Drug & supplement interaction

Echinacea + Bendamustine Hydrochloride

Bendamustine Hydrochloride brand name: Bendeka.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Echinacea has a moderate interaction with Bendamustine Hydrochloride. Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceB
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Echinacea and Bendamustine Hydrochloride

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

Why this applies to Bendamustine Hydrochloride

Bendamustine Hydrochloride falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Echinacea interacts with.

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.
Severity Moderate Likelihood Possible Evidence B

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with pairing echinacea and bendamustine. Your liver uses an enzyme called CYP1A2 to help break this chemo drug down. Echinacea appears to slow that enzyme down a bit (in studies it raised caffeine levels by about 30%). In theory, that could let more bendamustine build up in your blood than expected, which may mean stronger effects and more side effects.

With bendamustine, that could look like worse low blood counts, more infections, fatigue, nausea, or mouth sores. This is mostly theoretical, but bendamustine is serious cancer treatment, so I'd play it safe. Please don't start or stop echinacea on your own. Run it by your oncologist or pharmacist first, since they're closely watching your counts.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction 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.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Echinacea Also Interacts With Other Medications

Echinacea has 814 moderate, 1 minor known drug interactions in our database — the Bendamustine Hydrochloride one above is one of them. If you take anything else, check it against the full list below.

Moderate 814 Minor 1 No known interaction 2,015 (incl. Bendamustine Hydrochloride)
Taking anything else?

Check Another of Your Medications Against Echinacea

Covers the 2,830 medications we’ve checked against Echinacea. Pick one to open its full report.

From our Q&A

Questions About Echinacea or Bendamustine Hydrochloride

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Echinacea or Bendamustine Hydrochloride, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Bendamustine Hydrochloride

This page covers Echinacea only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bendamustine Hydrochloride page lists 86 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Acerola (moderate), Adrafinil (moderate), African Wild Potato (moderate), Alpha-lipoic Acid (moderate) and Ashitaba (moderate).

By severity: 62 moderate · 24 minor.

From our pharmacist’s overview on the Bendamustine Hydrochloride page

“Bendamustine (Bendeka), a chemotherapy used for certain leukemias and lymphomas, carries 86 supplement and herbal interactions on file, and none of them rates major, so this is a watch-and-adjust list rather than an alarm. Nearly all of the entries, about 80, involve the same liver enzyme, CYP1A2, which helps process bendamustine.”

Reviewed by 2 · Jul 18, 2026

Open the Bendamustine Hydrochloride interaction page

One more smart check

Taking Echinacea as Part of a Dietary Supplement Product? Check It for Interactions

We hold 350 real supplement products containing Echinacea, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Echinacea. Your product may carry other ingredients that interact with Bendamustine Hydrochloride too, on top of Echinacea — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Echinacea and Bendamustine Hydrochloride Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Echinacea
Top 5%

#71 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Bendamustine Hydrochloride
Top 25%

#385 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Echinacea

What is Echinacea?

Echinacea
  • Common cold
  • Flu and respiratory infections
  • Immune support
  • Sore throat
  • Wound and skin care (traditional)

Echinacea is a popular herb taken to help prevent or shorten the common cold, but study results are mixed and the overall benefit appears small at best. It is generally well tolerated for short-term use in most healthy adults, though people with allergies to daisy-family plants and those who are pregnant or breastfeeding should be cautious and talk to a pharmacist or doctor first.

Read the full Echinacea monograph & all interactions
Medication

About Bendamustine Injection

What Is Bendamustine Injection Used For?

Brand name: Bendeka

Bendamustine hydrochloride injection is used to treat adults with chronic lymphocytic leukemia (CLL). It is also used for adults with indolent B-cell non-Hodgkin lymphoma (NHL) — a slow-growing type of blood cancer — when the disease has continued to progress during or within six months of treatment with rituximab or a rituximab-containing regimen.

For CLL, how well bendamustine works compared to other first-line treatments (aside from chlorambucil) has not been fully established.

See full Bendamustine Injection drug information
Keep checking

Other Drugs & Echinacea

Browse every other medication we’ve checked against Echinacea — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
814Moderate
1Minor
2,014No known interaction
814 Moderate 1 Minor 2,014 No interaction
Moderate

814 interactions

Showing 60 of 814 moderate interactions — see all 814 on the Echinacea page.

Minor

1 interaction

No interaction 2,014 drugs checked — show the list

We also checked Echinacea against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,014 medications checked with no known interaction — see the full Echinacea list.

See the full Echinacea interactions page
See every supplement checked against Bendamustine Hydrochloride, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Echinacea monograph › Uses, safety, and every drug interaction in one place Bendamustine Hydrochloride supplement interactions › Every supplement checked against Bendamustine Hydrochloride, ranked by severity Bendamustine Injection drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Echinacea and Bendamustine Hydrochloride Together: Common Questions

Can you take Echinacea with Bendamustine Hydrochloride?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Echinacea and Bendamustine Hydrochloride interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Bendamustine Hydrochloride and Echinacea?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.