American Cone Flower, Black Sampson, Black Susans, Brauneria Angustifolia, Brauneria Pallida, Brauneria Purpurea, Comb Flower, Coneflower, Echinacea Angustifolia, Echinacea Pallida, Echinacea Purpurea, Echinacea Serotine, Echinacea Speciose, Echinaceawurzel, Échinacée, Échinacée Angustifolia, Échinacée Pallida, Échinacée Pourpre, Échinacée Purpurea, Equinácea, Fleur À Hérisson, Hedgehog, Helichroa Purpurea, Igelkopfwurzel, Indian Head, Kansas Snakeroot, Narrow-Leaved Echinacea, Narrow-Leaved Purple Coneflower, Narrow-Leaved Purple Cone Flower, Pale Coneflower, Pale Flower Echinacea, Pale Purple Coneflower, Purple Coneflower, Purple Cone Flower, Purpursonnenhutkraut, Purpursonnenhutwurzel, Racine D'echininacea, Red Sunflower, Rock-Up-Hat, Roter Sonnenhut, Rudbeckia Purpurea, Rudbeckie Pourpre, Schmallblaettrige Kegelblumenwurzel, Schmallblaettriger Sonnenhut, Scurvy Root, Snakeroot, Sonnenhutwurzel.
Overview InformationEchinacea is an herb that is native to areas east of the Rocky Mountains in the United States. It is also grown in western States, as well as in Canada and Europe. Several species of the echinacea plant are used to make medicine from its leaves, flower, and root. Echinacea was used in traditional herbal remedies by the Great Plains Indian tribes. Later, settlers followed the Indians' example and began using echinacea for medicinal purposes as well. For a time, echinacea enjoyed official status as a result of being listed in the US National Formulary from 1916-1950. However, use of echinacea fell out of favor in the United States with the discovery of antibiotics. But now, people are becoming interested in echinacea again because some antibiotics don't work as well as they used to against certain bacteria.
Echinacea is most commonly used for the common cold and other infections.
Commercially available echinacea products come in many forms including tablets, juice, and tea.
There are concerns about the quality of some echinacea products on the market. Echinacea products are frequently mislabeled, and some may not even contain echinacea, despite label claims. Don't be fooled by the term "standardized." It doesn't necessarily indicate accurate labeling. Also, some echinacea products have been contaminated with selenium, arsenic, and lead.
Coronavirus disease 2019 (COVID-19): Some experts warn that echinacea may interfere with the body's response against COVID-19. There is no strong data to support this warning. But there is also no good data to support using echinacea for COVID-19. Follow healthy lifestyle choices and proven prevention methods instead.
How does it 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 is no evidence that this occurs in people.
Echinacea also seems to contain some chemicals that can attack yeast and other kinds of fungi directly.
Uses & Effectiveness
Possibly Effective for
- Common cold. Taking echinacea by mouth while still healthy may help prevent colds. But the benefit is probably small. Taking echinacea after catching a cold doesn't seem to have much benefit.
Insufficient Evidence for
- Anxiety. Early research shows that taking 40 mg of a specific echinacea extract (ExtractumPharma ZRT) one or two times per day for 7 days reduces anxiety. But taking less than 40 mg per day does not seem to be effective.
- Eczema (atopic dermatitis). Early research shows that applying an echinacea cream (Linola Plus Cream) for 12 weeks can help reduce symptoms of mild eczema such as redness, swelling, itchiness, and dryness compared to using a cream with birch bark. It might take up to 12 weeks for the echinacea cream to show benefit. It's not clear if the echinacea cream works as well as steroid or anti-inflammatory eczema creams.
- Athletic performance. Early research shows that taking echinacea four times daily for 28 days increases oxygen intake during exercise tests in healthy men. But high doses of echinacea (8,000 mg and 16,000 mg) taken daily along with other ingredients doesn't seem to improve oxygen intake in athletes.
- Genital herpes. Evidence on the effect of echinacea for the treatment of herpes is unclear. Some research shows that taking an echinacea extract twice daily for 6 months does not seem to prevent genital herpes or make them less frequent or severe.
- Flu (influenza). Early research shows that taking an echinacea product daily for 15 days might improve the response to the flu vaccine in people with breathing problems such as bronchitis or asthma. It is unknown if echinacea has any benefit in people who are not vaccinated. Some research shows that drinking a product containing echinacea and elderberry five times a day for 3 days then three times a day for 7 days might help improve flu symptoms similar to the prescription medication, oseltamivir (Tamiflu).
- Ear infection (otitis media). Early research shows that taking a specific liquid echinacea extract three times daily for 3 days at the first sign of a common cold does not prevent an ear infection in children 1-5 years-old with a history of ear infections. Ear infections actually seemed to increase.
- Swelling (inflammation) of the tonsils (tonsillitis). Early research shows that taking 50 drops of a product containing echinacea three times daily for 2 weeks, along with an antibiotic, reduces sore throat and increases overall well-being in people with tonsillitis.
- Swelling (inflammation) of the eye (uveitis). Early research shows that taking echinacea 150 mg twice daily, in addition to eye drops and a steroid for 4 weeks, doesn't improve vision any more than using only eye drops and steroids in people with this condition.
- Warts. Early research shows that taking echinacea by mouth daily for up to 3 months does not clear warts on the skin.
- A mild form of gum disease (gingivitis).
- A sexually transmitted infection that can lead to genital warts or cancer (human papillomavirus or HPV).
- Attention deficit-hyperactivity disorder (ADHD).
- Bee stings.
- Bloodstream infections.
- Chronic fatigue syndrome (CFS).
- Cold sores (herpes labialis).
- Hay fever or other allergies.
- Low white blood cell count (leukopenia).
- Migraine headaches.
- Pink eye.
- Rattlesnake bites.
- Rheumatoid arthritis (RA).
- Strep infections.
- Swine flu.
- Urinary tract infections (UTIs).
- Yeast infections.
- Other conditions.
Side Effects & SafetyWhen taken by mouth: Echinacea is LIKELY SAFE for most people when taken by mouth in the short-term. Various liquid and solid forms of Echinacea have been used safely for up to 10 days. There are also some products, such as Echinaforce (A. Vogel Bioforce AG) that have been used safely for up to 6 months.
Some side effects have been reported such as fever, nausea, vomiting, bad taste, stomach pain, diarrhea, sore throat, dry mouth, headache, numbness of the tongue, dizziness, difficulty sleeping, a disoriented feeling, and joint and muscle aches. In rare cases, echinacea has been reported to cause inflammation of the liver.
When applied to the skin: Echinacea is POSSIBLY SAFE when applied to the skin, short-term. A cream (Linola Plus Cream) containing echinacea has been used safely for up to 12 weeks. In some people, applying echinacea to the skin may cause redness, itchiness, or a rash.
Echinacea is most likely to cause allergic reactions in children and adults who are allergic to ragweed, mums, marigolds, or daisies. If you have allergies, be sure to check with your healthcare provider before taking echinacea.
Special Precautions & Warnings:Children: Echinacea is POSSIBLY SAFE when taken by mouth or applied to the skin for up to 10 days. Taking echinacea by mouth seems to be safe in most children ages 2-11 years. But about 7% of these children may experience a rash that could be due to an allergic reaction. There is some concern that allergic reactions to echinacea could be more severe in some children. For this reason, some regulatory organizations have recommended against giving echinacea to children under 12 years of age. In newborns, a gauze containing echinacea and other ingredients has been safely applied to the skin around the eyes for up to 2 days.
Pregnancy: Echinacea is POSSIBLY SAFE when taken by mouth in the short-term. There is some evidence that echinacea might be safe when taken during the first trimester of pregnancy without harming the fetus. But until this is confirmed by additional research, it is best to stay on the safe side and avoid use.
Breast feeding: There is not enough reliable information about the safety of taking echinacea if you are breast feeding. Stay on the safe side and avoid use.
An inherited tendency toward allergies (atopy): People with this condition are more likely to develop an allergic reaction to echinacea. It's best to avoid exposure to echinacea if you have this condition.
"Auto-immune disorders" such as such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), a skin disorder called pemphigus vulgaris, or others: Echinacea might have an effect on the immune system that could make these conditions worse. Don't take echinacea if you have an auto-immune disorder.
Be cautious with this combination
Caffeine interacts with ECHINACEA
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.
Medications changed by the body (Cytochrome P450 3A4 (CYP3A4) substrates) interacts with ECHINACEA
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) interacts with ECHINACEA
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) interacts with ECHINACEA
Echinacea can increase the immune system. Taking echinacea along with some medications that decrease the immune system might decrease the effectiveness of medications that decrease the immune system.
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.
Be watchful with this combination
Midazolam (Versed) interacts with ECHINACEA
Taking midazolam with echinacea increases how much midazolam the body absorbs. This might increase the effects and side effects of midazolam, but more information is needed.
- For the common cold: For PREVENTING the common cold, a specific echinacea extract (Echinaforce, A. Vogel Bioforce AG) 0.9 mL three times daily (total dose: 2400 mg daily) for 4 months, with an increase to 0.9 mL five times daily (total dose: 4000 mg daily) at the first sign of a cold, has been used.
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- Ondrizek RR, Chan PJ, Patton WC, King A. Inhibition of human sperm motility by specific herbs used in alternative medicine. J Assist Reprod Genet 1999;16:87-91. View abstract.
- Parnham MJ. Benefit-risk assessment of the squeezed sap of the purple coneflower (Echinacea purpurea) for long-term oral immunostimulation. Phytomedicine 1996;3:95-102.
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