena.
Upotreba na koži: aplicirati na obolelo mesto u tankom sloju ili obliku impregniranog zavoja (flastera).
Za lokalnu upotrebu preparat je potrebno razblažiti u odnosu 1:1 do 1: 4 alkoholom niže koncentracije (25 – 40% v/v).
Ne koristiti na sluznicama, oštećenoj koži i oko očiju.

Napraviti pauzu posle 4 nedelje neprekidne oralne upotrebe, jednu nedelju.

Po preporukama, preparat postiže najbolje efekte pri upotrebi od 8 do 12 nedelja, duža upotreba je bezbedna uz pauze.

Kontraindikacije: preosetljivost na aktivne supstance,
preosetljivost na biljke porodice (genus Aesculus, family Sapindaceae),
ne sme se uzimati oralnim putem kod poremećaja zgrušavanja krvi zbog inhibitornog delovanja na lipooksigenazu u trombocitima, kao i na sposobnost agregacije trombocita.

Čuvanje: na tamnom, suvom i hladnom mestu do 20˚C, van domašaja dece i izlaganja EM zračenju, u dobro zatvorenoj originalnoj ambalaži.

Rok upotrebe: 5 godina, posle prvog otvaranja 6 meseci.

Pakovanje: 50 mL i 100 mL standardne farmaceutske braon bočice; 250 mL, 500 mL, 1000 mL i 5000 mL na zahtev.

Nutritivne informacije:
DIVLJI KESTEN HSS i TM
energetska vrednost u 100 mL (semen): 1504 kJ/ 360 kcal,
u preporučenoj dnevnoj dozi (PDD) 2 mL: 30 kJ/ 7,17 kcal,
energetska vrednost u 100 mL (flos): 1172 kJ/ 280 kcal,
u preporučenoj dnevnoj dozi (PDD) 2 mL: 23,45 kJ/ 5,6 kcal,
suve materije (DR) više od 1,1% semen, 2,8% flos (Fr. Ph.), 2,0% (HAB), semen 5,0 (HAB2000), RD 0,915 – 0,935.

 

Bez konzervanasa, proteina, masti i ugljenih hidrata.

DIVLJI KESTEN HSS i TM su rukom rađeni proizvodi. 

CENOVNIK

 

MATIČNA TINKTURA – hidroetanolni tečni ekstrakt svežih delova biljke, DIVLJI KESTEN TM, DER 1:2, 

50 mL – 600,00 RSD (5 e); 100 mL – 1200,00 RSD (10 e).

http://www.biljni-preparati.com/preparati/divlji-kesten/                         avgust 2019.

Upotreba divljeg kestena (Aesculus hippocastanum L.) sa referencama.

alternativ	Steinmetz, E.F. 1957. codex Vegetabilis. Published by the author, Amsterdam.
analgetik	Steinmetz, E.F. 1957. codex Vegetabilis. Published by the author, Amsterdam.
anodin	Steinmetz, E.F. 1957. codex Vegetabilis. Published by the author, Amsterdam.
adstrigent	Uphof, J.C. Th. 1968. Dictionary of economic plants. 2nd ed. Verlag von J. Cramer.
adstrigent	Steinmetz, E.F. 1957. codex Vegetabilis. Published by the author, Amsterdam.
bolovi u leđima	Uphof, J.C. Th. 1968. Dictionary of economic plants. 2nd ed. Verlag von J. Cramer.
Ca	Hartwell, J.L. 1967-71. Plants used against cancer. A survey. Lloydia 30-34.
groznica	Krochmal, Arnold and Connie. 1973. A guide to the medicinal plants of the United States. Quadrangle/The N.Y. Times Book Co.
groznica	Steinmetz, E.F. 1957. codex Vegetabilis. Published by the author, Amsterdam.
hemostatik	ANON. 1978. List of Plants. Kyoto Herbal Garden, Parmacognostic Research Lab., Central Research Division, Takeda Chem. Industries, Ltd., Ichijoji, Sakyoku, Kyoto, Japan.
malarija	Uphof, J.C. Th. 1968. Dictionary of economic plants. 2nd ed. Verlag von J. Cramer.
narkotik	Steinmetz, E.F. 1957. codex Vegetabilis. Published by the author, Amsterdam.
narkotik	Uphof, J.C. Th. 1968. Dictionary of economic plants. 2nd ed. Verlag von J. Cramer.
neuralgija	Uphof, J.C. Th. 1968. Dictionary of economic plants. 2nd ed. Verlag von J. Cramer.
neuralgija	Krochmal, Arnold and Connie. 1973. A guide to the medicinal plants of the United States. Quadrangle/The N.Y. Times Book Co.
pertusis	Steinmetz, E.F. 1957. codex Vegetabilis. Published by the author, Amsterdam.
hemoroidi	Krochmal, Arnold and Connie. 1973. A guide to the medicinal plants of the United States. Quadrangle/The N.Y. Times Book Co.
hemoroidi	Uphof, J.C. Th. 1968. Dictionary of economic plants. 2nd ed. Verlag von J. Cramer.
hemoroidi	Steinmetz, E.F. 1957. codex Vegetabilis. Published by the author, Amsterdam.
otrov	Standley, Paul C. Trees and shrubs of Mexico. Contributions U.S. National Herbarium, vol. 23. Govt. Printing Office, Washington, D.C.
preventivno (reumatizam)	Krochmal, Arnold and Connie. 1973. A guide to the medicinal plants of the United States. Quadrangle/The N.Y. Times Book Co.
rektitis	Uphof, J.C. Th. 1968. Dictionary of economic plants. 2nd ed. Verlag von J. Cramer.
rektum	Krochmal, Arnold and Connie. 1973. A guide to the medicinal plants of the United States. Quadrangle/The N.Y. Times Book Co.
reumatizam	Uphof, J.C. Th. 1968. Dictionary of economic plants. 2nd ed. Verlag von J. Cramer.
reumatizam	Steinmetz, E.F. 1957. codex Vegetabilis. Published by the author, Amsterdam.
skleroza (grudi)	Hartwell, J.L. 1967-71. Plants used against cancer. A survey. Lloydia 30-34.
inflamacija	Krochmal, Arnold and Connie. 1973. A guide to the medicinal plants of the United States. Quadrangle/The N.Y. Times Book Co.
sternutator	Steinmetz, E.F. 1957. codex Vegetabilis. Published by the author, Amsterdam.
tonik	Steinmetz, E.F. 1957. codex Vegetabilis. Published by the author, Amsterdam.
tonik	Uphof, J.C. Th. 1968. Dictionary of economic plants. 2nd ed. Verlag von J. Cramer.
tonik	Krochmal, Arnold and Connie. 1973. A guide to the medicinal plants of the United States. Quadrangle/The N.Y. Times Book Co.
vazokonstriktor	Steinmetz, E.F. 1957. codex Vegetabilis. Published by the author, Amsterdam.
vazokonstriktor	Font Query, P. 1979. Plantas Medicinales el Dioscorides Renovado. Editorial Labor, S.A. Barcelona. 5th Ed.
vulnerar	Steinmetz, E.F. 1957. codex Vegetabilis. Published by the author, Amsterdam.

Data by National Agricultural Library

X X X X X

UPUTSTVO ZA BILJNI DIJETETSKI DODATAK ISHRANI KESTEN HSS I TM 

Hidroetanolni tečni ekstrakt svežeg semena biljke kesten (Aesculus hippocastanum L., semen),

Hidroetanolni tečni ekstrakt svežeg cveta i cvasti biljke kesten (Aesculus hippocastanum L., flores et inflorescentiae).

– Ovo uputstvo je primenljivo isključivo za preparate KESTEN HSS i TM i za slične proizvode drugih proizvođača nije primenljivo.

– Ukoliko neko neželjeno dejstvo postane ozbiljno ili primetite neko neželjeno dejstvo koje nije navedeno u ovom uputstvu, molimo Vas da o tome obavestite svog lekara ili farmaceuta.

– Pažljivo pročitajte ovo uputstvo, pre nego što počnete da koristite ovaj dodatak ishrani, jer sadrži informacije koje su važne za Vas.

– Neophodno je da pažljivo koristite KESTEN HSS i TM, da biste sa njim postigli najbolje rezultate.

– Uputstvo sačuvajte. Može biti potrebno da ga ponovo pročitate.

– Ako imate dodatnih pitanja, obratite se svom lekaru ili farmaceutu.

– Ukoliko se Vaši simptomi pogoršaju ili Vam ne bude bolje posle 4 nedelje upotrebe, poželjno je obratiti se svom lekaru.

 

U ovom uputstvu pročitaćete:

1.Šta je DIVLJI KESTENi čemu je namenjen

2.Šta treba da znate pre nego što uzmete DIVLJI KESTEN

3.Kako se upotrebljava DIVLJI KESTEN

4.Moguća neželjena dejstva

5.Rok upotrebe i čuvanje

6.Dodatne informacije

 

1.Šta je DIVLJI KESTEN HSS i TM

DIVLJI KESTEN je biljni dijetetski suplement (biljni dodatak ishrani) hidroetanolna tinktura  svežeg semena biljke kesten (Aesculus hippocastanum L., semen) – pripremljena na poseban način (u skladu sa homeopatskim postupkom izrade, po metodama evropske farmakopeje ili farmakopeja važecih u nekoj od zemalja Evrope), pocetnog odnosa biljka/rastvarač 1:2.

U upotrebi je više od 2,5 milenijuma.

Ručno pojedinačno brane samonikle biljke u odredenim terminima (dani i sati 6-8 dana u sezoni), u skladu sa Lunarnim kalendarom (The Maria Thun Biodynamic Calendar 2014). Poštovani su principi APC (Anthroposophic Pharmaceutical Codex 3rd edition 2013), General monographs of preparations and specific production methods (Pharmaceutical processes) HAB 2a/3a**, (Homoopathische Arzneibuch 2013) odnosno GHP (German Homoeopathic Pharmacopoeia 2012);

(Methods of manufacture for Mother Tinctures & HAB manufacturing methods used in anthroposophic pharmacy).

Tinktura je u skladu sa BHP, AHP, Ph.H, HPUS, Fr.Ph., …(British homoeopathic pharmacopoeia, Australian Homoeopathic Pharmacopoeia, Pharmacopoeia Helvetica, The Homeopathic Pharmacopeia of the United States, French homeopathic pharmacopoeia, …).

Preparat je u skladu i sa Evropskom farmakopejom (European pharmacopoeia 8th edition 2014).

Seme/ cvetovi i cvasti samonikle biljke kestena brani su na privatnom posedu na terenima od preko 850 metara nadmorske visine (biljke sa mnogo više lekovitih svojstava i životne energije nego biljke sa nižih terena). Konzervirane su etanolom homeopatske koncentracije u roku ne dužem od trideset minuta (ubrane biljke počinju odmah da gube lekovita svojstva).

U kompletnom procesu nisu korišceni električni uređaji i metalni kontejneri za odležavanje (upotreba staklene i keramicke opreme i ambalaže, noževi, kontejneri, baloni, posude, …  prethodno solarizovane). Poštovane su Smernice dobre prakse sakupljanja lekovitog bilja (GACP of Wild Medicinal and Aromatic plants) i Smernice dobre proizvodjačke prakse (GMP).

 

Dobijen je vrhunski proizvod ali u vrlo maloj količini.

Farmakoterapijska grupa: DIVLJI KESTEN se može svrstati u grupu preparata za kardiovaskularni sistem, venoprotektori (drugi stabilizatori kapilara).

ATC kod:

V03ZA01 (opciono).

DEJSTVO: Preparat je namenjen poboljšanju opšteg stanja organizma kroz razna naucno dokazana dejstva

-ima jako:

antiedemično – smanjuje otoke,

antiinflamatorno -antizapaljensko,

vazokonstriktorno i vazoprotektorno dejstvo.

-ostala dejstva: ACTH-genic, adstrigent-deluje na površinsko skupljanje tkiva kod zapaljenja kože i sluzokože, analgetik-za otklanjanje bolova, antieksudativ-smanjuje propustljivost krvnih sudova, antihyaluronidase, antiiritant-, antireumatik-usporava progresiju reumatoidnog artritisa, antitumorno-, antivirotik-, protiv bora i strija, citotoksik-, cirkulotonik- ubrzava perifernu cirkulaciju, dermetik, diuretik-poboljšava izlučivanje mokraće iz organizma, ekspektorans-pomaže iskašljavanje, izbacivanje sluzi iz organa za disanje, febrifug-protiv groznice, hemostatik-smanjuje krvarenja, kortikogenik, hipertenziv-pomaže kod niskog krvnog pritiska, hipotenziv-pomaže kod visokog krvnog pritiska, natriuretik-indukuje natriurezu, piscicid, venotonik-tonizira, ojačava venske krvne sudove, vulnerar-za zarastanje rana.

-u allterativnoj tradicionalnoj medicini: narkotik, sternutator-, tonikum-oporavlja i ojačava organizam, vazokonstriktor –kontrahuje krvne sudove, vulnerar-pomaže zarastanje rana.

PRIMENA (TERAPIJSKE INDIKACIJE)

Biljka je u službenoj kliničkoj fitoterapiji odobrena za lecenje hronične venske insuficijencije, tegoba s proširenim venama, tegoba poput hemoroida te subjektivnih simptoma teških i otečenih nogu.

Evropske regulatorne agencije, poput ESCOP-a, odobrile su upotrebu kestena kao leka na temelju 13 kliničkih studija u kojima je dokazano povoljno delovanje njegovog ekstrakta kod takvih tegoba.

Biljni preparat na bazi hidroetanolnog ekstrakta semena kestena primenjuje se kod: -hronicne venske insuficijencije (CVI) – hronične venske slabosti, venskog zastoja, hemoroida, inflamacija-upalnih stanja, opekotina od sunca, edema-otoka, grčeva potkolenica, varikoza-proširenih vena, noćnih grčeva nogu.

-ostala primena: kod akni, artroza- degenerativnih oboljenja perifernih zglobova, artritisa, grčeva, modrica, sindroma karpalnog tunela, za slabost kapilara (anticapillary fragility), celulita, discitisa, dismenoreje, edema-otoka, influence-gripa, glavobolje, hematoma-krvnih podliva, kancera, visokog krvnog pritiska, svraba, niskog krvnog pritiska, malarije, bolova, paralize-oduzetosti, kolitisa/proktitisa-upale rektalne sluznice, prostatitisa-zapalenje prostate, uganuća, reumatizma- upalnog degenerativnog i metaboličkog reumatizma (gihta), sora-gljivičnih infekcija usne duplje, tromboza, tumora, vertiga, virusnih infekcija, ozleda/povreda, bora, bolnih sindroma kukova, kolena, ramena, krsta, …

-u tradicionalnoj medicini: kod astme, bola u leđima, nazeba, kongestije-zagušenja, dijareje-, dizenterije-, dispepsije-, ekcema-, enteritisa-, groznice-, gastroenteritisa, gastritisa-zapalenja želuca, hepatitisa-zapalenja jetre, induracije- očvrsnuca tkiva, lupusa-, mastitisa-zapaljenja dojki, neuralgija-zapalenja nerava, pertusisa-velikog kašalja, flebitisa-zapalenja vena, tromboflebitisa- tromboflebitickog zapalenja vena, ulceracija;

-u fitoterapiji biljkama sinergijskog dejstva: kod bolnih menstruacija i hiperplazije/povećanja prostate, otečenih mošnica, proširenih vena, groznice od prehlade i proliva.

-spoljašnja primena: kao sredstvo za zarastanje rana od opekotina i povreda, dekubitusa, hematoma, kod problema sa hemoroidima, kod mijalgija, delotvoran kod regeneracije oštećene kose, kod akni, spoljnih ulkusa, prišteva, ragada, suve kože, bora, strija, ljuskave kože, …

Pomaže u regulisanju telesne težine.

Upotrebom KESTEN-a dolazi i do opšteg psihičkog umirenja, upotreba je poželjna naročito kada uz opštu telesnu slabost istovremeno nastupe i neurološke pojave propraćene popuštanjem psihičke elastičnosti, povećanom razdražljivošću i nesanicom.

DIVLJI KESTEN je idealan izbor u slučajevima gde se, iz ma kog razloga, ne mogu koristiti drugi preparati za postizanje gore navedenih efekata.

 

2.ŠTA TREBA DA ZNATE PRE NEGO ŠTO UZMETE DIVLJI KESTEN

DIVLJI KESTEN mogu koristiti svi uzrasti od 18 godina nadalje.

Nije preporučljiv deci mlađoj od 2 godine.

Kontraindikacije:

DIVLJI KESTEN ne smete koristiti:

– ako ste preosetljivi na aktivne supstance ili na bilo koji druge sastojke preparata,

– ako ste alergični na biljke iz porodice (genus Aesculus, family Sapindaceae).

Interakcija sa lekovima i drugim preparatima

Preparati kestena imaju odličnu podnošljivost u monoterapiji.

Ekstrakt semena divljeg kestena

Oprezna upotreba kod osoba sa oštećenim bubrezima i jetrom, kod iritiranog ili inficiranog GI trakta.

Kontraindikovana je primena u trudnoći i dojenju.

Kažite svom lekaru i farmaceutu ako ste alergični na hranu, lekove ili druge supstance, ako uzimate ili ste do nedavno uzimali bilo koji drugi lek, uključujući i biljne lekove i one koji se mogu nabaviti bez lekarskog recepta, mada nije bilo izveštaja o interakcijama od znacaja.

Preparat sadrži 65% odnosno 51% V/V etil alkohola, potrebna je pažljiva upotreba sa lekovima koji se primenjuju u terapiji alkoholizma (Tetidis, Antabus, Esperal, Disulfiram, Tetradine, …).

Uzimanje sa hranom ili pićima:

Uzeti sat vremena pre obroka rastvoreno u dosta tečnosti.

Primena u periodu trudnoće i dojenja: U nedostatku sigurnih podataka treba izbegavati upotrebu ako planirate da zatrudnite, u trudnoći i tokom dojenja.

Pre nego što počnete da uzimate neki lek ili preparat, posavetujte se sa svojim lekarom ili farmaceutom.

Uticaj na upravljanje motornim vozilima i rukovanje mašinama

Ukoliko se koristi u preporučenim dnevnim dozama, nema nikakvog uticaja na upravljanje motornim vozilima i rukovanje mašinama.

 

3.KAKO SE UPOTREBLJAVA DIVLJI KESTEN

Doziranje:

DIVLJI KESTEN uzimajte uvek tačno onako kako je navedeno u uputstvu (ili vam je to objasnio lekar).

Ako niste sasvim sigurni, ili imate bilo kakvo pitanje, proverite sa svojim lekarom ili farmaceutom.

Uobicajena doza (preporucena dnevna doza PDD) je:

ODRASLI  2ml (80 kapi) dnevno podeljeno u 2 do 4 doze, sat vremena pre obroka, sa dosta tečnosti.

Deca ispod 2 godine ne bi trebalo da koriste preparat, konsultovati svog lekara ili farmaceuta.

U  akutnim stanjima svakih pola do jednog sata, najviše 12 puta dnevno (maksimalno 3 PDD ), na primer kod akutnih tegoba s hemoroidima – Commission E (nemački ekvivalent američke FDA).

Da bi se postigli maksimalni efekti neophodno je koristiti DIVLJI KESTEN u kontinuitetu, dok se ne potroši sadržaj pakovanja.

Prvi benefiti se postižu posle 3 do 4 nedelje, maksimalni posle 6 do 8 nedelja upotrebe. Napraviti dvonedeljnu pauzu, zatim po potrebi nastaviti primenu preparata. Pre upotrebe dobro promućkati.

Ako ste uzeli više nego što je trebalo neće biti nikakvih neželjenih dejstava.

Ako ste zaboravili da uzmete odredenu dozu ne uzimajte duplu dozu da bi nadoknadili preskočenu dozu  jednostavno nastavite tamo gde ste prekinuli unos.

Ako naglo prestanete da uzimate DIVLJI KESTEN neće biti nikakvih neželjenih efekata.

Ako imate bilo kakvih dodatnih pitanja o primeni, obratite se svom lekaru ili farmaceutu.

Prilagođenje na aktivne materije ukoliko preparat koristite prvi put (opciono):

Prva dva dana 3 puta po 10 kapi, sledeca dva dana 3 puta po 15 kapi, sledeca dva dana 3 puta po 20 kapi, zatim nastaviti sa 80 kapi dnevno (PDD 2ml) u 2 do 4 podjednake doze.

Traženje optimalne doze (opciono)

Početi sa 3 puta dnevno sa 5 kapi, svakog dana povećavati dozu za po jednu kap (3×6, 3×7, …), svakog sedmog dana ponoviti dozu prethodnog dana (3×10, 3×16, …) do momenta kada osetite neželjene efekte. Tada treba jednostavno smanjiti dozu dok se oni ne povuku i ostati na toj dozi kao optimalnoj.

Ovakav princip traženja optimalne doze – po šemi, poželjan je iz razloga jer je svaki organizam jedinstven te mu je potrebna i jedinstvena doza nekog preparata na koju ce organizam dati optimalni odgovor.

Mladi do 18 godina (opciono – Commission E):

Deca ispod 2 godine ne treba da uzimaju preparat bez konsultacije lekara (apsolutna kontraindikacija);

deca iznad 2 do 6 godina do 1/3 doze odraslih;

deca od 6 do 12 godina  do 2/3 doze odraslih;

deca iznad 12 godina mogu uzimati maksimalno do preporučene doze odraslih.

Dr. Otto Mausert 4-1/6, 6-1/4, 8-1/3, 12-1/2, 15-2/3 doze odraslih.

Boiron deca do 12 godina 1 kap po godini.

 

4.MOGUĆA NEŽELJENA DEJSTVA

Divlji kesten je sasvim sigurna biljka.

Ne postoje neželjena dejstva ako se koristi u preporučenim dozama (unos escina do 160 mg dnevno).

Najčešci moguci neželjeni efekti: enormno velike doze, deset puta veće od preporučene dnevne doze ili više, mogu izazvati blagu mučninu, poremećaj ukusa, GI tegobe, proliv, zatvor, žeđ, gubitak apetita, povračanje; urtikariju; uvećanje zenica, vrtoglavicu, poremećaje svesti, poremećaje u laboratorijskim parametrima funkcije jetre, lokalno kontaktni dermatitis. Tegobe se povlače u roku do nedelju dana od prestanka upotrebe preparata.

Kod akutnog trovanja Fleming preporučuje lavažu želuca, ispiranje natrijum sulfatom i primenu aktivnog uglja.

DIVLJI KESTEN kao i drugi preparati, može da ima neželjena dejstva, mada se ona ne moraju ispoljiti kod svih.

Ukoliko neko neželjeno dejstvo postane ozbiljno ili primetite neko neželjeno dejstvo koje nije navedeno u ovom uputstvu, molimo Vas da o tome obavestite svog lekara ili farmaceuta.

 

5.ROK UPOTREBE I ČUVANJE

Najbolje upotrebiti u roku 5 godina od datuma proizvodnje označenog na kutiji i bočici.

Rok upotrebe ističe poslednjeg dana navedenog meseca. Rok upotrebe nakon prvog otvaranja 6 meseci.

Nemojte koristiti DIVLJI KESTEN ako primetite  vidljive znakove neispravnosti.

Moguća blaga zamućenost ne predstavlja neispravnost.

Nemojte koristiti preparat posle isteka roka upotrebe naznačenog na kutiji i bočici.

Čuvati na temperaturi do 20 stepeni Celzijusa (68 stepeni Farenhajta), van domašaja i vidokruga dece,

u originalnoj farmaceutskoj staklenoj ambalaži zaštićeno od svetla, vlage i EM zračenja, dobro zatvoreno.

 

6.DODATNE INFORMACIJE

Šta sadrži DIVLJI KESTEN

– Aktivna supstanca ekstrakt semena divljeg kestena sa minimalno 1,1% suvog ostatka.

– Aktivna supstanca ekstrakt cveta divljeg kestena sa minimalno 2,8% suvog ostatka.

b) sadržaj (flos):minimum 0,10% ukupnih flavonoida, izraženih kao kvercitrin (quercitrin)

(Molecular Fornula: C₂₁H₂₀O₁₁: Molecular Weight: 448,3769 g/mol⁻¹).

a) Hidroetanolni tecni ekstrakt (tinktura, macerat) svežeg semena biljke kestena Aesculatus hippocastanum L. početnog odnosa biljka rastvarač 1:2),

b) Hidroetanolni tecni ekstrakt (tinktura, macerat) sveže cvasti biljke kestena Aesculatus hippocastanum L. početnog odnosa biljka rastvarač 1:1);

– Ostali sastojci:

-etil alkohol (C₂H₅OH 65%V/V (57% mm); 51g/ 100 mL; 1g/ 2 mL – u PDD),

-etil alkohol (C₂H₅OH 51%V/V (43% mm); 40g/ 100 mL; 0,8g/ 2 mL – u PDD),

-prečišcena voda (Aqua purificata).

 

Kako izgleda DIVLJI KESTEN i sadržaj pakovanja Pakovanje u farmaceutskim braon bočicama (UV rezistentno staklo) sa hologramskom zaštitnom nalepnicom i belim plastičnim zatvaračcem sa kapaljkom-dozatorom.

Sadržaj pakovanja  50mL i 100mL (za 4 odnosno 8 nedelja upotrebe) Svaki preparat treba da pokaže svoje dejstvo u periodu od 3 do 4 nedelje, odnosno organizam treba da odreaguje na aktivne supstance u njemu (pakovanje od 50 ml).

Nastavak tretmana može da bude po izboru sa pakovanjem od 50 ili 100mL, ili u slučaju da pozitivna reakcija izostane, može se prekinuti.

Dodatak ishrani ne može da zameni raznovrsnu i uravnoteženu ishranu.

DIVLJI KESTEN U HOMEOPATIJI TM-D3 (D20)

Strogo individualna primena; lecenje coveka u bolesti, a ne bolesti u coveku.

http://www.homeoint.org/books/boericmm/a/aesc.htm

TM*   je oznaka tinkture proizvedene po metodologiji proizvodnje TM

(Methods of manufacture for Mother Tinctures (Ph. Eur. monograph 2029));

HAB 2a/3a** predstavlja specifični metod proizvodnje koji se koristi u homeopatskoj i antropozofskoj farmaciji a saglasan je Ph. Eur. Method 1.1.3/ 1.1.5 odnosno HPUS Class N/M (Tinctures made by maceration  with  ethanolwater (Ph. Eur. monograph 2371) Methods of preparation of homoeopathic stocks and potentisation);

1:2/1:3*** predstavlja poćetni težinski odnos biljke i rastvaraća a rezervisan je isključivo za maceraciju svežih biljaka!!!

 

Proizvođac:

Miroslav Ilić Biljober

37000 Kruševac, Branka Radičevića 10

telefon: +381 63 7756922  +381 65 4700570

e-mail  yt1mi@yahoo.com

veb: http://www.biljni-preparati.com/

Ovo uputstvo je poslednji put izmenjeno 10. VIII 2015.

 

Korišceni podaci iz: European pharmacopoeia 5.0

ANTHROPOSOPHIC PHARMACEUTICAL CODEX APC 3.0. APC 3rd edition 2013.,

http://www.ajptr.com

http://www.drugs.com/cdi/horse-chestnut.html

http://www.drugs.com/sfx/horse-chestnut-side-effects.html

http://www.drugs.com/drug-interactions/horse-chestnut-index.htmlfilter=2&generic_only=

http://www.pfaf.org/user/Plant.aspx?LatinName=Aesculus+hippocastanum

http://www.homeoint.org/books/boericmm/a/aesc.htm

Tinktura divljeg kestena 1:5 – Florida herbal pharmacy

AESCULUS URT 20ml Tropfen CERES

AESCULUS Urtinktur DHU

Aesculus hippocastanum (Hippocastanaceae)
Horse Chestnut (Aesculus hippocastanum)

Horse Chestnut Tinctures-Liquid Herba Extracts Benefits & Uses LARGE

Horse Chestnut (also known as Aesculus Hippocastanum, Conkers, and Buckeye), has been used in many herbal medicines for centuries, and more recently in some cosmetics. Aesculus hippocastanum (Hippocastanaceae) seed extract is best known in complementary or alternative medicine, for its ability to relieve leg pain and other symptoms of venous insufficiency. Poor blood flow in the veins of the legs is one of the most common problems of aging. It is used extensively throughout Europe as an anti-inflammatory for a variety of conditions including leg ulcers, hemorrhoids, hardening of the arteries, spider veins, varicose veins, and frostbite. Herbalists recommend managing these types of problems with increased intake of fresh fruit, vegetables, drinking water, and exercise. Aesculus hippocastanum (Hippocastanaceae) is almost always included somewhere in the prescription. The seed extract of the herb has been utilized by some as a natural remedy for diarrhea. One of the best benefits of Aesculus hippocastanum (Hippocastanaceae) is its ability to help fight cancer. Studies have shown that it was helpful in killing cancer cells and shrinking tumors in certain instances, however, additional studies have to be done to ensure the usefulness of this therapy. Horse chestnut, when used externally in a cream, has been shown to help treat leg cramps due to poor blood circulation and decreased vein elasticity. Herbalists also recommend Aesculus hippocastanum (Hippocastanaceae) seed extracts for rheumatoid arthritis, sprains, muscle tension, and chronic leg edema.
Aesculus hippocastanum (Hippocastanaceae) extract is best known for its anti-inflammatory properties, which may be why it is so often used to relieve sprains, as well as rheumatic, and arthritic aches and pains. Many massage products used by athletes to relieve muscular and joint pain after extraneous workouts, or for sports injuries, such as strains and bruises. It has also been used to help with those thread veins.
Aesculus hippocastanum (Hippocastanaceae) tinctures have also been found to be comparable to Vitamin E and vitamin C in its ability to provide antioxidant properties to oils. Early results of testing show that the extract of Horse chestnut was almost 20 times more effective for dealing with free radical oxygen scavengers, as well as having anti-bacterial and anti-viral activities. The actions of the herb are found to be useful in anti-wrinkle formulas and helping to promote clear skin, good skin tone, and an even complexion. The anti-inflammatory also helps to get rid of swelling that causes dark circles under the eyes. When used topically it reduces pain and swelling and even helps to prevent bruising. It is also thought to shield against UV radiation damage. So as you can see the herb can have a valuable role in skin care, but you may not be able to find them on the shelves easily in name, but the herbal extract may be some worth exploring in your own formulations.
Aesculus hippocastanum (Hippocastanaceae)‘s reputation for reducing capillary leakage is one reason it has been used to reduce the formation of cellulite. Amazingly enough, by improving connective tissue integrity, it improves the condition of the skin that may be prone to cellulite. Reduced capillary fragility helps to prevent leakage of fluid into the surrounding tissue, thus reducing fluid retention and tissue swelling. And studies show that Horse chestnut seed extracts were far more effective when taken in the early in the stages of the complaint.
Researchers have also seen that when Aesculus hippocastanum (Hippocastanaceae) tincture is used in combination with Gotu Kola, Centella Asiatica, it shows major cellulite reduction benefits. Gotu kola also helps to speed up the elimination of toxins in the body, which may be helpful in much-needed weight loss.

Ingredients: Horse Chestnut – Aesculus hippocastanum (Hippocastanaceae), Structured Water, 96% Alcohol.

Non-Alcohol: Aesculus hippocastanum (Hippocastanaceae), Structured Water, Vegetable Glycerin.

All of our ingredients are Certified Organic, Kosher, or Responsibly Wildcrafted. No genetically modified organisms (GMO’s) are involved. All other products that are distributed by us meet our high-quality standards.

Instructions: Use 10-20 drops in juice or water, under the tongue or as desired. May be taken 2 times daily. Shake well. Store in cool dark place. Keep out of reach of children.

Contraindications: Pregnant and nursing women should avoid Aesculus hippocastanum (Hippocastanaceae), and overuse (many times the recommended dosage) may cause gastric distress. Very large amounts of Aesculus hippocastanum (Hippocastanaceae) may cause liver and kidney failure and should be avoided by those suffering from liver or kidney disease. Consult a physician before use if you are taking any blood-thinning medication. The seeds of the Aesculus hippocastanum (Hippocastanaceae) tree are toxic if eaten unprocessed.
Disclaimer: The information presented herein by Herbal Alchemy is intended for educational purposes only. These statements have not been evaluated by the FDA and are not intended to diagnose, cure, treat or prevent disease. Individual results may vary, and before using any supplements, it is always advisable to consult with your own healthcare provider.

Medicinal uses

Uses supported by clinical data

Internally, for treatment of symptoms of chronic venous insufficiency, including pain, feeling of heaviness in the legs, nocturnal calf-muscle spasms, itching and oedema (13–21). Externally, for the symptomatic treatment of chronic venous insufficiency, sprains and bruises (22–24).

Uses described in pharmacopoeias and in traditional systems of medicine

Treatment of coronary heart disease (25).

Uses described in folk medicine, not supported by experimental or clinical data

Treatment of bacillary dysentery and fevers. Also as a haemostat for excessive menstrual or other gynaecological bleeding, and as a tonic (6).

Pharmacology

Experimental pharmacology

Anti-inflammatory activity

Intravenous administration of a 95% ethanol extract of Semen Hippocastani (0.2-0.4 ml/kg body weight) decreased histamine-induced erythema in guineapigs (26). Intragastric administration of a 30% ethanol extract of the seeds suppressed carrageenan-induced footpad oedema and adjuvant-induced arthritis in rats (at doses of 0.6 and 1.5 ml/kg body weight, respectively) (27). Intraperitoneal administration of a saponin fraction isolated from a seed extract exhibited analgesic, anti-inflammatory and antipyretic activities in vivo; the saponin fraction also inhibited prostaglandin synthetase activity in vitro (28). Intragastric administration of a hydroalcoholic extract of the seeds to rats (200-400 mg/kg body weight) suppressed footpad oedema induced by peroxide and carrageenan (29). Intravenous or oral administration of aescin to rats (0.5-120 mg/kg body weight) inhibited footpad oedema induced by dextran, and granuloma induced by cotton pellet and formalin paper (30–32). Intravenous administration of aescin to rats reduced footpad oedema induced by ovalbumin, formalin and dextran (33, 34).

Vasoactive effects

A hydroalcoholic extract of the seeds induced contractions in canine saphenous veins in vitro, and an intravenous bolus (25-50 mg) increased venous pressure in perfused canine saphenous veins in vivo (29).

Cutaneous capillary hyperpermeability induced by chloroform, serotonin and histamine also decreased in rats and rabbits after intragastric administration of a hydroalcoholic extract of the seeds (50-400 mg/kg body weight) (29). Aescin (5-10 µg/ml) increased the tension of isolated human saphenous veins and rabbit portal veins in vitro. The effect was due to preferential formation of prostaglandin F_2α and was reversed by treatment with indometacin (35). The vasoactive effects of aescin were investigated in isolated peripheral blood vessels, isolated arteries and veins (constant-flow perfused cat rear paw, isolated perfused carotid artery of the guinea-pig and iliac veins of the pig). Aescin had a biphasic effect on blood vessels: initial transient dilation was followed by increased tone, which was long lasting in isolated arteries and veins, but was transient in isolated peripheral blood vessels (36). Aescin has also been shown to inhibit hyaluronidase activity in vitro (IC₅₀ 149.9 µmol/l) (37). A hydroalcoholic extract of the seeds (250 µg/ml) reduced lipid peroxidation and had radical-scavenging properties (IC₅₀ 0.24 µg/ml for superoxide dismutase radicals) (38).

Clinical pharmacology

Chronic venous insufficiency and related conditions

Nine placebo-controlled clinical trials (eight double-blind, one single-blind, seven with crossover design) assessed the efficacy of oral administration of a standardized Semen Hippocastani extract (250-600 mg, equivalent to 100-150 mg aescin daily) in a sustained-release form for the symptomatic treatment of patients with chronic venous insufficiency (CVI) (13–21). In one study, 96 patients with CVI received the extract over two treatment periods of 20 days each. Symptomatic improvement in skin colour, venous prominence, oedema, dermatosis, and pain, itching and feeling of heaviness in the legs were observed in the treated patients (13). However, the methodology of this study was poor, and no statistical analysis was performed. Two later studies assessed the efficacy of the extract in 212 patients (19) and 95 patients (17) with CVI, using a numerical scale to rate the severity of symptoms. A significant symptomatic improvement (P < 0.01-0.05) in oedema, calf-muscle spasms, pain and feeling of heaviness in the legs was observed in patients treated with the extract (during two treatment periods of 20 days each) (17, 19). The efficacy of the extract was assessed in a double-blind study of 20 female patients (13 with pregnancy-related varicose veins and seven with CVI) during two treatment periods of 14 days each. A significant reduction in leg volume (114 ml in patients with varicose veins and 126 ml in patients with CVI, P < 0.01) was demonstrated by water plethysmography in patients treated with the extract (21). Another double-blind study assessed the efficacy of the extract in the treatment of 74 patients with CVI and lower-leg oedema. In patients treated with the extract, the leg volume following induction of oedema was reduced from 32 ml to 27 ml (determined by water plethysmography); in the placebo group the leg volume increased from 27 ml to 31 ml (18).

Two further studies investigated the effects of the extract on the intravascular volume of the lower-extremity veins and on interstitial filtration (measured indirectly by venous-occlusion or water plethysmography) in patients with CVI (14, 20). In one of the studies, after a single dose of 600 mg extract (equivalent to 100 mg aescin), the transcapillary filtration coefficient decreased by 22%, as compared with a slight increase in the coefficient of the placebo group. This study demonstrated that the extract exerted its action primarily by reducing capillary permeability (14). In the other study, patients treated daily with 600 mg extract (equivalent to 100 mg aescin) for 28 days showed a significant reduction in extravascular volume of the foot and ankle (P < 0.01), as well as a significant improvement in oedema, and feelings of tension, pain, fatigue and itching of the legs (P < 0.05). However, no changes in venous capacity or calf-muscle spasms were observed (20).

The efficacy of the extract was assessed in a randomized, parallel, doubleblind study of 40 patients with venous oedema due to chronic deep-vein incompetence stage II. Patients received 369-412 mg extract (equivalent to 75mg aescin) twice daily for 6 weeks. A significant reduction was observed in leg volume (measured by water plethysmography after oedema induction) and leg circumference in the treated group (P < 0.01) (15). A randomized, singleblind, parallel study compared the efficacy and safety of class II compression stockings with the extract or placebo in 240 patients with CVI. Patients in the treatment group received 300 mg extract (equivalent to 50 mg aescin) twice daily for 12 weeks. The lower-leg volume of the affected limbs decreased by an average of 43.8 ml in patients treated with the extract and by 46.7 ml in patients wearing compression stockings. In the placebo group, the lower-leg volume increased by 9.8 ml. Thus, treatment with the extract or wearing class II compression stockings resulted in similar decreases in lower-leg volume (16).

A randomized, double-blind trial compared the efficacy of a standardized extract (360-412 mg, equivalent to 75 mg aescin, twice daily) and oxerutins (1000 mg O-(β-hydroxyethyl)-rutinosides twice daily) in 40 patients with CVI and peripheral venous oedema. A reduction in oedema (based on measurement of leg circumference) was observed in both treatment groups (39). Another randomized, double-blind study compared the efficacy of a standardized seed extract with oxerutins in the treatment of 137 postmenopausal women with chronic deep-vein incompetence stage II. Following a 1-week placebo run-in, patients were treated daily with either 600 mg extract (equivalent to 100 mg aescin) or 1000 mg oxerutins for 12 weeks, or 100 mg oxerutins for 4 weeks followed by 500 mg oxerutins for 12 weeks. Patients were observed for 6 weeks after treatment; the group treated with 1000 mg oxerutins had the greatest decrease in leg volume (40).

A placebo-controlled, double-blind crossover study assessed the effect of a standardized seed extract in the symptomatic treatment of 52 pregnant women with venous insufficiency. Patients were treated with either one capsule containing 300 mg extract (equivalent to 50 mg aescin) or a placebo twice daily for 2 weeks. The extract was superior to the placebo in reducing oedema and symptoms such as leg pain, fatigue and itching. Patients treated with the extract also showed a greater resistance to oedema induction (41). The ability of a standardized seed extract to reduce oedema was investigated in a randomized, double-blind, placebo-controlled trial of 30 patients with CVI. A significant reduction in leg circumference was found in the treatment group (P < 0.05) as compared to the placebo group (P < 0.05) (42).

A double-blind placebo-controlled study investigated the effect of a standardized seed extract (one dose of 600 mg, equivalent to 100 mg aescin) on vascular capacity and filtration in the arms and legs of 12 healthy volunteers. Using vein plethysmography, the study showed a decrease in both vascular capacity and filtration coefficient in subjects treated with the extract (43). The effect of a standardized seed extract (one dose of 1800 mg) on the flow velocity of venous blood between the instep and the groin was quantitatively determined in 30 patients with varicose veins by the xenon-133 appearance method. Blood flow increased by >30%, with a lasting effect observed after 12 days of treatment. Blood viscosity was also reduced and there was a 73% improvement in subjective complaints (44). A randomized double-blind study assessed the effect of a standardized seed extract on lower-leg oedema in 10 healthy volunteers during a 15-hour airflight. A single dose of the extract (600 mg, equivalent to 100 mg aescin) completely prevented or significantly reduced the increase in ankle and foot oedema (P < 0.05), determined by measuring the circumference of the ankle and heel before and after flying (45). A postmarketing surveillance study of over 5000 patients suffering from CVI demonstrated that treatment with a standardized seed extract (equivalent to 75mg aescin) twice daily for 4-10 weeks reduced the symptoms of leg pain, fatigue, oedema and itching (46). In a multicentre study without controls, 71 patients with CVI were treated daily with a topical gel containing 2% aescin. After 6 weeks of treatment, a significant reduction in ankle oedema (reduction of 0.7 cm in the ankle circumference, P < 0.001) and a significant reduction in the symptom score (60%, P < 0.001) was reported (24). In a postmarketing surveillance study involving over 4000 patients with CVI, treatment with a standardized extract of the crude drug (equivalent to 50 mg aescin) twice daily improved typical symptoms in more than 85% of patients (47).

A criteria-based systematic review assessed the randomized, double-blind, placebo-controlled trials of standardized seed extracts for symptomatic treatment of CVI. The data were extracted from the trials in a standardized manner, and the methodological quality and outcome of each trial were assessed by two independent reviewers. In all trials, the extract was shown to be superior to the placebo. Use of the extract was associated with a decrease in lower-leg oedema, and a reduction in the circumference of the calf and ankle. Other symptoms such as leg pain, itching and fatigue were reduced. Results from five comparative trials demonstrated that the extract was as effective as oxerutins, and one of the five trials showed that the extract was as effective as compression therapy (48).

Bruises

The efficacy of a topically applied gel containing 2% aescin in reducing the tenderness to pressure haematoma (experimentally induced by injection) was tested in a randomized, placebo-controlled, single-dose study involving 70 healthy volunteers. Based on tonometric sensitivity measurements, the aescin gel significantly reduced the tenderness to pressure haematoma (P < 0.001). This effect was seen 1 hour after treatment and lasted for 9 hours (49).

Other trials have assessed the efficacy and safety of a topically applied gel containing 2% aescin for the treatment of bruises and sprains (22, 23).

Contraindications

Semen Hippocastani is contraindicated in cases of known allergy to plants of the Hippocastanaceae family.

Warnings

No information available.

Precautions

Drug interactions

Two suspected cases of toxic nephropathy probably due to very high doses of aescin were reported (50). Therefore, Semen Hippocastani should not be administered with other drugs known to be nephrotoxic, such as gentamicin.

Carcinogenesis, mutagenesis, impairment of fertility

A 30% ethanol extract of Semen Hippocastani was not mutagenic in the Salmonella/microsome assay using S. typhimuriumstrains TA98 and TA100 (200 µl/ml) (51). Sodium aescinate had no effect on the fertility of male rats (52).

Pregnancy: teratogenic effects

A 40% ethanol extract of Semen Hippocastani was not teratogenic or embryotoxic in rats or rabbits following intragastric administration of 1.6 ml/kg body weight (53). Intragastric administration of a 40% ethanol extract of the seeds to rats (100-300 mg/kg body weight) or rabbits (100 mg/kg body weight) was not teratogenic. However, when pregnant rabbits were given 300 mg/kg body weight, a reduction in birth weight was observed (54).

Pregnancy: non-teratogenic effects

Semen Hippocastani has been used in clinical trials involving pregnant women with no ill effects (21, 41). However, the drug should not be administered during pregnancy without medical supervision.

Paediatric use

There is no therapeutic rationale for the use of Semen Hippocastani in children.

Other precautions

No information available on general precautions or precautions concerning drug and laboratory test interactions; or nursing mothers. Therefore, Semen Hippocastani should not be administered during lactation without medical supervision.

Adverse reactions

Case reports have indicated gastrointestinal side-effects such as nausea and stomach discomfort (47, 55). Allergic reactions have also been reported (56).

Dosage forms

Crude drug and extracts (7). Store away from light and humidity (1).

Posology

(Unless otherwise indicated)
Daily dosage: 250.0-312.5 mg twice daily of a standardized powdered extract of the crude drug (equivalent to 100 mg aescin) containing 16-20% triterpene glycosides, calculated as aescin (55); topical gels containing 2% aescin (22–24, 49).

Izvor: WHO

X X X X X

Horse chestnut (Aesculus hippocastanum)

Synonyms / Common Names / Related Terms

Aescin, aescine, Aesculaforce®, aescule, aesculetin, buckeye, bongay, chestnut, conkers, Conquerors, coumarins, eschilo, escin, escina, escine, fatty acids, fish poison, flavonoids, graine de marronier d’Inde (French), fraxetin glucoside, fraxin, H. vulgare Gaertnhestekastanje, HCSE, Hippocastabi foliu, Hippocastanaceae (family), Hippocastani semen, horse chestnut seed extract, horsechestnut, linolenic acid, Marron Europeen, Marronier, NV-101, palmitic acid, quinines, Rokastaniensamen, rosskastanie, scopoletin glucoside, scopolin, Spanish chestnut, tannins, steric acid, sterols, Venastat, Venoplant, Venostasin.

 

Mechanism of Action

Pharmacology:

• Constituents: Horse chestnut seed contains a triterpene saponin mixture called escin (3-6%), flavonoids, condensed tannins, quinines, sterols and fatty acids (including linolenic acid, palmitic acid and steric acid), and coumarins (including aesculetin, fraxin [fraxetin glucoside], and scopolin [scopoletin glucoside]). The main active ingredient is considered to be escin (or aescin), which acts on capillary membranes to normalize vascular permeability.⁸Horse chestnut seeds contain approximately 95mg of lectin per 1kg of fresh seeds.⁹
• Anti-inflammatory effects: Purified escin has been shown to decrease chemically-induced inflammation in rats.^5,6,2
• Antioxidant effects: HCSE extract has been reported to have antioxidant effects.^2,7
• Antithrombin effects: Horse chestnut contains the hydroxycoumarin component esculin, which may have antithrombin activity. Esculin is found in the bark, buds, and other parts of the fruits, but it should not be present in properly extracted HCSE.
• Vascular effects: Horse chestnut seed extract (HCSE) inhibits enzymes that are implicated in the pathogenesis of chronic venous insufficiency.¹It has been found to dose-dependently contract canine² and human³ isolated saphenous veins in vitro, possibly due to preferential formation of the vasoconstrictive eicosanoid, PGF 2-alpha⁴. HCSE has also been shown to: increase femoral venous pressure and flow, decrease the formation of edema induced in rat paw models, and to suppress plasma extravasation and leucocyte emigration into the pleural cavity in an experimental rat model of pleurisy.² Purified escin has been shown to decrease histamine and serotonin-induced capillary hyperpermeability.^5,6,2 In aggregate, these findings suggest that HCSE increases venous tone, improves venous return, and reduces vascular permeability, all which lead to the clinical benefit of dependent edema reduction.

 

Pharmacodynamics/Kinetics:

• Oral escin is not well absorbed and undergoes substantial first-pass effect. The half-life of horse chestnut is approximately 10-20 hours. Peak plasma levels occur 2-3 hours after ingestion.¹⁰The bioavailability of beta-aescin, the main active constituent of horse chestnut seed extract, was evaluated in two randomized crossover clinical trials involving 18 healthy volunteers each. The trials found that there was no difference between the absorption rates for the retarded versus nonretarded preparation and that daytime absorption was slightly better than nighttime.¹¹

References

1. Kreysel, H. W., Nissen, H. P., and Enghofer, E. A possible role of lysosomal enzymes in the pathogenesis of varicosis and the reduction in their serum activity by Venostasin. Vasa1983;12(4):377-382. 6659692
2. Guillaume, M. and Padioleau, F. Veinotonic effect, vascular protection, antiinflammatory and free radical scavenging properties of horse chestnut extract. Arzneimittelforschung1994;44(1):25-35. 8135874
3. Brunner, F., Hoffmann, C., and Schuller-Petrovic, S. Responsiveness of human varicose saphenous veins to vasoactive agents.Br J Clin Pharmacol 2001;51(3):219-224. 11298067
4. Longiave, D., Omini, C., Nicosia, S., and Berti, F. The mode of action of aescin on isolated veins: relationship with PGF2 alpha. Pharmacol Res Commun1978;10(2):145-152. 652841
5. Matsuda, H., Li, Y., Murakami, T., Ninomiya, K., Yamahara, J., and Yoshikawa, M. Effects of escins Ia, Ib, IIa, and IIb from horse chestnut, the seeds of Aesculus hippocastanum L., on acute inflammation in animals. Biol Pharm Bull1997;20(10):1092-1095. 9353571
6. Matsuda H, Yuhao, L, Murakami T, and et al. Antiinflammatory effects of escins Ia, Ib, IIa, and IIb from horse chestnut, the seeds of Aesculus Hippocastanum L. Bioorganic Med Chem Lett1997;7(13):1611-1616.
7. Masaki, H., Sakaki, S., Atsumi, T., and Sakurai, H. Active-oxygen scavenging activity of plant extracts. Biol Pharm Bull1995;18(1):162-166. 7735233
8. Brunner, F., Hoffmann, C., and Schuller-Petrovic, S. Responsiveness of human varicose saphenous veins to vasoactive agents. Br J Clin Pharmacol2001;51(3):219-224. 11298067
9. Antoniuk, V. O. [Isolation of lectin from horse chestnut (Aesculus hippocastanum L.) seeds and study of its interaction with carbohydrates and glycoproteins]. Ukr Biokhim Zh1992;64(5):47-52. 1462370
10. Schrader, E., Schwankl, W., Sieder, C., and Christoffel, V. [Comparison of the bioavailability of beta-aescin after single oral administration of two different drug formulations containing an extract of horse-chestnut seeds]. Pharmazie1995;50(9):623-627. 7480102
11. Bassler, D., Okpanyi, S., Schrodter, A., Loew, D., Schurer, M., and Schulz, H. U. Bioavailability of beta-aescin from horse chestnut seed extract: comparative clinical studies of two Galenic formulations. Adv Ther2003;20(5):295-304. 14964349

 

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