Dual Action Echinacea Ingredients & Drug Interactions
by Paradise
What is this page for?
First and foremost: checking Dual Action Echinacea 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
Dual Action Echinacea is a dietary supplement by Paradise with 1 active ingredient. 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 Root Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Dual Action Echinacea by Paradise
Ask about any prescription or over-the-counter medication and we check it for interactions with Dual Action Echinacea by Paradise — 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
Ask the Pharmacist
A licensed pharmacist will answer your question by email — free, usually within 24 hours.
Got it — thank you!
A licensed pharmacist will answer within 24 hours. Keep an eye on your email (worth checking spam, just in case).
HelloPharmacist Scorecard of Dual Action Echinacea by Paradise
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
This product contains one active ingredient: echinacea root extract. The inactive ingredient is plant cellulose, which is a filler used to form the capsule.
Does it work?
Couldn't assess
The data we hold does not establish reliable evidence for echinacea's effectiveness for any of the conditions listed—including anxiety, athletic performance, ADHD, burns, chronic fatigue, and migraine headache. Each is rated as having insufficient reliable evidence to support its use.
If you're considering this product for a specific health goal, that's worth discussing with your doctor or pharmacist, who can point you toward better-studied options.
How safe is it?
Well-documented data
Echinacea is generally well tolerated when taken short-term. The most common side effects are mild digestive complaints—abdominal pain, constipation, diarrhea, heartburn, nausea, vomiting, and stomach upset—as well as rashes.
Allergic reactions, including severe ones like anaphylaxis, are rare but have been reported, particularly in people sensitive to ragweed or related plants (chrysanthemums, marigolds, daisies). Very rare cases of liver injury (hepatitis) have also been documented.
Pregnancy is rated as possibly safe, but there isn't enough data on safety during breastfeeding to make a clear recommendation—talk with your doctor or pharmacist about whether it's right for you if you're nursing.
Meds to double-check
Moderate interaction found
Before taking Dual Action Echinacea, check with your doctor or pharmacist if you take blood thinners (like warfarin), immunosuppressant medications, chemotherapy drugs (especially etoposide), HIV protease inhibitors (like lopinavir/ritonavir), sedatives (like midazolam), or any drug metabolized by the liver enzymes CYP1A2 or CYP3A4. Echinacea can raise caffeine levels by around 30%, so if you're sensitive to caffeine, be aware your coffee or tea may have a stronger effect.
These interactions span 817 individual medications.
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 has documented moderate interactions with several major drug categories, especially those processed by liver enzymes and immune-suppressing medications. If you take any regular prescription medication, check it against this product's interactions before starting.
Echinacea is generally well tolerated short-term but can cause allergic reactions in people sensitive to ragweed-family plants and has rarely caused liver injury. Discuss it with your own doctor or pharmacist to decide if it's appropriate for your situation.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated Jul 18, 2023.
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 Dual Action Echinacea, straight from the product label.
| Brand | Paradise |
|---|---|
| Barcode (UPC) | 601944777180 |
| Net contents | 30 Vegetarian Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Jul 18, 2023 |
| DSLD ID | 288911 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), No Allergies, Gluten Free |
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 Dual Action Echinacea by Paradise, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Echinacea Root Extract | 250 mg | -- |
Other ingredients: Cellulose, Plant
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.
Formulation
Quality purity potency
We are dedicated to sourcing premium ultra pure ingredients that meet the highest standards of excellence. We never add unnecessary fillers, binders, preservatives or glow agents to our encapsulation process.
Vegan
Made with Non-GMO ingredients Gluten free
Contains no common allergens. Made without fillers.
Manufactured in the USA. GMP Quality Assured & FDA Registered.
General Statements
Paradise products have won over a decade of Best of Supplements Awards.
Formula
Active whole spectrum difference Our active whole spectrum extracts contain a full profile of naturally occurring constituents and are extracted without the use of toxic solvents and/or harsh chemicals. This unique method captures the true essence of the whole herb while still retaining a highly active and bioavailable concentration of phyto nutrients.
Dual Action Angustifolia & Purpurea Active Whole Spectrum Extract
Raw Material: Echinacea angustifolia and purpurea extract concentrated up to 10 times the original herb and containing a holistic full spectrum of active and synergistic constituents including echinacoside and polyphenols.
Storage
Warning: Keep in a cool dry place, out of the reach of children.
Precautions
Warning: Keep in a cool dry place, out of the reach of children.
If pregnant, nursing, or using any prescription medication consult your health care professional before using this product.
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.
Brand IP Statement(s)
Enhancing Nature's Miracles Since 1994
Paradise Premium Quality For Over 25 Years
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Suggested use: 1 vegetarian capsule daily or as directed by a qualified health care professional.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Dual Action Echinacea by Paradise 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 Dual Action Echinacea by Paradise
This is the 1 active ingredient this product is made of. Select it to open its full monograph.
Serving size1 Vegetarian Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.
Echinacea Root 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 Root Extract monograph & interactionsOther (inactive) ingredients: Cellulose, Plant. These complete the product’s ingredient list but are not active constituents.
Dual Action Echinacea by Paradise Drug Interactions
HelloPharmacist Interaction Report
Dual Action Echinacea by Paradise contains echinacea root extract, which has documented interactions with a range of medications.
The most serious interactions are Moderate in severity and involve several drug types: echinacea can inhibit the enzyme CYP1A2, raising levels of caffeine and other drugs it metabolizes; it has variable effects on the enzyme CYP3A4, which may increase or decrease levels of many common medications; it can stimulate the immune system in ways that may interfere with immunosuppressant therapy; and it may increase levels of the chemotherapy drug etoposide.
Read the full breakdown — every affected drug type, severity by severity
Additionally, echinacea interacts with blood thinners (warfarin), HIV protease inhibitors (lopinavir/ritonavir), and sedatives (midazolam), though these are rated Minor in severity. For warfarin, echinacea may speed its clearance; for the HIV drug and sedative, the effect is less certain but possible.
Almost 817 individual medications fall into these affected categories across the enzyme systems and drug types documented here. If you take any prescription medication—especially blood thinners, immune-suppressing drugs, chemotherapy, HIV treatments, sedatives, or anything metabolized by CYP1A2 or CYP3A4—run it through the interaction checker on this page before starting echinacea, or talk it over with your doctor or pharmacist.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Dual Action Echinacea?
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 Dual Action Echinacea interact with 816 drugs. Click any drug to see the details.
1 of the 1 ingredient in Dual Action Echinacea interact with drugs. Each result below shows which ingredient is responsible. Echinacea Root Extract
Acetaminophen, Pamabrom, PyrilamineMidol Max Strength PMS, Pamprin, Pamprin ES
How Acetaminophen, Pamabrom, Pyrilamine interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root 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 Root Extract + Acetaminophen, Pamabrom, Pyrilamine interactionAcetaminophen, PentazocineTalacen
How Acetaminophen, Pentazocine interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root 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 Root Extract + Acetaminophen, Pentazocine interactionAcetaminophen, Phenylephrine, ChlorpheniramineSuper Cold Tabs
How Acetaminophen, Phenylephrine, Chlorpheniramine interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root 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 Root Extract + Acetaminophen, Phenylephrine, Chlorpheniramine interactionAcetaminophen, PhenylpropanolamineTetra Caps
How Acetaminophen, Phenylpropanolamine interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root 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 Root Extract + Acetaminophen, Phenylpropanolamine interactionAcetaminophen, Phenylpropanolamine, PhenyltoloxamineSinubid
How Acetaminophen, Phenylpropanolamine, Phenyltoloxamine interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root 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 Root Extract + Acetaminophen, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, PhenyltoloxaminePercogesic, Relagesic
How Acetaminophen, Phenyltoloxamine interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root 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 Root Extract + Acetaminophen, Phenyltoloxamine interactionAcetaminophen, Phenyltoloxamine, SalicylamideLobac
How Acetaminophen, Phenyltoloxamine, Salicylamide interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root 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 Root Extract + Acetaminophen, Phenyltoloxamine, Salicylamide interactionAcetaminophen, PropoxypheneDarvocet-N 100, Darvocet-N 50, E-Lor, Wygesic
How Acetaminophen, Propoxyphene interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root 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 Root 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 Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root 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 Root Extract + Acetaminophen, Pseudoephedrine interactionAcetaminophen, Pseudoephedrine, TriprolidineActifed Plus ES
How Acetaminophen, Pseudoephedrine, Triprolidine interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root 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 Root Extract + Acetaminophen, Pseudoephedrine, Triprolidine interactionAdagrasibKrazati
How Adagrasib interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Adagrasib interactionAdalimumabHumira
How Adalimumab interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Root Extract + Adalimumab interactionAdalimumab-adazHyrimoz
How Adalimumab-adaz interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Root Extract + Adalimumab-adaz interactionAdalimumab-adbmCyltezo
How Adalimumab-adbm interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Root Extract + Adalimumab-adbm interactionAdalimumab-afzbAbrilada
How Adalimumab-afzb interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Root Extract + Adalimumab-afzb interactionAdalimumab-attoAmjevita
How Adalimumab-atto interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Root Extract + Adalimumab-atto interactionAdalimumab-bwwdHadlima
How Adalimumab-bwwd interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Root Extract + Adalimumab-bwwd interactionAdalimumab-fkjpHulio
How Adalimumab-fkjp interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Root Extract + Adalimumab-fkjp interactionAgomelatineValdoxan
How Agomelatine interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root 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 Root Extract + Agomelatine interactionAlefaceptAmevive
How Alefacept interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Root Extract + Alefacept interactionAlemtuzumabCampath
How Alemtuzumab interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Root Extract + Alemtuzumab interactionAlfentanilAlfenta
How Alfentanil interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Alfentanil interactionAlfuzosinUroxatral
How Alfuzosin interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Alfuzosin interactionAliskirenTekturna
How Aliskiren interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Aliskiren interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Alogliptin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Alprazolam interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with Dual Action Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Root Extract + Ambrisentan interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Dual Action Echinacea 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 Root 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 Dual Action Echinacea, from the product label.
Paradise
See all Paradise products- Name
- Paradise Herbs & Essentials, Inc.
- Street Address
- 19051 Goldenwest St. #106-304
- City
- Huntington Beach
- State
- CA
- ZipCode
- 92648
- Web Address
- www.paradiseherbs.com
Dual Action Echinacea by Paradise: Common Questions
Does Dual Action Echinacea by Paradise interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Will echinacea help me avoid getting a cold?
Is it safe to take if I'm pregnant?
Is it safe while breastfeeding?
What are the most common side effects?
I'm allergic to ragweed. Should I avoid this?
Can echinacea affect my other medications?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Dual Action Echinacea is safe with your meds?
Our pharmacists answer your medication & supplement questions — free.
Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Dual Action Echinacea’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sources & How We Checked
Dual Action Echinacea'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.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
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
- Mullins RJ. Echinacea-associated anaphylaxis. Med J Aust 1998;168:170-1. PubMed
- Mullins RJ. Allergic reactions to Echinacea. J Allergy Clin Immunol 2000;104:S340-341 (Abstract 1003).
- Chavez ML, Chavez PI. Echinacea. Hosp Pharm 1998;33:180-8.
- Grimm W, Muller HH. A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections. Am J Med 1999;106:138-43. PubMed
- Taylor JA, Weber W, Standish L, et al. Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial. JAMA 2003;290:2824-30.. PubMed
- Luettig B, Steinmuller C, Gifford GE, et al. Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst 1989;81:669-75. PubMed
- Stimpel M, Proksch A, Wagner H, et al. Macrophage activation and induction of macrophage cytotoxicity by purified polysaccharide fractions from the plant Echinacea purpurea. Infect Immun 1984;46:845-9. PubMed
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- Gallo M, Sarkar M, Au W, et al. Pregnancy outcome following gestational exposure to echinacea: A prospective controlled study. Arch Intern Med 2000;160:3141-3. PubMed
- Soon SL, Crawford RI. Recurrent erythema nodosum associated with echinacea herbal therapy. J Am Acad Dermatol 2001;44:298-9. PubMed
- Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51. PubMed
- Logan JL, Ahmed J. Critical hypokalemic renal tubular acidosis due to Sjogren's syndrome: association with the purported immune stimulant echinacea. Clin Rheumatol 2003;22:158-9.
- Schulten B, Bulitta M, Ballering-Bruhl B, et al. Efficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trial. Arzneimittelforschung 2001;51:563-8.. PubMed
- Yale SH, Glurich I. Analysis of the inhibitory potential of Ginkgo biloba, Echinacea purpurea, and Serenoa repens on the metabolic activity of cytochrome P450 3A4, 2D6, and 2C9. J Altern Complement Med 2005;11:433-9.
- Yale SH, Liu K. Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med 2004;164:1237-41. PubMed
- Gorski JC, Huang S, Zaheer NA, et al. The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo.Clin Pharmacol Ther 2003;73 (Abstract PDII-A-8):P94. PubMed
- Lee AN, Werth VP. Activation of autoimmunity following use of immunostimulatory herbal supplements. Arch Dermatol 2004;140:723-7. PubMed
- Goel V, Lovlin R, Barton R, et al. Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther 2004;29:75-83.
- Barrett B. Medicinal properties of Echinacea: a critical review. Phytomedicine 2003;10:66-86. PubMed
- Huntley AL, Thompson Coon J, Ernst E. The safety of herbal medicinal products derived from Echinacea species: a systematic review. Drug Saf 2005;28:387-400. PubMed
- Turner RB, Bauer R, Woelkart K, et al. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. N Engl J Med 2005;353:341-8.
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-40. .
- Perri D, Dugoua JJ, Mills E, Koren G. Safety and efficacy of echinacea (Echinacea augustafolia, e. purpurea and e. pallida) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e262-7.
- Kocaman O, Hulagu S, Senturk O. Echinacea-induced severe acute hepatitis with features of cholestatic autoimmune hepatitis. Eur J Intern Med 2008;19:148. PubMed
- Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77. PubMed
- Press Release: Echinacea herbal products should not be used in children under 12 years old. Medicines and Healthcare Products Regulatory Agency (UK). August 20, 2012. Available at: www.mhra.gov.uk/NewsCentre/Pressreleases/CON180627. (Accessed 21 October
- Barrett B, Brown R, Rakel D, Rabago D, et al. Placebo effects and the common cold: a randomized controlled trial. Ann.Fam.Med 2011;9:312-22. PubMed
- Haller J, Freund, TF, Pelczer, KG, et al. The anxiolytic potential and psychotropic side effects of an echinacea preparation in laboratory animals and healthy volunteers. Phytother.Res. 2013;27:54-61.
- Grbic J, Wexler I, Celenti R, et al. A phase II trial of a transmucosal herbal patch for the treatment of gingivitis. J Am Dent.Assoc. 2011;142:1168-75. PubMed
- Schapowal A, Berger D, Klein P, et al. Echinacea/sage or chlorhexidine/lidocaine for treating acute sore throats: a randomized double-blind trial. Eur.J Med Res 9-1-2009;14:406-12. PubMed
- Bossaer JB and Odle BL. Probable etoposide interaction with Echinacea. J.Diet.Suppl 2012;9:90-5.
- Abdul MI, Jiang X, Williams KM, et al. Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects. Br J Clin.Pharmacol. 2010;69:508-15. PubMed
- Kemp, D. E. and Franco, K. N. Possible leukopenia associated with long-term use of echinacea. J Am Board Fam.Pract. 2002;15(5):417-419.
- Liatsos, G., Elefsiniotis, I., Todorova, R., and Moulakakis, A. Severe thrombotic thrombocytopenic purpura (TTP) induced or exacerbated by the immunostimulatory herb Echinacea. Am J Hematol. 2006;81(3):224.
- Penzak, S. R., Robertson, S. M., Hunt, J. D., Chairez, C., Malati, C. Y., Alfaro, R. M., Stevenson, J. M., and Kovacs, J. A. Echinacea purpurea significantly induces cytochrome P450 3A activity but does not alter lopinavir-ritonavir exposure in healthy s
- Maskatia, Z. K. and Baker, K. Hypereosinophilia associated with echinacea use. South.Med J 2010;103(11):1173-1174. PubMed
- Parnham MJ. Benefit-risk assessment of the squeezed sap of the purple coneflower (Echinacea purpurea) for long-term oral immunostimulation. Phytomed 1996;3:95-102. PubMed
- Schroder-Aasen T, Molden G, Nilsen OG. In vitro inhibition of CYP3A4 by the multiherbal commercial product Sambucus Force and its main constituents Echinacea purpurea and Sambucus nigra. Phytother Res 2012;26(11):1606-13.
- Moltó J, Valle M, Miranda C, et al. Herb-drug interaction between Echinacea purpurea and darunavir-ritonavir in HIV-infected patients. Antimicrob Agents Chemother 2011;55(1):326-30.
- Goey AK, Meijerman I, Rosing H, et al. The effect of Echinacea purpurea on the pharmacokinetics of docetaxel. Br J Clin Pharmacol 2013;76(3):467-74.
- Moltó J, Valle M, Miranda C, et al. Herb-drug interaction between Echinacea purpurea and etravirine in HIV-infected patients. Antimicrob Agents Chemother 2012;56(10):5328-31. PubMed
- Lawrenson JA, Walls T, Day AS. Echinacea-induced acute liver failure in a child. J Paediatr Child Health 2014;50(10):841.
- Hansen TS, Nilsen OG. In vitro CYP3A4 metabolism: inhibition by Echinacea purpurea and choice of substrate for the evaluation of herbal inhibition. Basic Clin Pharmacol Toxicol 2008;103:445-9.
- Gabranis I, Koufakis T1, Papakrivos I, Batala S. Echinacea-associated acute cholestatic hepatitis. J Postgrad Med. 2015;61(3):211-2. PubMed
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Karsch-Völk M, Barrett B, Kiefer D, Bauer R, Ardjomand-Woelkart K, Linde K. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev.2014;(2):CD000530. doi: 10.1002/14651858.CD000530.pub3. PubMed
- Hoban CL, Byard RW, Musgrave IF. Analysis of spontaneous adverse drug reactions to echinacea, valerian, black cohosh and ginkgo in Australia from 2000 to 2015. J Integr Med. 2019;17(5):338-343. PubMed
- Ogal M, Johnston SL, Klein P, Schoop R. Echinacea reduces antibiotic usage in children through respiratory tract infection prevention: a randomized, blinded, controlled clinical trial. Eur J Med Res. 2021 Apr 8;26(1):33. PubMed
- Lopresti AL, Smith SJ. An investigation into the anxiety-relieving and mood-enhancing effects of Echinacea angustifolia (EP107 ™): A randomised, double-blind, placebo-controlled study. J Affect Disord 2021;293:229-237.
- Weishaupt R, Buchkov A, Kolev E, Klein P, Schoop R. Reduction of viral load in patients with acute sore throats: Results from an observational clinical trial with Echinacea / Salvia lozenges [published online ahead of print, 2023 Mar 8]. Complement Med Re
- Sumer J, Keckeis K, Scanferla G, et al. Novel Echinacea formulations for the treatment of acute respiratory tract infections in adults-A randomized blinded controlled trial. Front Med (Lausanne) 2023;10:948787. PubMed
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