Echinacea Golden Seal 400 mg Ingredients & Drug Interactions
by Viva Vitamins
What is this page for?
First and foremost: checking Echinacea Golden Seal 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 Golden Seal 400 mg is a dietary supplement by Viva Vitamins with 2 active ingredients. Its ingredients are commonly taken for common cold, flu and respiratory infections, immune support.Based on those ingredients, 1,336 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Goldenseal, Echinacea purpurea. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Echinacea Golden Seal 400 mg by Viva Vitamins
Ask about any prescription or over-the-counter medication and we check it for interactions with Echinacea Golden Seal 400 mg by Viva Vitamins — 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 Golden Seal 400 mg by Viva Vitamins
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
Echinacea Golden Seal 400 mg contains two active ingredients: echinacea purpurea (a purple coneflower used traditionally to support immune function) and goldenseal (an herb whose root contains alkaloids believed to have antimicrobial and anti-inflammatory properties). The capsule also holds rice flour and gelatin as inactive ingredients to form and stabilize the capsule.
Does it work?
Not established
The evidence we hold does not establish effectiveness for echinacea in anxiety, athletic performance, attention issues (ADHD), burns, chronic fatigue syndrome, or migraine headache—each is rated as having insufficient reliable evidence. Similarly, for goldenseal, evidence is insufficient to rate its use for acne, hay fever (allergic rhinitis), anorexia nervosa, or chronic fatigue syndrome.
Goldenseal is rated possibly ineffective for masking urine drug tests.
How safe is it?
Well-documented data
Echinacea is generally well tolerated for short-term use but can cause mild gastrointestinal side effects like abdominal pain, diarrhea, nausea, and upset stomach, as well as rashes. Allergic reactions—including severe ones like anaphylaxis—have been reported, especially in people sensitive to ragweed and related plants (chrysanthemums, marigolds, daisies).
Rare cases of liver inflammation (hepatitis) have also been reported. Goldenseal has limited human safety data and is generally used only short-term.
It may cause abdominal pain, diarrhea, constipation, nausea, headache, and bitter taste. The safety data advises against goldenseal during pregnancy because berberine (its active alkaloid) may harm the fetus and trigger contractions, and also advises against it while breastfeeding because berberine may pass to your infant.
For echinacea, pregnancy data indicate it is possibly safe, but there is not enough reliable safety information, so it is best to avoid unless your doctor approves.
Meds to double-check
Moderate interaction found
Before taking this product, check with your doctor or pharmacist if you take blood thinners (anticoagulants like warfarin), diabetes medications, blood pressure medications, heart or cancer drugs that depend on liver metabolism, immunosuppressants, sedatives (CNS depressants), caffeine supplements or heavy caffeine intake, or etoposide (a chemotherapy drug). Goldenseal and echinacea both inhibit liver enzymes that process many medications, and the direction and magnitude of these effects can be unpredictable.
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.
This two-ingredient formula may be worth considering if you're interested in traditional immune or antimicrobial support, but it carries real risks with many medications—particularly those metabolized by your liver's CYP enzymes, blood thinners, diabetes drugs, and immune-suppressing medications. Anyone taking prescription drugs should check their specific medications against the tool on this page before starting.
Pregnant or breastfeeding people should talk with their doctor or pharmacist before using it, especially the goldenseal component.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 2 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 23, 2020.
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 Golden Seal 400 mg, straight from the product label.
| Brand | Viva Vitamins |
|---|---|
| Barcode (UPC) | 726899921744 |
| Net contents | 100 Cap(s) |
| Market status | On market |
| Date entered into DSLD | Oct 23, 2020 |
| DSLD ID | 237981 |
| 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 Golden Seal 400 mg by Viva Vitamins, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Echinacea purpurea | 200 mg | -- |
| Goldenseal | 200 mg | -- |
Other ingredients: Rice Flour, Gelatin
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.
Suggested/Recommended/Usage/Directions
Directions: As a dietary supplement, adults take one or more capsules daily with meals or as directed by a health professional.
Formula
Echinacea and Golden Seal provide a strong defense when it comes to preventing or reducing the duration of a cold or flu. Additionally, Golden Seal has been known to have blood purifying capabilities.
Storage
Store in a cool, dry place and away from direct light.
Precautions
Keep out of the reach of children.
Do not use if safety seal under cap is broken or missing.
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.
Formulation
To support a healthy immune system
Free of: Gluten, milk, soy, salt, sugar, yeast, wheat, corn, egg, fish products, artificial coloring, flavoring, or preservatives.
Made in the USA
Non-GMO
Manufactured in an NSF - GMP Certified facility
General Statements
We always use the highest quality ingredients Premium formulas
For more information, visit www.VivaVitamins.com
In God we trust
FDA Statement of Identity
Dietary Supplement
Brand IP Statement(s)
2018 Manufactured exclusively for Viva Vitamins
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Echinacea Golden Seal 400 mg by Viva Vitamins 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 Golden Seal 400 mg by Viva Vitamins
These are the 2 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container100 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 & interactionsGoldenseal
Interacts with1,237 drugs
Goldenseal is a popular North American herb that contains berberine, a compound studied for antimicrobial effects. However, strong human evidence for...
Goldenseal monograph & interactionsOther (inactive) ingredients: Rice Flour, Gelatin. These complete the product’s ingredient list but are not active constituents.
Echinacea Golden Seal 400 mg by Viva Vitamins Drug Interactions
HelloPharmacist Interaction Report
Echinacea Golden Seal 400 mg by Viva Vitamins has documented interactions with medications through both its echinacea purpurea and goldenseal ingredients.
The most serious interaction is moderate in severity: echinacea may inhibit how your liver breaks down caffeine, increasing caffeine levels by around 30%, and goldenseal may inhibit several liver enzymes (CYP2D6, CYP2C9, and CYP3A4) that metabolize many common medications, potentially raising their blood levels.
Read the full breakdown — every affected drug type, severity by severity
Echinacea also interacts moderately with immunosuppressant drugs—it may interfere with their ability to suppress your immune system—and with etoposide (a cancer drug); it may increase etoposide levels and the risk of low platelet counts. Additionally, echinacea interacts with various drugs that depend on the liver enzyme CYP3A4 (such as certain blood pressure and heart medications).
Goldenseal raises similar concerns with CYP3A4 substrates, and theoretically may increase the blood-thinning (anticoagulation) risk of blood thinners, lower blood sugar (hypoglycemia) risk with diabetes drugs, lower blood pressure further with antihypertensive medications, and increase sedation with CNS depressants—though human evidence for these is limited. Goldenseal also may affect P-glycoprotein substrates, which include some heart and cancer drugs; the direction of effect (up or down) is unclear.
Echinacea carries a minor interaction with warfarin (a blood thinner), though the effect may not be clinically significant, and similarly minor interactions with midazolam (a sedative) and the HIV medication lopinavir/ritonavir. We could not check interactions for the inactive ingredients (rice flour and gelatin).
Altogether, these interactions span 1,337 individual medications. Use the medication checker on this page with your exact drugs before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Echinacea Golden Seal 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 Golden Seal 400 mg interact with 1,336 drugs. Click any drug to see the details.
2 of the 2 ingredients in Echinacea Golden Seal 400 mg interact with drugs. Each result below shows which ingredient is responsible. Goldenseal Echinacea purpurea
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Echinacea Golden Seal 400 mg — through 1 ingredient. Tap an ingredient for the detail:
Echinacea PurpureaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal + Ado-trastuzumab Emtansine interactionEchinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with Echinacea Golden Seal 400 mg — through 1 ingredient. Tap an ingredient for the detail:
GoldensealAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, goldenseal might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Read the full Goldenseal + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal + Abemaciclib interactionEchinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Abiraterone interactionGoldensealCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Abiraterone Acetate interactionGoldensealCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealAnticoagulant/antiplatelet Drugs, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Read the full Goldenseal + Abrocitinib interactionEchinacea PurpureaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal + Acalabrutinib interactionEchinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Echinacea Golden Seal 400 mg — through 1 ingredient. Tap an ingredient for the detail:
GoldensealAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, goldenseal might increase the risk of hypoglycemia when used with antidiabetes drugs.
Read the full Goldenseal + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Echinacea Golden Seal 400 mg — through 1 ingredient. Tap an ingredient for the detail:
GoldensealAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, goldenseal might increase the risk of hypotension when taken with antihypertensive drugs.
Read the full Goldenseal + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Echinacea Golden Seal 400 mg — through 1 ingredient. Tap an ingredient for the detail:
GoldensealAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, goldenseal might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Read the full Goldenseal + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Echinacea Golden Seal 400 mg — through 1 ingredient. Tap an ingredient for the detail:
GoldensealCns Depressants Moderate
Interaction Summary
Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Read the full Goldenseal + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal + Acetaminophen interactionEchinacea PurpureaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 2e1 (cyp2e1) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal + Acetaminophen, Aspirin interactionEchinacea PurpureaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealAnticoagulant/antiplatelet Drugs, Cytochrome P450 2e1 (cyp2e1) Substrates +1 Moderate
Interaction Summary
Theoretically, goldenseal might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Read the full Goldenseal + Acetaminophen, Aspirin, Caffeine interactionEchinacea PurpureaCytochrome 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 Purpurea + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionEchinacea PurpureaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal + Acetaminophen, Butalbital interactionEchinacea PurpureaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal + Acetaminophen, Butalbital, Caffeine interactionEchinacea PurpureaCytochrome 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 Purpurea + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates, Caffeine +1 Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Acetaminophen, Butalbital, Caffeine, Codeine interactionGoldensealCns Depressants, Cytochrome P450 2e1 (cyp2e1) Substrates +2 Moderate
Interaction Summary
Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Read the full Goldenseal + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCns Depressants, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Read the full Goldenseal + Acetaminophen, Butalbital, Codeine interactionEchinacea PurpureaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants +1 Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal + Acetaminophen, Butalbital, Codeine Phosphate interactionEchinacea PurpureaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCns Depressants, Cytochrome P450 2e1 (cyp2e1) Substrates +2 Moderate
Interaction Summary
Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Read the full Goldenseal + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionEchinacea PurpureaCytochrome 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 Purpurea + 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 Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +2 Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal + Acetaminophen, Caffeine, Codeine interactionEchinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaCaffeine, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea Purpurea + Acetaminophen, Caffeine, Codeine, Salicylamide interactionGoldensealCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Read the full Goldenseal + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants +2 Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal + Acetaminophen, Caffeine, Dihydrocodeine interactionEchinacea PurpureaCytochrome 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 Purpurea + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea Purpurea + Acetaminophen, Caffeine, Isometheptene interactionGoldensealCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal + Acetaminophen, Caffeine, Pyrilamine interactionEchinacea PurpureaCaffeine, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea Purpurea + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 2e1 (cyp2e1) Substrates, Dextromethorphan (robitussin Dm, Others) +2 Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionEchinacea PurpureaCytochrome 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 Purpurea + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome 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 Purpurea + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionGoldensealCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +2 Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Echinacea Golden Seal 400 mg — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 2e1 (cyp2e1) Substrates, Dextromethorphan (robitussin Dm, Others) +2 Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionEchinacea PurpureaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Echinacea Golden Seal 400 mg with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Goldenseal
Anticoagulant/Antiplatelet Drugs
Theoretically, goldenseal might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Goldenseal contains berberine. In vitro and animal research shows that berberine can inhibit platelet aggregation. However, this effect has not been reported in humans.
Antidiabetes Drugs
Theoretically, goldenseal might increase the risk of hypoglycemia when used with antidiabetes drugs.
Goldenseal contains berberine. Clinical research shows that berberine can lower blood glucose levels. However, this effect has not been reported with goldenseal.
Antihypertensive Drugs
Theoretically, goldenseal might increase the risk of hypotension when taken with antihypertensive drugs.
Goldenseal contains berberine. Animal research shows that berberine can have hypotensive effects. Also, an analysis of clinical research shows that taking berberine in combination with amlodipine can lower systolic and diastolic blood pressure when compared with amlodipine alone. However, this effect has not been reported with goldenseal.
Cns Depressants
Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Goldenseal contains berberine. Animal research shows that berberine can have sedative effects. However, this effect has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2C9.
In vitro research shows that goldenseal root extract can modestly inhibit CYP2C9. This effect may be due to its alkaloid constituents, hydrastine and berberine. However, this effect has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Clinical and in vitro research shows that goldenseal can significantly inhibit CYP2D6 enzymes, potentially increasing levels of drugs metabolized by CYP2D6.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
In vitro research shows that goldenseal root extract can inhibit the activity of CYP2E1. However, this effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Most clinical and in vitro research shows that goldenseal inhibits CYP3A4 enzyme activity and increases serum levels of CYP3A4 substrates, such as midazolam. However, in one small clinical study, goldenseal did not affect the levels of indinavir, a CYP3A4 substrate, in healthy volunteers. This is likely due to the fact that indinavir has a high oral bioavailability, making it an inadequate probe for CYP3A4 interactions and/or that it is primarily metabolized by hepatic CYP3A, while goldenseal has more potential to inhibit intestinal CYP3A enzyme activity. Both goldenseal extract and its isolated constituents berberine and hydrastine inhibit CYP3A, with hydrastine possibly having more inhibitory potential than berberine.
Dextromethorphan (Robitussin Dm, Others)
Theoretically, goldenseal might increase serum levels of dextromethorphan.
Goldenseal contains berberine. A small clinical study shows that berberine can inhibit cytochrome P450 2D6 (CYP2D6) activity and reduce the metabolism of dextromethorphan.
Digoxin (Lanoxin)
Goldenseal might increase serum levels of digoxin, although this effect is unlikely to be clinically significant.
Clinical research shows that goldenseal modestly increases digoxin peak levels by about 14% in healthy volunteers. However, goldenseal does not seem to affect other pharmacokinetic parameters such as area under the curve (AUC). This suggests that goldenseal does not cause a clinically significant interaction with digoxin. Digoxin is a P-glycoprotein substrate. Some evidence suggests that goldenseal constituents might affect P-glycoprotein; however, it is unclear whether these constituents inhibit or induce P-glycoprotein.
Losartan (Cozaar)
Theoretically, goldenseal might decrease the conversion of losartan to its active form.
Goldenseal contains berberine. A small clinical study shows that berberine inhibits cytochrome P450 2C9 (CYP2C9) activity and reduces the metabolism of losartan. However, this effect has not been reported with goldenseal.
Metformin (Glucophage)
Theoretically, goldenseal might reduce blood levels of metformin.
In vitro research shows that goldenseal extract decreases the bioavailability of metformin, likely by interfering with transport, intestinal permeability, or other processes involved in metformin absorption. It is unclear which, if any, of metformin's transporters are inhibited by goldenseal. Goldenseal does not appear to alter the clearance or half-life of metformin.
P-Glycoprotein Substrates
Theoretically, goldenseal might increase or decrease serum levels of P-glycoprotein (P-gp) substrates.
There is conflicting evidence about the effect of goldenseal on P-gp. In vitro research suggests that berberine, a constituent of goldenseal, modestly inhibits P-gp efflux. Other evidence suggests that berberine induces P-gp. In healthy volunteers, goldenseal modestly increases peak levels of the P-gp substrate digoxin by about 14%. However, it does not seem to affect other pharmacokinetic parameters such as area under the curve (AUC). This suggests that goldenseal is not a potent inhibitor of P-gp-mediated drug efflux. Until more is known, goldenseal should be used cautiously with P-gp substrates.
Pentobarbital (Nembutal)
Theoretically, goldenseal might increase the sedative effects of pentobarbital.
Animal research shows that berberine, a constituent of goldenseal, can prolong pentobarbital-induced sleeping time. However, this effect has not been reported with goldenseal.
Tacrolimus (Prograf)
Theoretically, goldenseal might increase serum levels of tacrolimus.
Goldenseal contains berberine. In a 16-year-old patient with idiopathic nephrotic syndrome who was being treated with tacrolimus 6.5 mg twice daily, intake of berberine 200 mg three times daily increased the blood concentration of tacrolimus from 8 to 22 ng/mL. Following a reduction of tacrolimus dosing to 3 mg daily, blood levels of tacrolimus decreased to 12 ng/mL.
Oseltamivir (Tamiflu)
Theoretically, goldenseal might reduce the therapeutic effects of oseltamivir by decreasing its conversion to its active form.
In vitro evidence suggests that goldenseal reduces the formation of the active compound from the prodrug oseltamivir. The mechanism of action and clinical relevance is unclear.
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 Golden Seal 400 mg, from the product label.
Viva Vitamins
- Name
- Viva Vitamins
- Web Address
- www.VivaVitamins.com
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The Full Monographs Behind Echinacea Golden Seal 400 mg’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Echinacea
Interacts with 816 drugsEchinacea is a popular herb taken to help prevent or shorten the common cold, but study results are mixed and the overall benefit appears small at best. It is generally well tolerated for sh...
Read the full Echinacea monograph → Herb & supplement monographGoldenseal
Interacts with 1,237 drugsGoldenseal is a popular North American herb that contains berberine, a compound studied for antimicrobial effects. However, strong human evidence for its many traditional uses is largely lac...
Read the full Goldenseal monograph →Sources & How We Checked
Echinacea Golden Seal 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 85 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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- Mullins RJ. Allergic reactions to Echinacea. J Allergy Clin Immunol 2000;104:S340-341 (Abstract 1003).
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- 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
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- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- Gallo M, Sarkar M, Au W, et al. Pregnancy outcome following gestational exposure to echinacea: A prospective controlled study. Arch Intern Med 2000;160:3141-3. PubMed
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- Logan JL, Ahmed J. Critical hypokalemic renal tubular acidosis due to Sjogren's syndrome: association with the purported immune stimulant echinacea. Clin Rheumatol 2003;22:158-9.
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- 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
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- Barrett B. Medicinal properties of Echinacea: a critical review. Phytomedicine 2003;10:66-86. PubMed
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- Turner RB, Bauer R, Woelkart K, et al. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. N Engl J Med 2005;353:341-8.
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-40. .
- Perri D, Dugoua JJ, Mills E, Koren G. Safety and efficacy of echinacea (Echinacea augustafolia, e. purpurea and e. pallida) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e262-7.
- Kocaman O, Hulagu S, Senturk O. Echinacea-induced severe acute hepatitis with features of cholestatic autoimmune hepatitis. Eur J Intern Med 2008;19:148. PubMed
- Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77. PubMed
- Press Release: Echinacea herbal products should not be used in children under 12 years old. Medicines and Healthcare Products Regulatory Agency (UK). August 20, 2012. Available at: www.mhra.gov.uk/NewsCentre/Pressreleases/CON180627. (Accessed 21 October
- Barrett B, Brown R, Rakel D, Rabago D, et al. Placebo effects and the common cold: a randomized controlled trial. Ann.Fam.Med 2011;9:312-22. PubMed
- Haller J, Freund, TF, Pelczer, KG, et al. The anxiolytic potential and psychotropic side effects of an echinacea preparation in laboratory animals and healthy volunteers. Phytother.Res. 2013;27:54-61.
- Grbic J, Wexler I, Celenti R, et al. A phase II trial of a transmucosal herbal patch for the treatment of gingivitis. J Am Dent.Assoc. 2011;142:1168-75. PubMed
- 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
Goldenseal 34 references
- Chan E. Displacement of bilirubin from albumin by berberine. Biol Neonate 1993;63:201-8. 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
- Sandhu RS, Prescilla RP, Simonelli TM, Edwards DJ. Influence of goldenseal root on the pharmacokinetics of indinavir. J Clin Pharmacol 2003;43:1283-8.. PubMed
- Janbaz KH, Gilani AH. Studies on preventive and curative effects of berberine on chemical-induced hepatotoxicity in rodents. Fitoterapia 2000;71:25-33.. PubMed
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77:415-26. PubMed
- Gurley BJ, Swain A, Barone GW, et al. Effect of goldenseal (Hydrastis canadensis) and kava kava (Piper methysticum) supplementation on digoxin pharmacokinetics in humans. Drug Metab Dispos 2007;35:240-5. PubMed
- Gurley BJ, Swain A, Hubbard MA, et al. Clinical assessement of CYP2D6-mediated herb-drug interactions in humans: Effects of milk-thistle, black cohosh, goldenseal, kava kava, St. John's wort, and Echinacea. Mol Nutr Food Res 2008;52:755-63.
- Zhang Y, Li X, Zou D, et al. Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol Metab 2008;93:2559-65. PubMed
- Chatterjee P, Franklin MR. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos 2003;31:1391-7. PubMed
- Choudhry, V. P., Sabir, M., and Bhide, V. N. Berberine in giardiasis. Indian Pediatr. 1972;9(3):143-146.
- Shanbhag, S. M., Kulkarni, H. J., and Gaitonde, B. B. Pharmacological actions of berberine on the central nervous system. Jpn.J Pharmacol 1970;20(4):482-487. PubMed
- Wu, J. F. and Liu, T. P. [Effects of berberine on platelet aggregation and plasma levels of TXB2 and 6-keto-PGF1 alpha in rats with reversible middle cerebral artery occlusion]. Yao Xue.Xue.Bao. 1995;30(2):98-102.
- Peng, W. H., Hsieh, M. T., and Wu, C. R. Effect of long-term administration of berberine on scopolamine-induced amnesia in rats. Jpn J Pharmacol 1997;74(3):261-266. DOI
- Sharda DC. Berberine in the treatment of diarrhoea of infancy and childhood. J Indian M A 1970;54(1):22-24.
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