Herb & supplement monograph

Echinacea Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by ·Updated July 2026
What is this page for?

First and foremost: how Echinacea interacts with medications. The heart of this page is the interaction list — every drug Echinacea is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Echinacea is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Echinacea Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Echinacea drug interaction appears low for most people. None of the listed interactions are rated major, and while hundreds carry a moderate rating, nearly all rest on theoretical concerns rather than proven harm in people.

Interactions deserving the most attention

The best-documented interaction is with caffeine: echinacea appears to slow how the body clears it, raising caffeine levels by about 30%, which could mean stronger or longer-lasting effects. We also give weight to immunosuppressants, because echinacea stimulates the immune system and could, in theory, work against transplant or autoimmune medicines where steady effect matters. A single report linked echinacea with worse low platelet counts in someone taking etoposide, a chemotherapy drug, so caution is reasonable there.

What the rest of the list means

Most of the long list comes from the possibility that echinacea affects enzymes the body uses to process many medications, not from harm actually seen in people. In fact, human studies with several medicines, including certain HIV drugs and a chemotherapy agent, found no meaningful change, and a warfarin study showed no significant effect on blood-thinning measures.

Check your medications against Echinacea

Based on HelloPharmacist’s Echinacea interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Echinacea

816 medications have a known interaction with Echinacea, graded by severity. Select any drug for the full evidence-based detail.

2,830 drugs
6-mercaptopurinePurinethol
Moderate Immunosuppressants

Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.

Read the full Echinacea + 6-mercaptopurine interaction 6-mercaptopurine drug page: uses, dosage & side effects
Ado-trastuzumab EmtansineKadcyla
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.

Read the full Echinacea + Ado-trastuzumab Emtansine interaction Ado-trastuzumab Emtansine drug page: uses, dosage & side effects
AbemaciclibVerzenio
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.

Read the full Echinacea + Abemaciclib interaction Abemaciclib drug page: uses, dosage & side effects
Abiraterone
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.

Read the full Echinacea + Abiraterone interaction Abiraterone drug page: uses, dosage & side effects
Abiraterone AcetateYonsa, Zytiga
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.

Read the full Echinacea + Abiraterone Acetate interaction Abiraterone Acetate drug page: uses, dosage & side effects
AbrocitinibCibinqo
Moderate Immunosuppressants

Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.

Read the full Echinacea + Abrocitinib interaction Abrocitinib drug page: uses, dosage & side effects
AcalabrutinibCalquence
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.

Read the full Echinacea + Acalabrutinib interaction Acalabrutinib drug page: uses, dosage & side effects
AcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen interaction Acetaminophen drug page: uses, dosage & side effects
Acetaminophen, AspirinGemnisyn
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen, Aspirin interaction
Acetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen, Aspirin, Caffeine interaction
Acetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen, Brompheniramine, Phenylpropanolamine interaction
Acetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen, Butalbital interaction
Acetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen, Butalbital, Caffeine interaction Acetaminophen, Butalbital, Caffeine drug page: uses, dosage & side effects
Acetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
Moderate Caffeine

Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.

Read the full Echinacea + Acetaminophen, Butalbital, Caffeine, Codeine interaction
Acetaminophen, Butalbital, CodeineBancap w/ Codeine
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen, Butalbital, Codeine interaction
Acetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen, Butalbital, Codeine Phosphate interaction
Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interaction
Acetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
Moderate Caffeine

Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.

Read the full Echinacea + Acetaminophen, Caffeine, Codeine interaction
Acetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen, Caffeine, Codeine, Salicylamide interaction
Acetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen, Caffeine, Dihydrocodeine interaction
Acetaminophen, Caffeine, IsomethepteneMigralam
Moderate Caffeine

Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.

Read the full Echinacea + Acetaminophen, Caffeine, Isometheptene interaction
Acetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.

Read the full Echinacea + Acetaminophen, Caffeine, Pyrilamine interaction
Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interaction
Acetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interaction
Acetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen, Chlorpheniramine, Dextromethorphan interaction
Acetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.

Read the full Echinacea + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interaction
Acetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interaction
Acetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.

Read the full Echinacea + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interaction
Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interaction
Acetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.

Read the full Echinacea + Acetaminophen, Chlorpheniramine, Phenylephrine interaction
Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction 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.
  • Possible. 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each drug listed above links to the full report for that exact Echinacea combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The big picture

The kinds of drugs Echinacea affects

Every type of medication (drug category) Echinacea is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 12 drug categories Echinacea interacts with
CaffeineCytochrome P450 1a2 (cyp1a2) SubstratesCytochrome P450 3a4 (cyp3a4) SubstratesEtoposide (vepesid)ImmunosuppressantsDarunavir (prezista)Dayquil SevereDocetaxel (taxotere)Etravirine (intelence)Lopinavir/ritonavir (kaletra)Midazolam (versed)Warfarin (coumadin)
Caffeine

Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Echinacea seems to increase plasma concentrations of caffeine by around 30%. This is likely due to inhibition of cytochrome P450 1A2 (CYP1A2) by echinacea.

Likelihood Probable Evidence B
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.

Likelihood Possible Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4. This may increase or decrease levels of drugs metabolized by CYP3A4.
Several clinical trials have shown that taking echinacea for up to one month does not significantly affect the metabolism of various CYP3A4 substrates, including midazolam, docetaxel, etravirine, lopinavir-ritonavir, and darunavir-ritonavir. However, other clinical research shows that echinacea may increase the clearance of midazolam, suggesting that echinacea might induce CYP3A4. The discrepancy is thought to be due to differing effects of echinacea on intestinal versus hepatic CYP3A4 enzymes. Echinacea appears to induce hepatic CYP3A4 but inhibit intestinal CYP3A4. In some cases, these effects might cancel each other out, but in others, drug levels may be increased or decreased depending on the level of effect at hepatic and intestinal sites. The effect of echinacea on CYP3A4 activity may differ depending on the CYP3A4 substrate.

Likelihood Possible Evidence B
Etoposide (Vepesid)

Echinacea may increase levels of etoposide.
In one report, concomitant use of etoposide and echinacea was associated with more severe thrombocytopenia than the use of etoposide alone, suggesting inhibition of etoposide metabolism. Etoposide is a cytochrome P450 3A4 (CYP3A4) substrate. Echinacea has variable effects on CYP3A4, but some studies have reported inhibition of the enzyme.

Likelihood Possible Evidence D
Immunosuppressants

Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Theoretically, echinacea may interfere with immunosuppressant therapy because of its immunostimulant activity.

Likelihood Possible Evidence B
Darunavir (Prezista)

Theoretically, echinacea may interfere with the metabolism of darunavir; however, a small clinical study found no effect.
Darunavir is metabolized by cytochrome P450 3A4 (CYP3A4) and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Echinacea has variable effects on CYP3A4, but administration of an E. purpurea root extract (Arkocapsulas Echinacea, Arkopharma) 500 mg four times daily for 14 days did not affect darunavir/ritonavir pharmacokinetics in 15 HIV-infected patients.

Likelihood Unlikely Evidence B
Dayquil Severe

Echinacea is reported to have varying effects on a number of Cytochrome P450 metabolizing enzymes in the liver, including CYP1A2 and CYP3A4, which play a role in acetaminophen and dextromethorphan metabolism (both contained in DayQuil Severe), respectively. Studies have reported both enzyme inhibition and induction, making it difficult to predict clinically significant drug interactions with reliability. Specific drug interaction studies reporting definitive results are rare, and potential drug interactions involving echinacea should likely be taken on a case-by-case basis. Based on what we know about how acetaminophen and dextromethorphan are metabolized, the risk of a clinically significant interaction between echinacea and DayQuil Severe is low.

Likelihood Unlikely Evidence A
Docetaxel (Taxotere)

Theoretically, echinacea may interfere with the metabolism of docetaxel; however, a small clinical study found no effect.
Docetaxel is metabolized by cytochrome P450 3A4 (CYP3A4). Echinacea has variable effects on CYP3A4, but taking E. purpurea whole plant extract (Echinaforce, A. Vogel Biopharma AG) 20 drops three times daily for 2 weeks did not alter the pharmacokinetics of docetaxel in one clinical study.

Likelihood Unlikely Evidence B
Etravirine (Intelence)

Theoretically, echinacea may interfere with the metabolism of etravirine; however, a small clinical study found no effect.
Etravirine is metabolized by cytochrome P450 3A4 (CYP3A4). Echinacea has variable effects on CYP3A4, but taking E. purpurea root extract (Arkocapsulas Echinacea, Arkopharma) 500 mg three times daily for 14 days did not alter the pharmacokinetics of etravirine in HIV-infected patients.

Likelihood Unlikely Evidence B
Lopinavir/Ritonavir (Kaletra)

Theoretically, echinacea may interfere with the metabolism of lopinavir; however, a small clinical study found no effect.
Lopinavir is metabolized by cytochrome P450 3A4 (CYP3A4) and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Echinacea has variable effects on CYP3A4, but taking E. purpurea (Echinamide, Natural Factors Nutritional Products, Inc.) 500 mg three times daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in healthy volunteers.

Likelihood Unlikely Evidence B
Midazolam (Versed)

Theoretically, echinacea may increase the metabolism of intravenous midazolam.
Echinacea induces hepatic CYP3A4 and might decrease plasma levels of midazolam by about 20%, reducing the effectiveness of intravenous midazolam. Echinacea also appears to inhibit intestinal CYP3A4, which could theoretically increase the bioavailability of oral midazolam. This may cancel out the decrease in availability caused by induction of hepatic CYP3A4, such that overall plasma levels after oral administration of midazolam are not affected by echinacea.

Likelihood Possible Evidence B
Warfarin (Coumadin)

Echinacea seems to increase the clearance of warfarin, although the effect may not be clinically significant.
Preliminary clinical research in healthy male volunteers suggests that taking echinacea increases the clearance of the active S-isomer of warfarin after a single dose of warfarin, but there was not a clinically significant effect on the INR.

Likelihood Possible Evidence B
Monograph

Echinacea: Uses, Safety & Side Effects

Medically reviewed by · Reviewed July 2026 ·
The bottom line

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
Scientific name
Echinacea purpurea
Family
Asteraceae
Part used
Roots, leaves, flowers, and whole aerial parts
Common forms
Capsules, tablets, tinctures, liquid extracts, teas, and lozenges
People commonly use it for
  • Common cold
  • Flu and respiratory infections
  • Immune support
  • Sore throat
  • Wound and skin care (traditional)

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance
OverallUse caution

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

PregnancyPossibly 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...

Read the full pregnancy detail
BreastfeedingInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

Echinacea is a flowering plant in the daisy family that grows wild across central and eastern North America. It is easy to recognize by its purple, cone-shaped flowers, which is why it is often called purple coneflower.

Native American communities used echinacea for many purposes long before it became a popular supplement. Today, several species are used, most often Echinacea purpurea, Echinacea angustifolia, and Echinacea pallida. Different parts of the plant — the roots, leaves, and flowers — may be used, and products can vary a lot from brand to brand.

Most people take echinacea hoping to prevent colds or to feel better faster when they are already sick. It is sold as capsules, tinctures, teas, and lozenges.

How it works

Echinacea contains several plant compounds, including alkamides, polysaccharides, glycoproteins, and caffeic acid derivatives such as cichoric acid. Researchers believe some of these may affect the immune system.

In laboratory and animal studies, echinacea extracts have shown effects on immune cells and on inflammation. Some research suggests it may influence how the body responds to viruses. However, these findings come mostly from test-tube and animal research and do not always translate into clear benefits in people.

In short, the exact way echinacea works in the human body is not fully understood, and the proposed immune-boosting effects remain unproven.

Effectiveness

Does Echinacea work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by .

Evidence overview · 25 uses evaluated
25 Insufficient evidence
How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.
2Likely EffectiveGood evidence, though not yet conclusive.
3Possibly EffectiveSome evidence suggests a benefit.
4Possibly IneffectiveSome evidence it may not help.
5Likely IneffectiveFairly strong evidence it doesn’t help.
6IneffectiveStrong evidence it doesn’t work.
7Insufficient Reliable Evidence to RateToo little research to say either way.

For Echinacea, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 25 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Anxiety
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral echinacea reduces anxiety.

Insufficient Reliable Evidence To Rate Athletic performance
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral echinacea improves athletic performance.

Insufficient Reliable Evidence To Rate Atopic dermatitis (eczema)
Rating & evidence shown verbatim from Natural Medicines

Some evidence shows that an echinacea cream may be effective in mild disease, but it has not been compared to conventional treatments such as corticosteroids.

Insufficient Reliable Evidence To Rate Attention deficit-hyperactivity disorder (ADHD)
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral echinacea for ADHD, there is insufficient reliable information about the clinical effects of echinacea for this purpose.

Insufficient Reliable Evidence To Rate Burns
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using topical echinacea for burns, there is insufficient reliable information about the clinical effects of echinacea for this purpose.

Insufficient Reliable Evidence To Rate Chronic fatigue syndrome (CFS)
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral echinacea for CFS, there is insufficient reliable information about the clinical effects of echinacea for this purpose.

Insufficient Reliable Evidence To Rate Coronavirus disease 2019 (COVID-19)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral echinacea is beneficial for preventing or treating COVID-19.

Insufficient Reliable Evidence To Rate Genital herpes
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral echinacea is beneficial for genital herpes in patients with herpes simplex virus (HSV) type 1 or 2.

Insufficient Reliable Evidence To Rate Gingivitis
Rating & evidence shown verbatim from Natural Medicines

Echinacea, in a mouth rinse or periodontal patch, has only been studied in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Herpes labialis (cold sores)
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using topical echinacea for herpes labialis, there is insufficient reliable information about the clinical effects of echinacea for this purpose.

Insufficient Reliable Evidence To Rate HIV/AIDS
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral echinacea for HIV/AIDS, there is insufficient reliable information about the clinical effects of echinacea for this purpose.

Insufficient Reliable Evidence To Rate Human papillomavirus (HPV)
Rating & evidence shown verbatim from Natural Medicines

Oral echinacea has only been studied in combination with other ingredients; its benefit when used alone is unclear.

Insufficient Reliable Evidence To Rate Influenza
Rating & evidence shown verbatim from Natural Medicines

Limited data suggest that oral echinacea may improve the response to influenza vaccine, and that a combination product containing echinacea may improve rates of recovery from influenza.

Insufficient Reliable Evidence To Rate Insect bite
Rating & evidence shown verbatim from Natural Medicines

It is unclear if topical homeopathy with a gel containing echinacea is beneficial for insect bite treatment. Oral echinacea has not been evaluated for this use.

Insufficient Reliable Evidence To Rate Lichen planus
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral echinacea is beneficial for patients with this condition.

Insufficient Reliable Evidence To Rate Malaria
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral echinacea for malaria, there is insufficient reliable information about the clinical effects of echinacea for this purpose.

Insufficient Reliable Evidence To Rate Migraine headache
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral echinacea for migraine headache, there is insufficient reliable information about the clinical effects of echinacea for this purpose.

Insufficient Reliable Evidence To Rate Otitis media
Rating & evidence shown verbatim from Natural Medicines

Oral echinacea does not seem to reduce the rate of recurrence of otitis media in young children, and may actually increase it.

Insufficient Reliable Evidence To Rate Psoriasis
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using topical echinacea for psoriasis, there is insufficient reliable information about the clinical effects of echinacea for this purpose.

Insufficient Reliable Evidence To Rate Rheumatoid arthritis (RA)
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral echinacea for RA, there is insufficient reliable information about the clinical effects of echinacea for this purpose.

Insufficient Reliable Evidence To Rate Tonsillitis
Rating & evidence shown verbatim from Natural Medicines

Oral echinacea has been used with azithromycin to reduce relapses of recurrent tonsillitis in children. A throat spray containing echinacea has also been evaluated for tonsillitis-associated sore throat. It is unclear if echinacea is beneficial for either purpose.

Insufficient Reliable Evidence To Rate Upper respiratory tract infection (URTI)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral echinacea is beneficial for preventing or treating URTIs.

Insufficient Reliable Evidence To Rate Urinary tract infections (UTIs)
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral echinacea for UTIs, there is insufficient reliable information about the clinical effects of echinacea for this purpose.

Insufficient Reliable Evidence To Rate Vaginal candidiasis
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral echinacea for vaginal candidiasis, there is insufficient reliable information about the clinical effects of echinacea for this purpose.

Insufficient Reliable Evidence To Rate Water warts
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral echinacea is beneficial for water warts (molluscum contagiosum).

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

For most healthy adults, echinacea appears reasonably safe when used short-term. Still, there are some important cautions.

People who are allergic to plants in the daisy (Asteraceae) family — such as ragweed, marigolds, daisies, and chrysanthemums — may be more likely to have an allergic reaction. People with asthma or a history of allergies should be especially careful.

People with autoimmune conditions or weakened immune systems should talk to their doctor before using echinacea, since its effects on the immune system are not well understood. Long-term safety has not been well studied.

Because there is not enough reliable safety information, pregnant and breastfeeding women should avoid echinacea or use it only with guidance from their doctor. Safety in young children is also uncertain, so check with a pediatrician first.

Side effects

Echinacea is usually well tolerated, but some people do have side effects. The most common are mild stomach upset, nausea, and an unpleasant taste, especially with liquid forms.

The most important risk is an allergic reaction, which can include rash, itching, swelling, or trouble breathing. Severe allergic reactions are rare but possible, particularly in people with other plant or pollen allergies. Stop using it and seek medical care right away if you have signs of a serious allergic reaction.

Echinacea: Reported Adverse Effects

Documented safety reports on Echinacea from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

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.

Reports by condition
Anorexia Hepatic

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. He presented with significantly elevated liver function tests (LFTs), elevated immunoglobulin G (IgG) levels, and a positive test for anti-smooth muscle antibodies, indicating an autoimmune process. Elevated LFTs and IgG levels returned to normal within one month of stopping echinacea. Another case report describes acute cholestatic hepatitis in a 44-year-old male who had taken echinacea root tablets 600 mg daily for 5 days to treat flu-like symptoms. He presented with elevated LFTs, prothrombin time, and international normalized ratio (INR). His condition gradually improved after stopping echinacea, and his LFTs normalized within 3 months.

Seven cases of hepatitis associated with echinacea use were reported to the Australian Adverse Drug Reactions Advisory Committee between 1979 and 2000, but specific details are lacking.

One case report describes acute liver failure in a 2 year-old child who had been given about 100 mg of echinacea daily for 2 weeks. The patient presented with jaundice, diarrhea, lethargy, anorexia, and significantly elevated LFTs. A liver biopsy showed hepatocyte swelling, spotty necrosis, and inflammatory infiltrate with eosinophils. A full recovery was made over a 2-week period.

  1. Kocaman O, Hulagu S, Senturk O. Echinacea-induced severe acute hepatitis with features of cholestatic autoimmune hepatitis. Eur J Intern Med 2008;19:148.
  2. Gabranis I, Koufakis T1, Papakrivos I, Batala S. Echinacea-associated acute cholestatic hepatitis. J Postgrad Med. 2015;61(3):211-2.
  3. Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51.
  4. Lawrenson JA, Walls T, Day AS. Echinacea-induced acute liver failure in a child. J Paediatr Child Health 2014;50(10):841.
Asthma Immunologic

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 weakness, electrolyte abnormalities, renal tubular acidosis, fatigue, and dry mouth and eyes after taking echinacea, kava, and St. John's Wort for 2 weeks., She also had a positive antinuclear antibody (ANA) test, with elevated anti-dsDNA antibodies SSA and SSB. Sjogren syndrome was diagnosed; the authors hypothesize that it may have been triggered by the immunostimulant effects of echinacea. A 55-year-old male with a history of pemphigus vulgaris in remission for about a year experienced a flare of the disease after taking an echinacea supplement for one week. After stopping echinacea, medical treatment resulted in partial control of the disease. Another case report describes a 58-year-old male who presented with marked eosinophilia and elevated immunoglobulin E (IgE) levels while taking an echinacea supplement. He required prednisone therapy until he stopped taking echinacea 3 years later, at which time his eosinophils and IgE normalized. A 41-year-old male experienced four episodes of erythema nodosum, each occurring after he had taken echinacea for early symptoms of influenza. After stopping echinacea, he had no further exacerbations of erythema nodosum, suggesting that it had been triggered by the immunostimulant effects of echinacea.

  1. Mullins RJ. Echinacea-associated anaphylaxis. Med J Aust 1998;168:170-1.
  2. Mullins RJ. Allergic reactions to Echinacea. J Allergy Clin Immunol 2000;104:S340-341 (Abstract 1003).
  3. Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51.
  4. 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.
  5. Lee AN, Werth VP. Activation of autoimmunity following use of immunostimulatory herbal supplements. Arch Dermatol 2004;140:723-7.
  6. Maskatia, Z. K. and Baker, K. Hypereosinophilia associated with echinacea use. South.Med J 2010;103(11):1173-1174.
  7. Soon SL, Crawford RI. Recurrent erythema nodosum associated with echinacea herbal therapy. J Am Acad Dermatol 2001;44:298-9.
Cluster headache Neurologic/CNS

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.

  1. 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.
  2. 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.
  3. Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77.
  4. 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.
  5. 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.
  6. Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51.
Common cold Hematologic

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. A 32-year-old male presented with severe thrombotic thrombocytopenic purpura (TTP) about 2 weeks after using an extract of E. pallida to treat a cold. He required admission to an intensive care unit and extensive plasmapheresis. The authors speculate that immunostimulant effects of echinacea induced or exacerbated the TTP.

  1. 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.
  2. 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.
Constipation Gastrointestinal

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.

  1. 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..
  2. 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.
  3. 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.
  4. 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.
  5. Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77.
  6. 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.
  7. 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.
  8. 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.
  9. 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.
  10. 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.
  11. 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.
Myalgia Musculoskeletal

Reports of arthralgia and myalgia have been associated with echinacea.

  1. 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.
Pruritus Dermatologic

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. The Medicines and Healthcare Products Regulatory Agency in the United Kingdom (UK) recommends against the use of oral echinacea products in children under 12 years of age due to this risk of allergic reaction. However, another study in children 4-12 years old shows that a specific E. purpurea product (Echinaforce Junior, A. Vogel) did not cause allergic or urticarial reactions more frequently than vitamin C.

  1. Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51.
  2. 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.
  3. Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77.
  4. 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.
  5. 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.
  6. 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.
  7. 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
  8. 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.
  9. 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..
  10. 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.
  11. 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
  12. 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.
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.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

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. If you are unsure how much to take or how long to use it, ask your pharmacist or doctor for advice.

Pregnancy & Breastfeeding

Echinacea & 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.

  1. 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.
  2. 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.
  3. 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.

Echinacea & Breastfeeding

Insufficient reliable information

Insufficient reliable information available; avoid using.

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

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

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.

  1. Mullins RJ. Echinacea-associated anaphylaxis. Med J Aust 1998;168:170-1. PubMed
  2. Mullins RJ. Allergic reactions to Echinacea. J Allergy Clin Immunol 2000;104:S340-341 (Abstract 1003).
  3. Chavez ML, Chavez PI. Echinacea. Hosp Pharm 1998;33:180-8.
  4. 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
  5. 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
  6. 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
  7. 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
  8. 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
  9. 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
  10. Soon SL, Crawford RI. Recurrent erythema nodosum associated with echinacea herbal therapy. J Am Acad Dermatol 2001;44:298-9. PubMed
  11. Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51. PubMed
  12. 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.
  13. 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
  14. 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.
  15. 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
Keep reading

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.

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

Brand directory

Brands that make products with Echinacea

630 brands in our database make a supplement containing Echinacea.

Product directory

Supplement products with Echinacea

3,771 products in our database contain Echinacea. Open any to see its full ingredient list and every drug interaction we check.

Air-Immune Natural Berry Flavor by Air-Immune Tablet Or Pill View ingredients & interactions Airborne by Airborne Tablet Or Pill 30 Tablet(s) View ingredients & interactions Airborne + Everyday Stress Away Zesty Orange by Airborne Powder 16 Powder Packet(s) · 0.18 Oz(s) · 5 Gram(s) · 2.9 Oz(s) · 80 Gram(s) View ingredients & interactions Airborne + Good Rest Very Berry by Airborne Powder 16 Powder Packet(s) · 0.18 Oz(s) · 5 Gram(s) · 2.8 Oz(s) · 80 Gram(s) View ingredients & interactions Airborne + Probiotic Assorted Fruit Flavors by Airborne Gummy Or Jelly 27 Gummy(ies) View ingredients & interactions Airborne Assorted Fruit Flavors by Airborne Original Gummy Or Jelly 42 Gummy(ies) View ingredients & interactions Airborne Assorted Fruit Flavors by Airborne Original Gummy Or Jelly 21 Gummy(ies) View ingredients & interactions Airborne Berry by Airborne Original Tablet Or Pill 116 Chewable Tablet(s) View ingredients & interactions Airborne Citrus by Airborne Original Tablet Or Pill 116 Chewable Tablet(s) View ingredients & interactions Airborne Citrus by Airborne Tablet Or Pill 64 Chewable Tablet(s) View ingredients & interactions Airborne Citrus by Airborne Original Tablet Or Pill 64 Chewable Tablet(s) View ingredients & interactions Airborne Citrus by Airborne Original Tablet Or Pill 32 Chewable Tablet(s) View ingredients & interactions Airborne Citrus by Airborne Tablet Or Pill 4 Chewable Tablet(s) View ingredients & interactions Airborne Elderberry Effervescent Tablets by Airborne Tablet Or Pill 20 Effervescent Tablet(s) View ingredients & interactions Airborne Everyday by Airborne Tablet Or Pill 120 Tablet(s) View ingredients & interactions Airborne Everyday by Airborne Tablet Or Pill 60 Tablet(s) View ingredients & interactions Airborne Everyday by Airborne Tablet Or Pill 30 Tablet(s) View ingredients & interactions Airborne Everyday Assorted Fruit by Airborne Gummy Or Jelly 50 Gummie(s) View ingredients & interactions Airborne Everyday Berry by Airborne Tablet Or Pill 120 Chewable Tablet(s) View ingredients & interactions Airborne Everyday Berry by Airborne Tablet Or Pill 100 Chewable Tablet(s) View ingredients & interactions Airborne Everyday Berry by Airborne Tablet Or Pill 50 Chewable Tablet(s) View ingredients & interactions Airborne Everyday Berry Blast by Airborne Gummy Or Jelly 50 Gummie(s) View ingredients & interactions Airborne Everyday Citrus Blast by Airborne Gummy Or Jelly 50 Gummie(s) View ingredients & interactions Airborne Kids Assorted Fruit Flavors by Airborne Gummy Or Jelly 63 Gummy(ies) View ingredients & interactions
Pharmacist Counseling Corner

Echinacea: Common Questions

What is Echinacea used for, and does it work?
People use Echinacea for a range of reasons, but according to the Natural Medicines database the current clinical evidence is insufficient to confirm it works for the specific conditions it has been studied for. See the graded list on this page, and talk to your pharmacist or doctor before relying on it for any condition.
Does Echinacea interact with prescription medications?
Yes. We list 816 medications with a known interaction with Echinacea. Use the checker above to see how Echinacea interacts with a specific drug.
How are Echinacea interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Echinacea with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Echinacea interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
Does Echinacea really prevent or cure colds?
Some studies suggest a small benefit in lowering the risk or shortening the length of a cold, but the evidence is mixed and not strong. Echinacea is not a proven cure, so do not rely on it in place of standard care.
Is Echinacea safe to take every day?
Echinacea is mainly studied for short-term use, and its long-term safety is not well established. Talk to your pharmacist or doctor before taking it daily for long periods.
Can I take Echinacea if I am pregnant or breastfeeding?
There is not enough reliable safety information, so it is best to avoid Echinacea during pregnancy and breastfeeding unless your doctor approves.
Who should avoid Echinacea?
People allergic to daisy-family plants like ragweed, and those with autoimmune conditions or weakened immune systems, should be cautious and check with a healthcare provider first.

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

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