Echinacea 200 mg Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Echinacea 200 mg 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
Echinacea 200 mg is a dietary supplement by Swanson Superior Herbs 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. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Echinacea 200 mg by Swanson Superior Herbs
Ask about any prescription or over-the-counter medication and we check it for interactions with Echinacea 200 mg by Swanson Superior Herbs — 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 Echinacea 200 mg by Swanson Superior Herbs
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 2 active ingredients: echinacea purpurea and echinacea angustifolia root extract, together making up the 200 mg dose per capsule. Both are forms of echinacea, a plant traditionally used to support immune function.
The capsules also contain gelatin and microcrystalline cellulose as inactive ingredients (standard capsule materials and fillers).
Does it work?
Couldn't assess
The data we hold shows insufficient reliable evidence to rate echinacea for the conditions listed: anxiety, athletic performance, attention deficit-hyperactivity disorder (ADHD), burns, chronic fatigue syndrome, and migraine headache. That means the evidence available doesn't yet establish how well — or whether — echinacea works for these uses.
If you're considering it for a specific health goal, talk with your doctor or pharmacist about whether the current research supports its use for your situation.
How safe is it?
Well-documented data
Echinacea is generally well tolerated when used short-term. The most common side effects are mild stomach-related — abdominal pain, constipation, diarrhea, heartburn, nausea, and upset stomach — as well as rashes.
Rare but serious adverse effects include severe allergic reactions and hepatitis (liver inflammation). Allergic reactions are more likely if you're sensitive to ragweed or related plants like chrysanthemums, marigolds, or daisies.
Because safety data is limited, it's best to avoid this product unless your doctor approves. Pregnancy is rated possibly safe based on available data, but there isn't enough information about lactation — talk with your doctor or pharmacist if you're pregnant or nursing and want to use echinacea.
Meds to double-check
Moderate interaction found
Before you take this echinacea product, double-check with your doctor or pharmacist if you're on any of the following: chemotherapy drugs like etoposide; immunosuppressants (medications that suppress your immune system); blood thinners like warfarin; sedatives like midazolam; HIV medications like lopinavir/ritonavir; or any drug metabolized by the liver enzymes CYP1A2 or CYP3A4 — a category that includes many common medications. Echinacea can raise or lower the blood levels of these drugs, potentially affecting how well they work or how many side effects you experience.
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 200 mg is generally well tolerated short-term but has documented Moderate and Minor interactions with several medication types, most notably etoposide, caffeine-metabolized drugs, immune suppressants, and blood thinners. Anyone on prescription medications — especially those for cancer, HIV, sedation, or immune suppression — should check their specific drugs before starting.
If you're allergic to ragweed or related plants, be cautious because allergic reactions have been reported. Talk with your doctor or pharmacist about whether echinacea is appropriate for you and your current medications.
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 Apr 25, 2018.
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 Echinacea 200 mg, straight from the product label.
| Brand | Swanson Superior Herbs |
|---|---|
| Barcode (UPC) | 087614140193 |
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Apr 25, 2018 |
| DSLD ID | 176306 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other |
| Intended target group(s) | Adult (18 - 50 Years) |
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 Echinacea 200 mg by Swanson Superior Herbs, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Echinacea purpurea | 200 mg | -- |
| Echinacea angustifolia root extract | 200 mg | -- |
Other ingredients: Gelatin, Microcrystalline Cellulose
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.
FDA Statement of Identity
Standardized Herbal Supplement
Seals/Symbols
Guaranteed purity & potency
Formula
4% Echinacosides
Precautions
Do not use if seal is broken.
Keep out of reach of children.
Warning: Do not use if you are pregnant or nursing.
Consult your healthcare provider before use if you have an autoimmune condition.
Storage
Store in a cool, dry place.
Suggested/Recommended/Usage/Directions
Suggested Use: As a dietary supplement, take one capsule one to two times per day with water. Limit use to 8 consecutive weeks. Use periodically for a few weeks at a time (for maintenance purposes).
General Statements
To reorder, call toll free 1-800-437-4148 or visit our website at www.swansonvitamins.com
General
SWH019 Rev 0 12 12 17
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Echinacea 200 mg by Swanson Superior Herbs 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 Echinacea 200 mg by Swanson Superior Herbs
These are the 2 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule 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
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 monograph & interactionsEchinacea angustifolia 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 angustifolia root extract monograph & interactionsOther (inactive) ingredients: Gelatin, Microcrystalline Cellulose. These complete the product’s ingredient list but are not active constituents.
Echinacea 200 mg by Swanson Superior Herbs Drug Interactions
HelloPharmacist Interaction Report
Echinacea 200 mg by Swanson Superior Herbs does interact with medications.
Through both its echinacea purpurea and echinacea angustifolia root extract content, this product affects how your body metabolizes several drug types. The most serious documented interaction is Moderate severity: echinacea may increase blood levels of etoposide (a chemotherapy drug), and there's a case report of more severe low platelet counts (thrombocytopenia) when etoposide was used with echinacea.
Read the full breakdown — every affected drug type, severity by severity
Echinacea also has Moderate interactions with other drug types. It can inhibit the metabolism of caffeine and similar drugs broken down by the liver enzyme CYP1A2, potentially raising their blood levels by around 30%.
It may also interfere with drugs metabolized by the liver enzyme CYP3A4 — either increasing or decreasing their levels — and it can interfere with immunosuppressant medications because echinacea stimulates the immune system, which may work against drugs meant to suppress it.
Minor interactions are documented with warfarin (a blood thinner), lopinavir/ritonavir (an HIV medication), and midazolam (a sedative). Echinacea may increase how quickly warfarin leaves your body, though the effect may not be clinically important.
For lopinavir/ritonavir and midazolam, the theoretical risk exists, though clinical studies have found limited or no effect.
Altogether, these interactions span 817 individual medications. Before you start echinacea, check your exact medications with the tool on this page, and discuss the results with your doctor or pharmacist.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Echinacea 200 mg?
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 Echinacea 200 mg interact with 816 drugs. Click any drug to see the details.
1 of the 2 ingredients in Echinacea 200 mg interact with drugs. Each result below shows which ingredient is responsible. Echinacea purpurea
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Angustifolia Root Extract + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Angustifolia Root Extract + Ado-trastuzumab Emtansine interactionAbemaciclibVerzenio
How Abemaciclib interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Angustifolia Root Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Angustifolia Root Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Angustifolia Root Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Angustifolia Root Extract + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Angustifolia Root Extract + Acalabrutinib interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia 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 Angustifolia Root Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia 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 Angustifolia Root Extract + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia Root Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia 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 Angustifolia Root Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia 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 Angustifolia Root Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia Root Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Caffeine +1 Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Angustifolia Root Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia 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 Angustifolia Root Extract + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia 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 Angustifolia Root Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia Root Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea Angustifolia Root Extract + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia Root Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Caffeine +1 Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Angustifolia Root Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Angustifolia Root Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea Angustifolia Root Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia 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 Angustifolia Root Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia 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 Angustifolia Root Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia 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 Angustifolia Root Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Angustifolia Root Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia 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 Angustifolia Root Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Angustifolia Root Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
How Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia 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 Angustifolia Root Extract + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
How Acetaminophen, Chlorpheniramine, Phenylephrine interacts with Echinacea 200 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Angustifolia Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Angustifolia Root Extract + Acetaminophen, Chlorpheniramine, Phenylephrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Echinacea 200 mg 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
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 Echinacea 200 mg, from the product label.
Swanson Superior Herbs
See all Swanson Superior Herbs products- Name
- Swanson Health Products
- City
- Fargo
- State
- ND
- ZipCode
- 58104
- Phone Number
- 1-800-437-4148
- Web Address
- www.swansonvitamins.com
Echinacea 200 mg by Swanson Superior Herbs: Common Questions
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The Full Monographs Behind Echinacea 200 mg’s Ingredients
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Sources & How We Checked
Echinacea 200 mg'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
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- 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
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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.
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- 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
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- 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.
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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
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- 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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- 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