Echinacea - Aleve (Naproxen) Interaction

Interaction Details

Naproxen is classified as belonging to the following category: Cytochrome P450 1A2 (Cyp1A2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Echinacea appears to inhibit CYP1A2 enzymes in humans. Additionally, echinacea seems to increase plasma concentrations of caffeine, a CYP1A2 substrate, by around 30%. Theoretically, echinacea might increase levels of other drugs metabolized by CYP1A2.

Interaction Rating

Likelihood of Occurrence

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists

Pharmacist Analysis

Echinacea has been reported to affect certain metabolizing enzymes, such as CYP1A2, which is partially responsible for the metabolism of Aleve (naproxen).

Theoretically, inhibition of this enzyme could result in an increase in drug concentrations, increasing the risk of side effects.

However, naproxen is a substrate of several CYP enzymes, including the aforementioned CYP1A2, as well as CYP2C8 and CYP2C9. Studies suggest that CYP2C9 is the predominant metabolic pathway.

Due to the multiple metabolic pathways of naproxen, it is unlikely that the inhibition of CY1A2 by echinacea would significantly alter the overall metabolism of naproxen to a clinically significant degree.

Nevertheless, if you would like to avoid this potential interaction completely, ibuprofen, another NSAID like naproxen, is not known to interact at all with echinacea.

References

• Gorski JC, Huang S, Zaheer NA, et al. The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo.Clin Pharmacol Ther 2003;73 (Abstract PDII-A-8):P94.

Naproxen Overview

• Prescription naproxen is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints), rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), juvenile arthritis (a form of joint disease in children), and ankylosing spondylitis (arthritis that mainly affects the spine). Prescription naproxen tablets, extended-release tablets, and suspension are also used to relieve shoulder pain caused by bursitis (inflammation of a fluid-filled sac in the shoulder joint), tendinitis (inflammation of the tissue that connects muscle to bone), gouty arthritis (attacks of joint pain caused by a build-up of certain substances in the joints), and pain from other causes, including menstrual pain (pain that happens before or during a menstrual period). Nonprescription naproxen is used to reduce fever and to relieve mild pain from headaches, muscle aches, arthritis, menstrual periods, the common cold, toothaches, and backaches. Naproxen is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation.

Echinacea - More Interactions

Echinacea interacts with 785 drugs

Interaction Rating Key

These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.