Daunorubicin and Echinacea: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Daunorubicin
Echinacea
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Decreased DAUNOrubicin efficacy in treatment of acute myeloid leukemia
Interaction Deep Dive
In an in-vitro study, echinacea hindered DAUNOrubicin's efficacy in an acute myeloid leukemia (AML) cell-line, significantly reducing the ability of cytarabine to induce cell death. In 96-well plates of AML cells treated with aliquots of echinacea 1 mg/mL alone or in combination with 0.05 mcM DAUNOrubicin, there was significant inhibition of DAUNOrubicin's cytotoxicity in AML cells. Concomitant use should be avoided1.
Why it happens (mechanism)
Upregulation of antiapoptotic Bcl-2 protein by echinacea
Literature reports
1 report — tap to read
a) In an in-vitro study, acute myeloid leukemia (AML) cells (1.5 x 10(4)/well) were seeded in 96-well plates and treated with aliquots of echinacea 1 mg/mL alone or in combination with 0.05 mcM DAUNOrubicin and incubated for 72 hours for assessment of cell growth and viability resulted in significant inhibition of DAUNOrubicin's cytotoxicity in AML cells 1.
Common questions
Can I take Daunorubicin and Echinacea together?
Decreased DAUNOrubicin efficacy in treatment of acute myeloid leukemia Always confirm with your pharmacist or prescriber before making any change.
How serious is the Daunorubicin and Echinacea interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Daunorubicin or Echinacea need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Spagnuolo P: Interactions between nutraceutical supplements and standard acute myeloid leukemia chemotherapeutics. J Pharm Pharm Sci 2015; 18(4):339-343. PubMed
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