A.Vogel Echinaforce Ingredients & Drug Interactions
by Bioforce
What is this page for?
First and foremost: checking A.Vogel Echinaforce against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
A.Vogel Echinaforce is a dietary supplement by Bioforce with 2 active ingredients. Its ingredients are commonly taken for common cold, flu and respiratory infections, immune support.Based on those ingredients, 816 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Echinacea purpurea (aerial part) (fresh) extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against A.Vogel Echinaforce by Bioforce
Ask about any prescription or over-the-counter medication and we check it for interactions with A.Vogel Echinaforce by Bioforce — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of A.Vogel Echinaforce by Bioforce
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
A.Vogel Echinaforce contains 2 active ingredients: fresh extracts of echinacea purpurea (both the aerial part and the root). The product is delivered as a liquid in a 65% alcohol base.
Both echinacea extracts come from the same plant species and carry the same interaction and safety profile.
Does it work?
Couldn't assess
The evidence we hold on echinacea for the conditions listed — anxiety, athletic performance, ADHD, burns, chronic fatigue syndrome, and migraine headache — is insufficient to rate. That means reliable evidence establishing how well it works for these uses is not established in our data.
How safe is it?
Well-documented data
Echinacea is generally well tolerated in the short term. The most common side effects are gastrointestinal — abdominal pain, constipation, diarrhea, heartburn, nausea, vomiting, and stomach upset — and skin rashes.
Rarely, severe allergic reactions and hepatitis have been reported. If you're sensitive to ragweed or other plants in the daisy family (chrysanthemums, marigolds, daisies), your risk of an allergic reaction is higher.
Pregnancy is rated possibly safe, but there isn't enough safety data for lactation — talk with your pharmacist or doctor for personalized guidance if you're nursing.
Meds to double-check
Moderate interaction found
Before taking this product, double-check if you're on medications metabolized by CYP1A2 or CYP3A4 (Moderate severity). Also flag any immunosuppressants, etoposide, warfarin, lopinavir/ritonavir, or midazolam (Moderate for immunosuppressants and etoposide; Minor for the blood thinner and HIV/sedative drugs).
Your pharmacist can run these through our interaction checker.
The bottom line
Scorecard at a glanceFully disclosed formula with no assessable stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
Echinacea is a common herbal immune support, but it interacts significantly with medications that rely on liver enzymes to work. If you take any prescription drugs — especially blood thinners, HIV medications, sedatives, cancer drugs, or immunosuppressants — check with us before starting.
Anyone with a ragweed or daisy-family plant allergy should be cautious.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 2 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 25, 2013.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about A.Vogel Echinaforce, straight from the product label.
| Brand | Bioforce |
|---|---|
| Barcode (UPC) | 364031510809 |
| Net contents | 1.7 fl. Oz.; 50 mL |
| Market status | On market |
| Date entered into DSLD | Oct 25, 2013 |
| DSLD ID | 26943 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Children 4 or More Years of Age, Adult (18 - 50 Years), Children more than 1 but less than 4 |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for A.Vogel Echinaforce by Bioforce, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Echinacea purpurea (aerial part) (fresh) extract | 521 mg | -- |
| Echinacea purpurea (root) (fresh) extract | 27 mg | -- |
Other ingredients: Alcohol 65% v/v
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements
Like Fresh Herbs in a bottle. Exclusive A.Vogel Formula Made according to Swiss Pharmaceutical Manufacturing Practices Standardized Tests before, during and after processing guarantee uniform quality and purity
Special dispensing insert guarantees accurate measurement and helps prevent contamination Organic cultivation certified by Bio-Suisse
Swiss Product
Cultivation with a Conscience
Organically Grown
Best Before: Lot No.:
Making Nature Work
Fresh Herb Extract
~ Supports healthy immune function Organically grown from our own herb cultivations by our own expert herbalists.
Bioforce uses a unique process-extracting from fresh herbs, not dried. Fresh herbs are harvested at their prime and usually processed within 24 hours before they can dry out. Special extraction process guarantees a maximum of important freshelements inherent in each herb.
Formula
Contains organically grown herbs
Fresh Herb Extract of Echinacea
Suggested/Recommended/Usage/Directions
Suggested Use: Adults: 20-25 drops (Children from age 2: 1 drop per year of age) in small amount of water 3 times a day. Shake well before using.
Precautions
If pregnant or nursing a baby, seek professional advice before using this product.
Safety Sealed Bottle. If ring at bottom of cap is missing or broken, do not use!
Keep out of reach of children.
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
General
96714.04 030407
FDA Statement of Identity
Dietary Supplement
Seals/Symbols
PRODUCED IN ACCORDANCE WITH SWISS GOOD MANUFACTURING PRACTICES SWISS GMP Standards
Bioforce
Brand IP Statement(s)
(C) 2004, Bioforce AG Switzerland
Formulation
No pesticides, insecticides, fungicides or chemical fertiliers.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
A.Vogel Echinaforce by Bioforce label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in A.Vogel Echinaforce by Bioforce
These are the 2 active ingredients this product is made of. Select any to open its full monograph.
Serving size20 Drop(s) Dosage formLiquid Servings per container82 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Echinacea purpurea (aerial part) (fresh) extract
Interacts with816 drugs
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 bes...
Echinacea purpurea (aerial part) (fresh) extract monograph & interactionsEchinacea purpurea (root) (fresh) extract
Interacts with816 drugs
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 bes...
Echinacea purpurea (root) (fresh) extract monograph & interactionsOther (inactive) ingredients: Alcohol 65% v/v. These complete the product’s ingredient list but are not active constituents.
A.Vogel Echinaforce by Bioforce Drug Interactions
HelloPharmacist Interaction Report
A.Vogel Echinaforce by Bioforce contains echinacea and does interact with a number of medications.
The most serious interactions are Moderate in severity. Echinacea can inhibit an enzyme called CYP1A2, which metabolizes caffeine and other drugs — it may increase caffeine levels by around 30%, and theoretically boost levels of other medications broken down this way.
Read the full breakdown — every affected drug type, severity by severity
Echinacea also has mixed effects on another enzyme, CYP3A4. It may induce (speed up) the hepatic version while inhibiting the intestinal version, which could increase or decrease levels of drugs metabolized by CYP3A4.
One specific concern is etoposide (a cancer drug), where echinacea may raise levels and increase the risk of a serious drop in platelets (thrombocytopenia). Echinacea's immunostimulant activity may also interfere with immunosuppressant medications (drugs that dampen the immune system).
Minor interactions are documented with warfarin (a blood thinner), lopinavir/ritonavir (HIV medications), and midazolam (a sedative), though the clinical significance of these is uncertain. Altogether, these interactions span 803 individual medications.
Check your exact prescriptions with the tool on this page before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against A.Vogel Echinaforce?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in A.Vogel Echinaforce interact with 816 drugs. Click any drug to see the details.
1 of the 2 ingredients in A.Vogel Echinaforce interact with drugs. Each result below shows which ingredient is responsible. Echinacea purpurea (aerial part) (fresh) extract
Acetaminophen, Pamabrom, PyrilamineMidol Max Strength PMS, Pamprin, Pamprin ES
How Acetaminophen, Pamabrom, Pyrilamine interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea (root) (fresh) Extract + Acetaminophen, Pamabrom, Pyrilamine interactionAcetaminophen, PentazocineTalacen
How Acetaminophen, Pentazocine interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea (root) (fresh) Extract + Acetaminophen, Pentazocine interactionAcetaminophen, Phenylephrine, ChlorpheniramineSuper Cold Tabs
How Acetaminophen, Phenylephrine, Chlorpheniramine interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea (root) (fresh) Extract + Acetaminophen, Phenylephrine, Chlorpheniramine interactionAcetaminophen, PhenylpropanolamineTetra Caps
How Acetaminophen, Phenylpropanolamine interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea (root) (fresh) Extract + Acetaminophen, Phenylpropanolamine interactionAcetaminophen, Phenylpropanolamine, PhenyltoloxamineSinubid
How Acetaminophen, Phenylpropanolamine, Phenyltoloxamine interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea (root) (fresh) Extract + Acetaminophen, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, PhenyltoloxaminePercogesic, Relagesic
How Acetaminophen, Phenyltoloxamine interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea (root) (fresh) Extract + Acetaminophen, Phenyltoloxamine interactionAcetaminophen, Phenyltoloxamine, SalicylamideLobac
How Acetaminophen, Phenyltoloxamine, Salicylamide interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea (root) (fresh) Extract + Acetaminophen, Phenyltoloxamine, Salicylamide interactionAcetaminophen, PropoxypheneDarvocet-N 100, Darvocet-N 50, E-Lor, Wygesic
How Acetaminophen, Propoxyphene interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea (root) (fresh) Extract + Acetaminophen, Propoxyphene interactionAcetaminophen, PseudoephedrineChildren's Tylenol Sinus, Dristan N.D., Non-Aspirin Sinus, Ornex, Ornex-Max, Sinutab +5 more
How Acetaminophen, Pseudoephedrine interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea (root) (fresh) Extract + Acetaminophen, Pseudoephedrine interactionAcetaminophen, Pseudoephedrine, TriprolidineActifed Plus ES
How Acetaminophen, Pseudoephedrine, Triprolidine interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea (root) (fresh) Extract + Acetaminophen, Pseudoephedrine, Triprolidine interactionAdagrasibKrazati
How Adagrasib interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea (root) (fresh) Extract + Adagrasib interactionAdalimumabHumira
How Adalimumab interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea (root) (fresh) Extract + Adalimumab interactionAdalimumab-adazHyrimoz
How Adalimumab-adaz interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea (root) (fresh) Extract + Adalimumab-adaz interactionAdalimumab-adbmCyltezo
How Adalimumab-adbm interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea (root) (fresh) Extract + Adalimumab-adbm interactionAdalimumab-afzbAbrilada
How Adalimumab-afzb interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea (root) (fresh) Extract + Adalimumab-afzb interactionAdalimumab-attoAmjevita
How Adalimumab-atto interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea (root) (fresh) Extract + Adalimumab-atto interactionAdalimumab-bwwdHadlima
How Adalimumab-bwwd interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea (root) (fresh) Extract + Adalimumab-bwwd interactionAdalimumab-fkjpHulio
How Adalimumab-fkjp interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea (root) (fresh) Extract + Adalimumab-fkjp interactionAgomelatineValdoxan
How Agomelatine interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea (root) (fresh) Extract + Agomelatine interactionAlefaceptAmevive
How Alefacept interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea (root) (fresh) Extract + Alefacept interactionAlemtuzumabCampath
How Alemtuzumab interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea (root) (fresh) Extract + Alemtuzumab interactionAlfentanilAlfenta
How Alfentanil interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea (root) (fresh) Extract + Alfentanil interactionAlfuzosinUroxatral
How Alfuzosin interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea (root) (fresh) Extract + Alfuzosin interactionAliskirenTekturna
How Aliskiren interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea (root) (fresh) Extract + Aliskiren interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea (root) (fresh) Extract + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea (root) (fresh) Extract + Alogliptin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea (root) (fresh) Extract + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea (root) (fresh) Extract + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea (root) (fresh) Extract + Alprazolam interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with A.Vogel Echinaforce — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea (root) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea (root) (fresh) Extract + Ambrisentan interactionEach ingredient & the kinds of drugs it affects
For each ingredient in A.Vogel Echinaforce with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.
Echinacea purpurea (aerial part) (fresh) extract
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.
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.
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.
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.
Immunosuppressants
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Theoretically, echinacea may interfere with immunosuppressant therapy because of its immunostimulant activity.
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.
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.
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.
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.
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.
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.
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.
Brand information
Manufacturer and brand details for A.Vogel Echinaforce, from the product label.
A.Vogel Echinaforce by Bioforce: Common Questions
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The Full Monographs Behind A.Vogel Echinaforce’s Ingredients
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Sources & How We Checked
A.Vogel Echinaforce's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
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The 51 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Echinacea 51 references
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- 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
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- 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.
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- 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
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- 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
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- Bossaer JB and Odle BL. Probable etoposide interaction with Echinacea. J.Diet.Suppl 2012;9:90-5.
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- 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.
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- 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.
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- 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
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