Drug & supplement interaction

Echinacea + Spironolactone

Spironolactone brand names: Aldactone, Spiroton, Carospir.

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated July 2026 · Pair last verified Sep 13, 2026

The bottom line No known interaction

We found no known interaction between Echinacea and Spironolactone in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Echinacea and Spironolactone

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Spironolactone and Echinacea in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Echinacea safety at a glance

Echinacea overall Use caution Generally well tolerated short-term, but it may cause allergic reactions, especially in people sensitive to ragweed and related plants.

Pregnancy Possibly Safe When used orally, short-term. There is preliminary evidence that mothers can safely use echinacea in the form of E. purpurea or E. angustifolia solid dosage for... Read the full pregnancy detail

Breastfeeding Use caution There is not enough reliable safety information, so caution or avoidance is advised.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Spironolactone and Echinacea? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

How we checked

Why No Interaction Is Listed for Spironolactone

Interactions in our licensed database are recorded against drug classes, not just single drug names. Spironolactone is filed under 4 classifications — including potassium-sparing diuretics, diuretic drugs, antihypertensive drugs. Echinacea has documented interactions with 12 drug classes — the most serious being caffeine (moderate), cytochrome p450 1a2 (cyp1a2) substrates (moderate) and cytochrome p450 3a4 (cyp3a4) substrates (moderate) — and none of Spironolactone’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Echinacea Does Interact With Other Medications

Echinacea has 815 moderate, 1 minor known drug interactions in our database — Spironolactone isn’t one of them. If you take anything else, check it against the full list below.

Moderate 815 Minor 1 No known interaction 2,014 (incl. Spironolactone)

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.

What to actually watch for

No Interaction Found — But Data Suggests Echinacea and Spironolactone May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 4 of them are worth acting on rather than waiting out — marked below.

Hives Worth acting on Additional detail
Echinacea
“Allergic reactions, including urticaria, runny nose, dyspnea, bronchospasm, acute asthma, angioedema, and anaphylaxis, have been reported with various echinacea preparations. Atopic individuals and those sensitive to other members of the Asteraceae family (ragweed, chrysanthemums, marigolds, daisies) seem to be at higher risk for these reactions.

A case report describes a 36-year-old female who presented with muscle…”

Echinacea · Natural Medicines adverse-effect record, reported in asthma.
6 sources cited

638. Mullins RJ. Echinacea-associated anaphylaxis. Med J Aust 1998;168:170-1. PubMed

1358. Mullins RJ. Allergic reactions to Echinacea. J Allergy Clin Immunol 2000;104:S340-341 (Abstract 1003).

8225. Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51. PubMed

10319. Logan JL, Ahmed J. Critical hypokalemic renal tubular acidosis due to Sjogren's syndrome: association with the purported immune stimulant echinacea. Clin Rheumatol 2003;22:158-9.

12171. Lee AN, Werth VP. Activation of autoimmunity following use of immunostimulatory herbal supplements. Arch Dermatol 2004;140:723-7. PubMed

48623. Maskatia, Z. K. and Baker, K. Hypereosinophilia associated with echinacea use. South.Med J 2010;103(11):1173-1174. PubMed
“Itching, urticaria, tingling, and allergic rashes have been reported with various echinacea preparations. In a study of children aged 2-11 years, rash occurred in about 7% of children treated with an extract of the above-ground parts of E. purpurea (EC31J2, Echinacin Saft, Madaus AG), compared with about 3% of those treated with placebo. There is concern that allergic reactions could be severe in some children.”

Echinacea · Natural Medicines adverse-effect record, reported in pruritus.
6 sources cited

8225. Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51. PubMed

12355. Goel V, Lovlin R, Barton R, et al. Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther 2004;29:75-83.

17519. Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77. PubMed

20059. Barrett B, Brown R, Rakel D, Rabago D, et al. Placebo effects and the common cold: a randomized controlled trial. Ann.Fam.Med 2011;9:312-22. PubMed

20077. Schapowal A, Berger D, Klein P, et al. Echinacea/sage or chlorhexidine/lidocaine for treating acute sore throats: a randomized double-blind trial. Eur.J Med Res 9-1-2009;14:406-12. PubMed

101592. Hoban CL, Byard RW, Musgrave IF. Analysis of spontaneous adverse drug reactions to echinacea, valerian, black cohosh and ginkgo in Australia from 2000 to 2015. J Integr Med. 2019;17(5):338-343. PubMed
Spironolactone

Listed in the ADVERSE REACTIONS section of the FDA label for Spironolactone. Read the label on DailyMed ›
A low white blood cell count / Bleeding or bruising Worth acting on Additional detail
Echinacea
“A 51-year-old female presented with leukopenia after taking echinacea 450 mg three times daily for 2 months, along with ginkgo biloba, multivitamins, and calcium. Her leukocyte count recovered upon stopping these supplements, but dropped again when she restarted echinacea alone about a year later. The problem resolved when echinacea was stopped permanently.”

Echinacea · Natural Medicines adverse-effect record, reported in common cold.
2 sources cited

48533. Kemp, D. E. and Franco, K. N. Possible leukopenia associated with long-term use of echinacea. J Am Board Fam.Pract. 2002;15(5):417-419.

48572. Liatsos, G., Elefsiniotis, I., Todorova, R., and Moulakakis, A. Severe thrombotic thrombocytopenic purpura (TTP) induced or exacerbated by the immunostimulatory herb Echinacea. Am J Hematol. 2006;81(3):224.
Spironolactone

Listed in the ADVERSE REACTIONS section of the FDA label for Spironolactone. Read the label on DailyMed ›
An allergic reaction Worth acting on Additional detail

Echinacea

“Orally, echinacea is well tolerated.

Most Common Adverse Effects:

Orally: Abdominal pain, constipation, diarrhea, heartburn, nausea and vomiting, rashes, and stomach upset.

Serious Adverse Effects (Rare):

Orally: Severe allergic reactions and hepatitis have been reported.”

Echinacea · Natural Medicines adverse-effect record, reported in constipation.

Spironolactone

Listed in the ADVERSE REACTIONS section of the FDA label for Spironolactone. Read the label on DailyMed ›
Drowsiness / Dizziness Additional detail
Echinacea
“Headache has been reported in people taking various echinacea preparations orally. Dizziness has also been reported. In one study using an alcoholic extract of the above-ground parts of E. purpurea (EC31J0, Echinacin, Madaus AG), somnolence and a tendency to aggressiveness were reported.”

Echinacea · Natural Medicines adverse-effect record, reported in cluster headache.
6 sources cited

3282. Grimm W, Muller HH. A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections. Am J Med 1999;106:138-43. PubMed

11970. Yale SH, Liu K. Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med 2004;164:1237-41. PubMed

17519. Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77. PubMed

20059. Barrett B, Brown R, Rakel D, Rabago D, et al. Placebo effects and the common cold: a randomized controlled trial. Ann.Fam.Med 2011;9:312-22. PubMed

20064. Haller J, Freund, TF, Pelczer, KG, et al. The anxiolytic potential and psychotropic side effects of an echinacea preparation in laboratory animals and healthy volunteers. Phytother.Res. 2013;27:54-61.

8225. Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51. PubMed
Spironolactone

Listed in the ADVERSE REACTIONS section of the FDA label for Spironolactone. Read the label on DailyMed ›
Stomach upset Additional detail
Echinacea
“Gastrointestinal adverse effects include nausea and vomiting, abdominal pain, stomach upset, heartburn, diarrhea, and constipation. An unpleasant taste, dry mouth, and burning, tingling or numbness of the tongue also occur.”

Echinacea · Natural Medicines adverse-effect record, reported in constipation.
6 sources cited

10802. Schulten B, Bulitta M, Ballering-Bruhl B, et al. Efficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trial. Arzneimittelforschung 2001;51:563-8.. PubMed

11970. Yale SH, Liu K. Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med 2004;164:1237-41. PubMed

12355. Goel V, Lovlin R, Barton R, et al. Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther 2004;29:75-83.

13419. Turner RB, Bauer R, Woelkart K, et al. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. N Engl J Med 2005;353:341-8.

17519. Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77. PubMed

20059. Barrett B, Brown R, Rakel D, Rabago D, et al. Placebo effects and the common cold: a randomized controlled trial. Ann.Fam.Med 2011;9:312-22. PubMed
Spironolactone

Listed in the ADVERSE REACTIONS section of the FDA label for Spironolactone. Read the label on DailyMed ›
Tiredness Additional detail
Echinacea
“Although uncommon, cases of echinacea-induced hepatitis have been reported. One case report describes acute cholestatic autoimmune hepatitis in a 45-year-old male who had been taking an echinacea root extract 1500 mg daily for about 2 weeks.”

Echinacea · Natural Medicines adverse-effect record, reported in anorexia.
4 sources cited

17518. Kocaman O, Hulagu S, Senturk O. Echinacea-induced severe acute hepatitis with features of cholestatic autoimmune hepatitis. Eur J Intern Med 2008;19:148. PubMed

91528. Gabranis I, Koufakis T1, Papakrivos I, Batala S. Echinacea-associated acute cholestatic hepatitis. J Postgrad Med. 2015;61(3):211-2. PubMed

8225. Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51. PubMed

88166. Lawrenson JA, Walls T, Day AS. Echinacea-induced acute liver failure in a child. J Paediatr Child Health 2014;50(10):841.
Spironolactone

Listed in the ADVERSE REACTIONS section of the FDA label for Spironolactone. Read the label on DailyMed ›
Diarrhea Additional detail

Echinacea

Recorded for Echinacea in the same Natural Medicines adverse-effect record shown under An allergic reaction above.

Spironolactone

Listed in the ADVERSE REACTIONS section of the FDA label for Spironolactone. Read the label on DailyMed ›
A skin rash Additional detail

Echinacea

Recorded for Echinacea in the same Natural Medicines adverse-effect record shown under Hives above.

Spironolactone

Listed in the ADVERSE REACTIONS section of the FDA label for Spironolactone. Read the label on DailyMed ›

Showing the 10 most notable of 13 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Echinacea but not commonly for Spironolactone: muscle weakness, stomach pain, constipation and wheezing.

Effects for Spironolactone come from the ADVERSE REACTIONS section of its FDA label; effects for Echinacea come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Echinacea in Pregnancy & Breastfeeding

Pregnancy Possibly Safe

When used orally, short-term. There is preliminary evidence that mothers can safely use echinacea in the form of E. purpurea or E. angustifolia solid dosage forms, 250-1000 mg daily, or tinctures, up to 30 drops daily, for 5 days to 7 days during the first trimester without adversely affecting the fetus. There is insufficient reliable information available about the safety of echinacea when used for longer than 7 days.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

From our Q&A

Questions About Echinacea or Spironolactone

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 Spironolactone, 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 Spironolactone

This page covers Echinacea only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Spironolactone page lists 206 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Lithium (major) and Oleander (major).

By severity: 7 major · 174 moderate · 25 minor.

From our pharmacist’s overview on the Spironolactone page

“Potassium is the supplement I check first for anyone on spironolactone (Aldactone, Carospir), because this water pill works by holding potassium in the body, and supplementing more on top of that can push blood levels too high. It is one of 206 supplement and herbal ingredients with documented interactions here, and the list warrants g…”

Reviewed by 2 · Jul 18, 2026

Open the Spironolactone 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. Even though Echinacea itself has no known interaction with Spironolactone, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Echinacea and Spironolactone 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 Spironolactone

Top 25%

#286 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.

Where does our data come from?

Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Echinacea reference on this page ↓
Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Echinacea and Spironolactone records this page draws on were last updated July 11, 2026.
What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.

Data structure & sourcing designed and verified by Dr. Brian Staiger, PharmD, BCPS.

Supplement

About Echinacea

What is 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.

Echinacea purpurea · Asteraceae · Roots, leaves, flowers, and whole aerial parts · Capsules, tablets, tinctures, liquid extracts, teas, and lozenges

An interaction check asks whether these two react with each other — it does not ask whether Echinacea is a good idea for someone in your situation. Here is what our Echinacea record says about it on its own.

Echinacea: dosing

There is no single official or standardized dose for echinacea. The right amount depends on the species, the plant part, and the type of product, and these vary widely between brands.The best approach is to follow the directions on the product label and not to exceed them. Many people use echinacea only for short periods, such as at the start of a cold.

From our Echinacea monograph — the full record covers uses, side effects and every documented interaction.

Read the full Echinacea monograph & all interactions

Medication

About Spironolactone

What Is Spironolactone Used For?

Brand names: Aldactone, Spiroton, Carospir

Spironolactone tablets (including Aldactone) are used to treat moderate-to-severe heart failure, high blood pressure, and fluid retention (edema) caused by liver cirrhosis or nephrotic syndrome. They are also used to diagnose and manage primary hyperaldosteronism — a condition where the adrenal glands produce too much of the hormone aldosterone.

Spironolactone oral suspension shares several of these uses — heart failure, high blood pressure, and edema from liver cirrhosis — but is not the same as Aldactone and is not therapeutically interchangeable with it. Your prescriber will choose the right form for your situation.

See full Spironolactone 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

815Moderate

1Minor

2,013No known interaction

815 Moderate 1 Minor 2,013 No interaction

Moderate

815 interactions

Showing 60 of 815 moderate interactions — see all 815 on the Echinacea page.

Minor

1 interaction

Acetaminophen, Dextromethorphan, Phenylephrine, Guaifenesin ›

No interaction 2,013 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 2,013 medications checked with no known interaction — see the full Echinacea list.

See the full Echinacea interactions page

See every supplement checked against Spironolactone, ranked by severity

Evidence & sources

Echinacea References

The 51 references that drive our Echinacea monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

Mullins RJ. Echinacea-associated anaphylaxis. Med J Aust 1998;168:170-1. PubMed
Mullins RJ. Allergic reactions to Echinacea. J Allergy Clin Immunol 2000;104:S340-341 (Abstract 1003).
Chavez ML, Chavez PI. Echinacea. Hosp Pharm 1998;33:180-8.
Grimm W, Muller HH. A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections. Am J Med 1999;106:138-43. PubMed
Taylor JA, Weber W, Standish L, et al. Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial. JAMA 2003;290:2824-30.. PubMed
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
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
Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
Gallo M, Sarkar M, Au W, et al. Pregnancy outcome following gestational exposure to echinacea: A prospective controlled study. Arch Intern Med 2000;160:3141-3. PubMed
Soon SL, Crawford RI. Recurrent erythema nodosum associated with echinacea herbal therapy. J Am Acad Dermatol 2001;44:298-9. PubMed
Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51. PubMed
Logan JL, Ahmed J. Critical hypokalemic renal tubular acidosis due to Sjogren's syndrome: association with the purported immune stimulant echinacea. Clin Rheumatol 2003;22:158-9.
Schulten B, Bulitta M, Ballering-Bruhl B, et al. Efficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trial. Arzneimittelforschung 2001;51:563-8.. PubMed
Yale SH, Glurich I. Analysis of the inhibitory potential of Ginkgo biloba, Echinacea purpurea, and Serenoa repens on the metabolic activity of cytochrome P450 3A4, 2D6, and 2C9. J Altern Complement Med 2005;11:433-9.
Yale SH, Liu K. Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med 2004;164:1237-41. PubMed
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
Lee AN, Werth VP. Activation of autoimmunity following use of immunostimulatory herbal supplements. Arch Dermatol 2004;140:723-7. PubMed
Goel V, Lovlin R, Barton R, et al. Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther 2004;29:75-83.
Barrett B. Medicinal properties of Echinacea: a critical review. Phytomedicine 2003;10:66-86. PubMed
Huntley AL, Thompson Coon J, Ernst E. The safety of herbal medicinal products derived from Echinacea species: a systematic review. Drug Saf 2005;28:387-400. PubMed
Turner RB, Bauer R, Woelkart K, et al. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. N Engl J Med 2005;353:341-8.
Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-40. .
Perri D, Dugoua JJ, Mills E, Koren G. Safety and efficacy of echinacea (Echinacea augustafolia, e. purpurea and e. pallida) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e262-7.
Kocaman O, Hulagu S, Senturk O. Echinacea-induced severe acute hepatitis with features of cholestatic autoimmune hepatitis. Eur J Intern Med 2008;19:148. PubMed
Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77. PubMed
Press Release: Echinacea herbal products should not be used in children under 12 years old. Medicines and Healthcare Products Regulatory Agency (UK). August 20, 2012. Available at: www.mhra.gov.uk/NewsCentre/Pressreleases/CON180627. (Accessed 21 October
Barrett B, Brown R, Rakel D, Rabago D, et al. Placebo effects and the common cold: a randomized controlled trial. Ann.Fam.Med 2011;9:312-22. PubMed
Haller J, Freund, TF, Pelczer, KG, et al. The anxiolytic potential and psychotropic side effects of an echinacea preparation in laboratory animals and healthy volunteers. Phytother.Res. 2013;27:54-61.
Grbic J, Wexler I, Celenti R, et al. A phase II trial of a transmucosal herbal patch for the treatment of gingivitis. J Am Dent.Assoc. 2011;142:1168-75. PubMed
Schapowal A, Berger D, Klein P, et al. Echinacea/sage or chlorhexidine/lidocaine for treating acute sore throats: a randomized double-blind trial. Eur.J Med Res 9-1-2009;14:406-12. PubMed
Bossaer JB and Odle BL. Probable etoposide interaction with Echinacea. J.Diet.Suppl 2012;9:90-5.
Abdul MI, Jiang X, Williams KM, et al. Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects. Br J Clin.Pharmacol. 2010;69:508-15. PubMed
Kemp, D. E. and Franco, K. N. Possible leukopenia associated with long-term use of echinacea. J Am Board Fam.Pract. 2002;15(5):417-419.
Liatsos, G., Elefsiniotis, I., Todorova, R., and Moulakakis, A. Severe thrombotic thrombocytopenic purpura (TTP) induced or exacerbated by the immunostimulatory herb Echinacea. Am J Hematol. 2006;81(3):224.
Penzak, S. R., Robertson, S. M., Hunt, J. D., Chairez, C., Malati, C. Y., Alfaro, R. M., Stevenson, J. M., and Kovacs, J. A. Echinacea purpurea significantly induces cytochrome P450 3A activity but does not alter lopinavir-ritonavir exposure in healthy s
Maskatia, Z. K. and Baker, K. Hypereosinophilia associated with echinacea use. South.Med J 2010;103(11):1173-1174. PubMed
Parnham MJ. Benefit-risk assessment of the squeezed sap of the purple coneflower (Echinacea purpurea) for long-term oral immunostimulation. Phytomed 1996;3:95-102. PubMed
Schroder-Aasen T, Molden G, Nilsen OG. In vitro inhibition of CYP3A4 by the multiherbal commercial product Sambucus Force and its main constituents Echinacea purpurea and Sambucus nigra. Phytother Res 2012;26(11):1606-13.
Moltó J, Valle M, Miranda C, et al. Herb-drug interaction between Echinacea purpurea and darunavir-ritonavir in HIV-infected patients. Antimicrob Agents Chemother 2011;55(1):326-30.
Goey AK, Meijerman I, Rosing H, et al. The effect of Echinacea purpurea on the pharmacokinetics of docetaxel. Br J Clin Pharmacol 2013;76(3):467-74.
Moltó J, Valle M, Miranda C, et al. Herb-drug interaction between Echinacea purpurea and etravirine in HIV-infected patients. Antimicrob Agents Chemother 2012;56(10):5328-31. PubMed
Lawrenson JA, Walls T, Day AS. Echinacea-induced acute liver failure in a child. J Paediatr Child Health 2014;50(10):841.
Hansen TS, Nilsen OG. In vitro CYP3A4 metabolism: inhibition by Echinacea purpurea and choice of substrate for the evaluation of herbal inhibition. Basic Clin Pharmacol Toxicol 2008;103:445-9.
Gabranis I, Koufakis T1, Papakrivos I, Batala S. Echinacea-associated acute cholestatic hepatitis. J Postgrad Med. 2015;61(3):211-2. PubMed
Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
Karsch-Völk M, Barrett B, Kiefer D, Bauer R, Ardjomand-Woelkart K, Linde K. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev.2014;(2):CD000530. doi: 10.1002/14651858.CD000530.pub3. PubMed
Hoban CL, Byard RW, Musgrave IF. Analysis of spontaneous adverse drug reactions to echinacea, valerian, black cohosh and ginkgo in Australia from 2000 to 2015. J Integr Med. 2019;17(5):338-343. PubMed
Ogal M, Johnston SL, Klein P, Schoop R. Echinacea reduces antibiotic usage in children through respiratory tract infection prevention: a randomized, blinded, controlled clinical trial. Eur J Med Res. 2021 Apr 8;26(1):33. PubMed
Lopresti AL, Smith SJ. An investigation into the anxiety-relieving and mood-enhancing effects of Echinacea angustifolia (EP107 ™): A randomised, double-blind, placebo-controlled study. J Affect Disord 2021;293:229-237.
Weishaupt R, Buchkov A, Kolev E, Klein P, Schoop R. Reduction of viral load in patients with acute sore throats: Results from an observational clinical trial with Echinacea / Salvia lozenges [published online ahead of print, 2023 Mar 8]. Complement Med Re
Sumer J, Keckeis K, Scanferla G, et al. Novel Echinacea formulations for the treatment of acute respiratory tract infections in adults-A randomized blinded controlled trial. Front Med (Lausanne) 2023;10:948787. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Related: nutrient depletion

Spironolactone Is Linked to Lower Levels of 7 Nutrients

Natural Medicines records Spironolactone as a medicine that can lower these. This is not an interaction with Echinacea — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:

Read the full Spironolactone nutrient depletion report ›

Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.

Pharmacist Counseling Corner

Taking Echinacea and Spironolactone Together: Common Questions

Is it safe to take Echinacea with Spironolactone?

We do not list a known interaction between Echinacea and Spironolactone. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.

Do Echinacea and Spironolactone have any of the same side effects?

Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.

How was the Echinacea and Spironolactone combination checked?

Interactions in our licensed database are recorded against drug classes. Spironolactone is filed under 4 classifications, and Echinacea has documented interactions with 12 drug classes — none of Spironolactone's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.

Does Echinacea interact with any other medications?

Yes. Echinacea has 816 documented drug interactions in our database — Spironolactone is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.

Does Spironolactone interact with any supplements?

Yes. Spironolactone has documented interactions with 206 supplements in our database — Echinacea is not one of them. The Spironolactone interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Echinacea monograph Uses, safety profile, and every drug interaction in one place Spironolactone drug information The full plain-English guide to this medication Spironolactone supplement interactions Every supplement checked against Spironolactone, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 51 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

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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.