Drug & supplement interaction

Echinacea + Lenalidomide

Lenalidomide brand name: Revlimid.

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

Echinacea has a moderate interaction with Lenalidomide. Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Echinacea and Lenalidomide

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

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Lenalidomide

Lenalidomide falls under IMMUNOSUPPRESSANTS — the group Echinacea interacts with.

Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Theoretically, echinacea may interfere with immunosuppressant therapy because of its immunostimulant activity.
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 thinking behind this one. Echinacea is believed to give the immune system a little nudge, while lenalidomide (Revlimid) works in part by shaping how your immune system responds to cancer cells like multiple myeloma or myelodysplastic syndrome. On paper, an herb that revs immune activity could pull against the careful immune effects your oncology team is counting on, so the two could theoretically work at cross purposes.

I want to be honest about the strength of this. It's theoretical, based on how echinacea behaves in the lab rather than clear proof in patients on Revlimid. Still, lenalidomide is a serious cancer medicine, so this isn't a call to make on your own. Before adding any echinacea product, please check with your oncologist or pharmacist so they can weigh it for your specific treatment plan.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Chavez ML, Chavez PI. Echinacea. Hosp Pharm 1998;33:180-8.
  2. Luettig B, Steinmuller C, Gifford GE, et al. Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst 1989;81:669-75. PubMed
  3. Stimpel M, Proksch A, Wagner H, et al. Macrophage activation and induction of macrophage cytotoxicity by purified polysaccharide fractions from the plant Echinacea purpurea. Infect Immun 1984;46:845-9. PubMed
  4. Barrett B. Medicinal properties of Echinacea: a critical review. Phytomedicine 2003;10:66-86. 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 Lenalidomide 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. Lenalidomide)
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 Lenalidomide

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 Lenalidomide, 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 Lenalidomide

This page covers Echinacea only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Lenalidomide page lists 70 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Active Hexose Correlated Compound (ahcc) (moderate), Alfalfa (moderate), American Ginseng (moderate) and Andrographis (moderate).

By severity: 1 major · 59 moderate · 10 minor.

From our pharmacist’s overview on the Lenalidomide page

“People taking lenalidomide (Revlimid) for multiple myeloma are often drawn to immune-boosting supplements, which is exactly why this list deserves genuine care. Fifty-three of its 70 entries are herbs and mushrooms thought to stimulate the immune system, astragalus, ginseng, and beta-glucans among them, and each could theoretically pus…”

Reviewed by 2 · Jul 18, 2026

Open the Lenalidomide 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 Lenalidomide 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 Lenalidomide 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%

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

29 days ago today
Medication Lenalidomide
Top half

#1,342 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 Lenalidomide

What Is Lenalidomide Used For?

Brand name: Revlimid

Lenalidomide capsules (brand name Revlimid) are used to treat several blood cancers and related conditions in adults. These include multiple myeloma (MM) — taken in combination with dexamethasone, or as maintenance therapy after a stem cell transplant — and transfusion-dependent anemia caused by low- or intermediate-1-risk myelodysplastic syndromes (MDS) with a specific chromosome change called deletion 5q.

Lenalidomide capsules are also used for mantle cell lymphoma (MCL) that has come back or stopped responding after at least two prior treatments (one of which must have included bortezomib), and for previously treated follicular lymphoma (FL) or marginal zone lymphoma (MZL) — both in combination with a rituximab product. It is not approved for chronic lymphocytic leukemia (CLL) outside of clinical trials.

See full Lenalidomide 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 Lenalidomide, 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 Lenalidomide supplement interactions › Every supplement checked against Lenalidomide, ranked by severity Lenalidomide 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 Lenalidomide Together: Common Questions

Can you take Echinacea with Lenalidomide?
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 Lenalidomide 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 Lenalidomide and Echinacea?

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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.