| Horsetail is used in traditional medicine as a diuretic | | | | diuretics, and laxative stimulants), there's an |
| and an antitubercular drug, and in the treatment | | | | increased risk of hypokalemia. Overuse of licorice |
| of kidney and bladder disturbances. It's been used | | | | with horsetail may increase potassium depletion |
| topically in cosmetics, and as an astringent to stop | | | | and risk of cardiac toxicity. Excessive alcohol |
| bleeding and stimulate wound healing. | | | | consumption while horsetail is being used may lead |
| Horsetail's mild diuretic action is probably the result | | | | to thiamine deficiency. |
| of the equisetonin and flavonoid glycoside | | | | Pregnant patients, breast-feeding patients, those |
| constituents. Horsetail also contains small amounts | | | | with impaired heart or kidney function, those with |
| of pharmacologically active nicotine and inorganic | | | | liver problems, those who are taking a cardiac |
| silica components. Horsetail is available as dried | | | | glycoside, and those who have a history or |
| extract in powdered form, dried or fresh stem of | | | | potential of thiamine deficiency (for example, |
| horsetail plant, infusion, liquid extract 1:1 in 25% | | | | alcoholic patients) should avoid using horsetail. |
| alcohol), and tea, in products such as Springtime | | | | Safety Risk The liquid extract contains 25% |
| Horsetail and Wild Countryside. | | | | alcohol and there fore shouldn't be used with |
| Reported uses | | | | disulfiram, metronidazole, and benzodiazepines. |
| Horsetail is used orally to treat diuresis, edema, | | | | Clinical considerations |
| and general disturbances of the kidney and | | | | Horsetail dosage varies with the formulation. Large |
| bladder. It's used topically for supportive | | | | amounts may cause a toxic reaction. |
| treatment of burns and wounds. Horsetail has also | | | | The dried, powdered extract is more |
| been used to treat brittle fingernails, rheumatic | | | | concentrated than stem alone. |
| diseases, gout, frostbite, and profuse | | | | Monitor patient's serum potassium level. |
| menstruation. | | | | Assess patient for signs and symptoms of |
| Administration | | | | hypokalemia, including weakness, muscle flaccidity, |
| Diuresis: Dosage is 6 g of the dried stem by | | | | and abnormal ECG results. |
| mouth every day with plenty of fluids, or 1 cup | | | | Horsetail shouldn't be used for extended periods |
| of tea taken several times between meals, or 1 | | | | because of the potential for toxic reaction and |
| to 4 ml ofliquid extract by mouth three times a | | | | thiamine depletion. |
| day | | | | Instruct patients to stop taking horsetail |
| Infusion: An infusion is prepared by placing 1.5 g of | | | | immediately if signs or symptoms of nicotine |
| dried stem in 1 cup of water; dosage is 2 to 4 g | | | | toxicity (muscle weakness, abnormal pulse rate, |
| by mouth every day | | | | fever, ataxia, and cold extremities) or potassium |
| Tea: A tea is prepared by pouring boiling water | | | | depletion (muscle cramping, irritability, or |
| over 2 to 3 g of the herb, boiling for 5 minutes, | | | | weakness) occur. |
| and then straining after 10 to 15 minutes; | | | | If patient is pregnant or breast-feeding, advise her |
| consumed several times a day between meals | | | | not to use horsetail. |
| Topical support for burns or wounds: A compress | | | | Advise patients taking a potassium wasting |
| containing 10 g of stem/L of water may be | | | | diuretic, a cardiac glycoside (Lanoxin), a |
| applied to affected areas. | | | | corticosteroid, or licorice not to use horsetail. |
| Hazards | | | | Tell patient to notify pharmacist of any herbal or |
| Side effects of horsetail include electrolyte | | | | dietary supplement that he's taking when obtaining |
| imbalance, skin irritation from topical use, thiamine | | | | a new prescription. |
| deficiency from long-term use, and symptoms of | | | | Advise patient to consult his health care provider |
| nicotine poisoning and toxicity including nausea and | | | | before using an herbal preparation because a |
| vomiting, muscle weakness, abnormal pulse rate, | | | | conventional treatment with proven efficacy may |
| fever, and ataxia. Use of horsetail with | | | | be available. |
| benzodiazepines, disulfiram, or metronidazole may | | | | Safety Risk Horsetail should be kept out of reach |
| cause a disulfiram-like reaction. Horsetail may | | | | of children because poisonings have been reported |
| increase digitalis toxicity as a result of potassium | | | | in those that used the stems as blowguns or |
| loss with diuretic effect. When it's used with | | | | whistles. |
| potassium-wasting drugs (including corticosteroids, | | | | |