Echinacea 400 mg Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Echinacea 400 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 400 mg is a dietary supplement by Sundown Naturalist 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. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Echinacea 400 mg by Sundown Naturalist
Ask about any prescription or over-the-counter medication and we check it for interactions with Echinacea 400 mg by Sundown Naturalist — 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 400 mg by Sundown Naturalist
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, 400 mg per capsule. Echinacea is a plant-derived herbal extract.
The capsule itself is made from gelatin, an inactive ingredient that serves as the container.
Does it work?
Not established
The evidence we hold does not establish that echinacea is effective for the conditions listed—anxiety, athletic performance, ADHD, burns, chronic fatigue, and migraine headache all show insufficient reliable evidence. That doesn't mean echinacea doesn't work for other uses, just that the data we have doesn't support these six claims.
How safe is it?
Well-documented data
Echinacea is generally well tolerated for short-term use. The most common side effects from oral use are abdominal pain, constipation, diarrhea, heartburn, nausea, vomiting, rashes, and stomach upset.
Rare but serious adverse effects include severe allergic reactions and liver inflammation (hepatitis). People allergic to ragweed, chrysanthemums, marigolds, or daisies are at higher risk for allergic reactions to echinacea.
Because safety data are limited, your doctor should approve its use before you start. For pregnancy, echinacea is rated possibly safe, but the data are sparse.
There is no lactation safety rating on file for this ingredient.
Meds to double-check
Moderate interaction found
Before taking this product, check with your pharmacist if you take any drugs processed by your liver's CYP1A2 or CYP3A4 enzymes—a category that includes hundreds of medications. Double-check specifically if you're on a blood thinner like warfarin, an immunosuppressant, etoposide, or intravenous midazolam.
Avoid high-caffeine products while using echinacea, since it can raise caffeine levels by about 30%.
The bottom line
Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
Echinacea may be worth considering if you're looking for an herbal option and your doctor approves, but it's not the right choice if you take medications that go through your liver—especially blood thinners, immune-suppressant drugs, or caffeine-containing products. Talk to your pharmacist or doctor before adding this to your routine, particularly if you have a sensitivity to ragweed or similar plants.
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 Sep 22, 2016.
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 400 mg, straight from the product label.
| Brand | Sundown Naturalist |
|---|---|
| Barcode (UPC) | 030768000738 |
| Net contents | 75 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Sep 22, 2016 |
| DSLD ID | 64896 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar 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 Echinacea 400 mg by Sundown Naturalist, sourced from the NIH Dietary Supplement Label Database.
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.
Seals/Symbols
100% Quality Assurance Laboratory Tested
General Statements
Traditionally Used for Immune Health*
Naturalist’s Whole Herb products utilize ground plant parts. IMPORTANT FACTS YOU SHOULD KNOW Echinacea has been traditionally used to support the body’s natural defense system and helps support immune function.* Echinacea is one of the world’s leading herbs for immune support.*
Quality Guaranteed Lab Tested Laboratory tested to meet strict quality control standards for potency, purity and disintegration. 100% Quality Guaranteed.
Actual size
FDA Statement of Identity
Dietary Supplement
Formulation
No yeast, wheat, gluten, milk or milk derivatives, lactose, sugar, preservatives, soy, artificial color, artificial flavor, sodium.
Suggested/Recommended/Usage/Directions
DIRECTIONS: FOR ADULTS, TAKE ONE (1) CAPSULE SEVEN TIMES DAILY, PREFERABLY WITH MEALS. Capsules may be opened and prepared as a tea.
Precautions
WARNING: If you are pregnant, nursing, taking any medications or have any medical condition, consult your doctor before use.
Avoid this product if you are allergic to sunflowers or daisy-like flowers.
Discontinue use and consult your doctor if any adverse reactions occur.
Not intended for use by persons under the age of 18. KEEP OUT OF REACH OF CHILDREN.
TAMPER RESISTANT: DO NOT USE IF SEAL UNDER CAP IS BROKEN OR MISSING.
Storage
STORE AT ROOM TEMPERATURE AND AVOID EXCESSIVE HEAT.
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)
2016
General
Prod. No. 44753 07F B5633
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Echinacea 400 mg by Sundown Naturalist 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 400 mg by Sundown Naturalist
This is the 1 active ingredient this product is made of. Select it to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Amounts shown are per serving.
Echinacea
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 monograph & interactionsOther (inactive) ingredients: Gelatin. These complete the product’s ingredient list but are not active constituents.
Echinacea 400 mg by Sundown Naturalist Drug Interactions
HelloPharmacist Interaction Report
Echinacea 400 mg by Sundown Naturalist does interact with several medications.
The most serious concerns are moderate-severity interactions with drugs your liver breaks down, particularly those processed by the CYP1A2 enzyme system. Echinacea can inhibit this pathway and raise levels of caffeine by around 30%, and theoretically increase levels of other drugs metabolized the same way.
Read the full breakdown — every affected drug type, severity by severity
Echinacea also has moderate interactions with CYP3A4 substrates (drugs your liver clears through a different pathway), immunosuppressants, etoposide, and warfarin. The CYP3A4 picture is complex: echinacea can both speed up and slow down how your body processes these drugs, depending on where the drug is broken down.
For etoposide specifically, one case report linked echinacea use to more severe side effects. Minor interactions are documented with midazolam and lopinavir/ritonavir, though study evidence is mixed.
Altogether, these interactions span 817 individual medications. If you take any prescription medication, use the interaction checker below to look up your exact drugs before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Echinacea 400 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 400 mg interact with 816 drugs. Click any drug to see the details.
1 of the 1 ingredient in Echinacea 400 mg interact with drugs. Each result below shows which ingredient is responsible. Echinacea
Acetaminophen, Pamabrom, PyrilamineMidol Max Strength PMS, Pamprin, Pamprin ES
How Acetaminophen, Pamabrom, Pyrilamine interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome 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 + Acetaminophen, Pamabrom, Pyrilamine interactionAcetaminophen, PentazocineTalacen
How Acetaminophen, Pentazocine interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome 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 + Acetaminophen, Pentazocine interactionAcetaminophen, Phenylephrine, ChlorpheniramineSuper Cold Tabs
How Acetaminophen, Phenylephrine, Chlorpheniramine interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome 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 + Acetaminophen, Phenylephrine, Chlorpheniramine interactionAcetaminophen, PhenylpropanolamineTetra Caps
How Acetaminophen, Phenylpropanolamine interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome 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 + Acetaminophen, Phenylpropanolamine interactionAcetaminophen, Phenylpropanolamine, PhenyltoloxamineSinubid
How Acetaminophen, Phenylpropanolamine, Phenyltoloxamine interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome 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 + Acetaminophen, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, PhenyltoloxaminePercogesic, Relagesic
How Acetaminophen, Phenyltoloxamine interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome 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 + Acetaminophen, Phenyltoloxamine interactionAcetaminophen, Phenyltoloxamine, SalicylamideLobac
How Acetaminophen, Phenyltoloxamine, Salicylamide interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome 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 + Acetaminophen, Phenyltoloxamine, Salicylamide interactionAcetaminophen, PropoxypheneDarvocet-N 100, Darvocet-N 50, E-Lor, Wygesic
How Acetaminophen, Propoxyphene interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome 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 + Acetaminophen, Propoxyphene interactionAcetaminophen, PseudoephedrineChildren's Tylenol Sinus, Dristan N.D., Non-Aspirin Sinus, Ornex, Ornex-Max, Sinutab +5 more
How Acetaminophen, Pseudoephedrine interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome 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 + Acetaminophen, Pseudoephedrine interactionAcetaminophen, Pseudoephedrine, TriprolidineActifed Plus ES
How Acetaminophen, Pseudoephedrine, Triprolidine interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome 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 + Acetaminophen, Pseudoephedrine, Triprolidine interactionAdagrasibKrazati
How Adagrasib interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Adagrasib interactionAdalimumabHumira
How Adalimumab interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + Adalimumab interactionAdalimumab-adazHyrimoz
How Adalimumab-adaz interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + Adalimumab-adaz interactionAdalimumab-adbmCyltezo
How Adalimumab-adbm interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + Adalimumab-adbm interactionAdalimumab-afzbAbrilada
How Adalimumab-afzb interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + Adalimumab-afzb interactionAdalimumab-attoAmjevita
How Adalimumab-atto interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + Adalimumab-atto interactionAdalimumab-bwwdHadlima
How Adalimumab-bwwd interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + Adalimumab-bwwd interactionAdalimumab-fkjpHulio
How Adalimumab-fkjp interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + Adalimumab-fkjp interactionAgomelatineValdoxan
How Agomelatine interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome 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 + Agomelatine interactionAlefaceptAmevive
How Alefacept interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + Alefacept interactionAlemtuzumabCampath
How Alemtuzumab interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + Alemtuzumab interactionAlfentanilAlfenta
How Alfentanil interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Alfentanil interactionAlfuzosinUroxatral
How Alfuzosin interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Alfuzosin interactionAliskirenTekturna
How Aliskiren interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Aliskiren interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Alogliptin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Alprazolam interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with Echinacea 400 mg — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Ambrisentan interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Echinacea 400 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
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 400 mg, from the product label.
Sundown Naturalist
See all Sundown Naturalist products- Name
- Rexall Sundown, Inc.
- City
- Boca Raton
- State
- FL
- ZipCode
- 33487
- Phone Number
- 1-888-848-2435
Echinacea 400 mg by Sundown Naturalist: Common Questions
Does Echinacea 400 mg by Sundown Naturalist interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Can I take echinacea if I'm pregnant?
What side effects might I notice?
Does echinacea actually work for colds or the flu?
Will echinacea affect how my medications work?
Is it safe if I'm allergic to ragweed?
How long can I safely take echinacea?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Echinacea 400 mg 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 Echinacea 400 mg’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sources & How We Checked
Echinacea 400 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
- 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
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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.
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