Aescin

Aescin, also known as escin, is a standardized extract obtained from the seeds of the horse chestnut tree (Aesculus hippocastanum). It is a mixture of triterpenoid saponins, with alpha- and beta-aescin as its principal components. Aescin is used in medicines and supplements for its venotonic and anti-edematous properties.

Pharmacology and mechanism of action: Aescin is thought to reduce capillary permeability and increase venous tone, which helps decrease edema and improve circulation. It also exhibits anti-inflammatory effects, partly through stabilization of lysosomal membranes and inhibition of enzymes such as hyaluronidase. These actions contribute to symptom relief in conditions involving venous insufficiency and inflammation.

Clinical use: Aescin-containing preparations are used for chronic venous insufficiency (leg edema, aching, heaviness) and for hemorrhoidal disease. They can be administered orally (tablets or capsules) or applied topically, and are sometimes combined with other venotonic or anti-inflammatory agents.

Evidence and safety: Clinical trials and reviews have reported modest benefits for leg symptoms and edema in chronic venous insufficiency, and relief of hemorrhoidal symptoms in some cases. Side effects are generally mild and may include gastrointestinal upset, headache, or dizziness; allergic reactions can occur. Rare cases of liver injury have been reported in association with horse chestnut seed extracts, particularly with nonstandardized preparations, underscoring the importance of using standardized products from reputable sources. Caution is advised during pregnancy and lactation, and individuals on anticoagulant or antiplatelet therapy should consult a clinician due to potential interactions.

Chemistry and regulation: Aescin denotes the mixture of saponins derived from Aesculus seeds. Quality, composition, and safety can vary by manufacturer, making standardized extracts preferable for clinical use.