Butcher's broom
Summary
Butcher's broom is a shrub whose root extract is used for chronic venous insufficiency. Most trials tested it with hesperidin methyl chalcone and vitamin C; pooled placebo-controlled trials found less leg heaviness, pain and ankle swelling (grade B). One single-ingredient trial cut leg volume modestly. A case of diabetic ketoacidosis has been reported in a woman with diabetes.
Key facts
- 10 double-blind placebo-controlled trials (719 patients) of Ruscus products for chronic venous disease[1]
- Most trials used a combination: 150 mg Ruscus extract, 150 mg hesperidin methyl chalcone and 100 mg vitamin C per capsule[2]
- Ankle circumference fell about 0.58 cm with Ruscus extract in a comparison of venoactive drugs[4]
- Described as an alpha-adrenergic agonist that tightens veins[5]
- 3 graded human outcomes on this page
- October 13, 2026
How it works
ProposedRuscus contains ruscogenins and flavonoids. It is described as an alpha-adrenergic agonist that constricts veins by activating alpha-1 and alpha-2 receptors and releasing noradrenaline in the vessel wall, reducing venous capacity and pooling in the legs.[5][2]
What the human research says
Human trials only, one row per outcome. The form column shows what each trial actually tested. Grades follow our evidence-grading policy.
| Outcome | Effect | Grade | Best evidence | PMID |
|---|---|---|---|---|
| Leg heaviness, pain and swelling in chronic venous disease (Ruscus products) | Improved | Grade B | Meta-analysis · n = 719 · 2017 Adults with chronic venous disease in double-blind placebo-controlled trials Form: Ruscus extracts, mostly combined with hesperidin methyl chalcone and vitamin C (Cyclo 3 Fort) · Dose: As used in each trial · Duration: Varied Versus placebo, Ruscus products reduced leg pain (RR 0.35, NNT 5), heaviness (RR 0.26, NNT 2.4), paresthesia and global symptoms, and reduced ankle circumference (SMD −0.74) and leg or foot volume (SMD −0.61). | 28225220 (opens PubMed)Source [1] |
| Venous symptom severity (Ruscus + hesperidin methyl chalcone + vitamin C) | Improved | Grade C | Meta-analysis · n = 10,246 · 2003 Adults with chronic venous insufficiency (31 studies, including 6 single-arm) Form: Cyclo 3 Fort: 150 mg Ruscus root extract, 150 mg hesperidin methyl chalcone and 100 mg vitamin C per capsule · Dose: As used in each study · Duration: Varied On a 0–3 scale, pain fell 0.44, heaviness 0.53, cramps 0.26 and paresthesia 0.29 points more than placebo; venous capacity also fell. Edema score and calf and ankle circumference did not fall significantly. | 14612852 (opens PubMed)Source [2] |
| Lower-leg volume in chronic venous insufficiency (single-ingredient extract) | Improved | Grade C | RCT · n = 148 · 2002 Women aged 30–89 with chronic venous insufficiency (CEAP 3–4) Form: Butcher's broom rhizome extract capsules (Fagorutin Ruscus) · Dose: Daily dose per the German monograph (amount not stated in the abstract) · Duration: 12 weeks Leg volume fell 20.5 mL more than placebo at 12 weeks, with smaller ankle and calf circumferences and less heaviness and tension. Tolerability was rated good to very good. | 12040966 (opens PubMed)Source [3] |
Forms
| Form | Elemental % | Absorption (human data) | GI tolerance | Studied for |
|---|---|---|---|---|
| Butcher's broom rhizome extract capsules | Varies[3] | No human absorption data in the cited abstracts.[3] | In a 12-week trial, 22 of 48 adverse events occurred in the extract group and only one was judged possibly (unlikely) related.[3] | Chronic venous insufficiency (single-ingredient, 12 weeks) |
| Ruscus + hesperidin methyl chalcone + vitamin C (Cyclo 3 Fort) | Varies[2] | Each capsule holds 150 mg Ruscus extract, 150 mg hesperidin methyl chalcone and 100 mg vitamin C.[2] | A case of prolonged diarrhea attributed to the combination has been reported.[7] | Venous symptoms and swelling (most of the trial evidence) |
Studied doses
Doses studied in human trials ranged from combination capsules holding 150 mg of Ruscus extract (with 150 mg hesperidin methyl chalcone and 100 mg vitamin C) to a single-ingredient rhizome extract at the German monograph dose for 12 weeks. Daily capsule counts are not given in the abstracts.[2][3]
Interactions
Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.
None found in our sources.
Who should be careful
- High blood pressure or blood-pressure medicines
- Butcher's broom is described as an alpha-adrenergic agonist that tightens blood vessels, which is why it has been proposed for low blood pressure on standing. Its effect on blood pressure in people with hypertension, or alongside alpha-blockers and other blood-pressure drugs, has not been studied; ask a clinician first.[5]
- People with diabetes
- A 39-year-old woman with diabetes developed diabetic ketoacidosis 5 days after starting butcher's broom for ankle swelling.[6]
Talk to your pharmacist or clinician before starting a supplement, especially if you take prescription medicines.
How to read the label
Frequently asked questions
Does butcher's broom help varicose veins or heavy legs?
For chronic venous disease, pooled placebo-controlled trials of Ruscus products found less leg heaviness, pain and swelling. Most tested a combination with hesperidin methyl chalcone and vitamin C.[1][2]
Does butcher's broom work on its own?
One 12-week trial of 148 women found the single-ingredient extract reduced lower-leg volume by about 20 mL and eased heaviness versus placebo.[3]
Is butcher's broom safe?
Trials reported good tolerability. Case reports describe prolonged diarrhea with the combination product and diabetic ketoacidosis in a woman with diabetes.[3][7][6]
How does butcher's broom work?
It is described as an alpha-adrenergic agonist that tightens veins and reduces blood pooling in the legs.[5]
Can butcher's broom raise blood pressure?
No trial cited here measured that. Its proposed vein-tightening, adrenergic action is why it has been suggested for low blood pressure on standing, an idea that has not been tested in trials.[5]
Sources
- [1]Efficacy of Ruscus extract, HMC and vitamin C, constituents of Cyclo 3 fort®, on improving individual venous symptoms and edema: a systematic review and meta-analysis of randomized double-blind placebo-controlled trials.. Int Angiol, 2017. meta-analysis
- [2]Meta-analysis of clinical trials of Cyclo 3 Fort in the treatment of chronic venous insufficiency.. Int Angiol, 2003. meta-analysis
- [3]Efficacy and safety of a Butcher's broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency.. Arzneimittelforschung, 2002. RCT
- [4]Meta-analysis of the impact of the principal venoactive drugs agents on malleolar venous edema.. Int Angiol, 2012. meta-analysis
- [5]Ruscus aculeatus (butcher's broom) as a potential treatment for orthostatic hypotension, with a case report.. J Altern Complement Med, 2000. review
- [6]An unusual case of Butcher's Broom precipitating diabetic ketoacidosis.. J Emerg Med, 2013. observational
- [7][A case of prolonged diarrhea caused by Cyclo 3 fort].. Presse Med, 1989. observational
What changed
- Adversarial review pass: every evidence row's numbers re-checked against its abstract (Europe PMC for abstracts PubMed truncates, PMC full text where open), grades checked against the grading rubric, and safety and overclaim wording re-read. Fixes: Added a blood-pressure caution (proposed alpha-adrenergic, vessel-tightening action; untested in hypertension or with blood-pressure drugs).
- First draft. Every PMID checked against NCBI E-utilities esummary (title and year taken from the record) and abstracts read for the cited rows.
- Strict second-pass self review (no separate reviewer agent was available for this batch): every PMID re-fetched via esummary and every evidence row, dose and safety line re-read against its abstract or fact sheet. No NIH ODS or NCCIH fact sheet covers butcher's broom. Combination-product evidence is labelled as not single-ingredient; the 2002 single-ingredient trial is the only form-specific row. The 2000 orthostatic-hypotension paper is a review with one case report and is cited for mechanism only. Retraction and erratum flags checked on all PMIDs: none.