A.Vogel Venaforce® Gel Heavy, swollen and painful legs associated with venous insufficiency and varicose veins Refreshes and revitalizes tired legs Composition 1 g of Venaforce Gel contains: Medicinal ingredient: Dry extract of Fresh Horse Chestnut (Aesculus hippocastanum) ...54 – 117 mg(DER 5.0 – 6.1:1, QDE: 270 mg – 714 mg) standardized to 2% aescin. Non-medicinal ingredients: water, alcohol, hypromellose, polyglyceryl-4 caprate, glycerine. Dosage For external use: Adults: Apply sparingly on legs 2 to 3 times daily. Avoid rubbing. Always massage the legs upwards toward the heart to promote venous return. Duration: Consult a healthcare practitioner for use beyond 6 weeks. A 6 week treatment - 2 week pause cycle is suggested. Historical overview Venous insufficiency is a complex state involving an increase in capillary and vein pressure, an increase in capillary permeability, a blood stasis, an edema, inflammation, etc. Its precise cause is still unknown but many risk factors have been identified: excess weight, hypertension, tobacco, alcohol, lack of physical activity, bad diet, pregnancy, standing or sitting stationary work (nurse, pharmacist, clerk), constipation, etc. The symptoms of venous insufficiency may be benign, like heavy and tired legs, but may also be much more serious, like varicose veins, painful hemorrhoids and even phlebitis. Aside from surgery (that eliminates the diseased veins but does not stop the progression of varicose veins), there are few treatments for venous insufficiency. Support stockings are effective but so uncomfortable that very few people wear them. Horse Chestnut seed extract is used for venous insufficiency problems (including phlebitis), fragile capillaries, liver congestion, diarrhea and fever. Actions and pharmacology The gel form, adds to Horse Chestnut effects (see Venaforce® tablets or Venaforce® Liquid information sheets) a refreshing local effect, increasing the relief of tired legs. For more effectiveness, combine Venaforce® gel with Venaforce® liquid or tablets. Scientific studies Many clinical references confirm the topical application of Horse Chestnut seed extract to relieve poor circulation problems and symptoms. For example, a study conducted on healthy volunteers demonstrated the efficacy of a Horse Chestnut seed gel, standardized to a 2% aescine content, to speed up hematoma (bruise) healing and to relieve pain.(1) A 1997 clinical study on Venaforce® gel was conducted on 71 patients suffering from chronic venous insufficiency with edema of the lower limbs. After 6 weeks, the diameter of the ankle was significantly reduced by 0.7 cm; symptoms had dropped by 60% according to the scale used (edema, tired and heavy legs, stretching sensation, pain, burning sensation, etc.); and 85% of patients deemed Venaforce® gel effective.(2) Precautions, contraindications and interactions For external use only. Avoid contact with eyes and mucous membranes. Wash hands thoroughly after use. Do not apply to inflamed skin or open wounds. Do not use if you are pregnant or breastfeeding. Avoid taking in case of allergy to any of the ingredients in the product. Do not use if safety seal is broken. Keep out of the reach of children. References 1-Calabrese C, Preston P. Report of the results of a double-blind, randomized, single-dose trial of a topical 2% escine gel versus placebo in the acute treatment of experimentally-induced hematoma in volunteers. Planta Med 1993 Oct;59(5):394-7 2-Geissbühler S, Gegenring FH. Traitement de l'insuffisance veineuse chronique par Aesculaforce (Venaforce® au Canada) gel pour les veines. Schweiz Zschr GanzheitMedizin 1999;11(2):82-87.