Supplements Details

Echinacea

What other names is Echinacea known by?

American Cone Flower, Black Sampson, Black Susans, Brauneria Angustifolia, Brauneria Pallida, Comb Flower, Coneflower, Echinacea Angustifolia, Echinacea Pallida, Echinacea Purpurea, Echinaceawurzel, Échinacée, Échinacée Angustifolia, Échinacée Pallida, Échinacée Pourpre, Échinacée Purpurea, Equinácea, Fleur à Hérisson, Hedgehog, Igelkopfwurzel, Indian Head, Kansas Snakeroot, Narrow-Leaved Purple Cone Flower, Pale Coneflower, Purple Cone Flower, Purpursonnenhutkraut, Purpursonnenhutwurzel, Racine d'echininacea, Red Sunflower, Rock-Up-Hat, Roter Sonnenhut, Rudbeckie Pourpre, Schmallblaettrige Kegelblumenwurzel, Schmallblaettriger Sonnenhut, Scurvy Root, Snakeroot, Sonnenhutwurzel.

What is Echinacea?

Echinacea is an herb. Several species of the echinacea plant are used to make medicine from its leaves, flower, and root.

Is Echinacea effective?

There is some scientific evidence that echinacea can reduce the symptoms of cold or flu if started when the symptoms are first noticed and continued for 7-10 days. Echinacea does not prevent colds or flu.

Echinacea also seems to help prevent vaginal yeast infections when used with some medicated creams.

There is some evidence that echinacea applied to the skin can help wounds and ulcers heal.

There isn't enough information to know if echinacea works for the other conditions people use it for, including: urinary tract infections, migraines, eczema, bee stings, and many others.

Possibly Effective for...

  • Treating a common cold. Many scientific studies say that taking echinacea when cold symptoms are first noticed can modestly reduce symptoms of the common cold in adults. But some scientific studies show no benefit. The problem is that scientific studies have used different types of echinacea plants and different methods of preparation. Since the studies have not been consistent, it is not surprising that different studies show different results.
    If it helps for treating a cold, the benefit will likely be modest at best.
    Keep in mind that TREATING a common cold is different than PREVENTING a common cold. Taking echinacea does not seem to PREVENT a cold from starting.
  • Preventing vaginal yeast infections when used with a medicated cream called econazole (Spectazole).

Possibly Ineffective for...

  • Preventing recurrent genital herpes.

Insufficient Evidence to Rate Effectiveness for...

  • Urinary tract infections (UTIs), migraine headaches, chronic fatigue syndrome (CFS), eczema, hayfever, allergies, bee stings, attention deficit-hyperactivity disorder (ADHD), influenza (flu), and other conditions.

How does Echinacea work?

Echinacea seems to activate chemicals in the body that decrease inflammation, which might reduce cold and flu symptoms. Laboratory research suggests that echinacea can stimulate the body's immune system, but there's no evidence that this occurs in people. Echinacea also seems to contain some chemicals that can attack yeast and other kinds of fungus directly.

Are there safety concerns?

Echinacea seems to be safe for most people when used short-term. There is not enough information to know if echinacea is safe for long-term use. Some side effects have been reported such as fever, nausea, vomiting, unpleasant taste, stomach pain, diarrhea, sore throat, dry mouth, headache, numbness of the tongue, dizziness, insomnia, disorientation, and joint and muscle aches.

Echinacea can also cause allergic reactions, especially in people who are allergic to ragweed, mums, marigolds, or daisies. If you have allergies, be sure to check with your healthcare professional before taking echinacea.

Applying echinacea to the skin can cause redness, itchiness, or a rash.

Do not take echinacea if:

  • You are pregnant or breast-feeding.
  • You have a skin condition called pemphigus vulgaris.
  • You have an immune system disorder such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), or other immune system conditions called "autoimmune disease."

Are there any interactions with medications?



Caffeine
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

The body breaks down caffeine to get rid of it. Echinacea might decrease how quickly the body breaks down caffeine. Taking echinacea along with caffeine might cause too much caffeine in the bloodstream and increase the risk of side effects. Common side effects include jitteriness, headache, and fast heartbeat.



Etoposide (VePesid)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Etoposide is changed and broken down by the body. Echinacea might change how the body breaks down some medications. Taking echinacea along with etoposide might increase the side effects of etoposide. Before taking echinacea, talk to your healthcare provider if you are taking any medications that are changed by the body.



Medications changed by the body (Cytochrome P450 3A4 (CYP3A4) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the body. Echinacea might change how the body breaks down some medications. Taking echinacea along with some medications might increase the effects and side effects of some medications. Before taking echinacea, talk to your healthcare provider if you are taking any medications that are changed by the body.

Some medications changed by the body include lovastatin (Mevacor), clarithromycin (Biaxin), cyclosporine (Neoral, Sandimmune), diltiazem (Cardizem), estrogens, indinavir (Crixivan), triazolam (Halcion), and many others.



Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Echinacea might decrease how quickly the liver breaks down some medications. Taking echinacea along with some medications might increase the effects and side effects of some medications. Before taking echinacea, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some of the medications that are changed by the liver include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, zileuton (Zyflo), zolmitriptan (Zomig), and others



Medications that decrease the immune system (Immunosuppressants)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Echinacea can increase the activity of the immune system. Taking echinacea along with some medications that decrease the immune system might decrease these medications' effectiveness.

Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.



Midazolam (Versed)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

Taking midazolam (Versed) with echinacea increases how much midazolam (Versed) the body absorbs. This might increase the effects and side effects of midazolam (Versed), but more information is needed.



Warfarin (Coumadin)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

Warfarin (Coumadin) is used to slow blood clotting. The body breaks down warfarin (Coumadin) to get rid of it. Echinacea might increase the breakdown and decrease the effectiveness of warfarin (Coumadin). Decreasing the effectiveness of warfarin (Coumadin) might increase the risk of clotting. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

Dosing considerations for Echinacea.

The following doses have been studied in scientific research:

BY MOUTH:

For treatment of upper respiratory infections including the common cold and influenza, a wide variety of doses have been used depending on how the echinacea is prepared. These preparations include:

  • A tablet containing 6.78 mg of Echinacea purpurea crude extract based on 95% herb and 5% root (Echinaforce, Bioforce AG): two tablets given 3 times daily.
  • Freeze-dried echinacea juice extract capsules: 100 mg three times daily.
  • Echinacea purpurea herb juice: a daily dose of 6-9 mL for up to a maximum of 8 weeks. Echinacea purpurea herb juice has also been used in a dose of 20 drops every 2 hours for the first day followed by 20 drops three times daily until cold or flu symptoms improve.
  • An echinacea pallida root tincture equivalent to 900 mg herb daily.
  • An echinacea herbal compound tea (Echinacea Plus, Traditional Medicinals), consisting of leaves, flowers, and stems of Echinacea purpurea and Echinacea angustifolia plus dried extract of Echinacea purpurea root, has been used by drinking 5-6 cups of tea on the first day of symptoms and titrating down to 1 cup per day over the next 5 days. The tea is prepared by pouring 8 ounces of boiling water over one tea bag and steeping, covered, for 10-15 minutes.
  • Echinacea liquid (Echinagard): 20 drops every 2 hours for the first day of symptoms, then 3 times daily for up to 10 days.
  • A tablet containing 100 mg of a proprietary Echinacea angustifolia root extract (Monoselect Echinacea, PharmExtracta, Italy): 2 tablets daily for 15 days, then 1 tablet daily for 15 days, then 1 tablet every other day for 60 days to help prevent colds and the flu.
  • Echinacea purpurea liquid: 0.9 mL 3 times daily for 4 months to help prevent colds.

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