Echinacea Goldenseal Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Echinacea Goldenseal 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 Goldenseal is a dietary supplement by Thymely Solutions with 4 active ingredients. Its ingredients are commonly taken for digestive upset and diarrhea, colds and respiratory infections, sore throat and mouth sores.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 angustifolia. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Echinacea Goldenseal by Thymely Solutions
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HelloPharmacist Scorecard of Echinacea Goldenseal by Thymely Solutions
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 4 active ingredients: goldenseal, two forms of echinacea (Echinacea angustifolia and Echinacea purpurea). Goldenseal is a root traditionally used for immune support, while echinacea species are flowering plants also used to support immune function.
The capsule also contains modified vegetable cellulose as an inactive ingredient.
Does it work?
Insufficient evidence
The data we hold don't establish effectiveness for goldenseal or echinacea for any of the conditions listed. Goldenseal shows insufficient evidence for acne, allergic rhinitis (hay fever), anorexia nervosa, and chronic fatigue syndrome, and is rated possibly ineffective for helping pass urine drug tests.
Echinacea is rated insufficient evidence for anxiety, athletic performance, ADHD, burns, chronic fatigue syndrome, and migraine headaches. Neither ingredient's evidence supports its use for a specific disease or symptom we can point to here.
How safe is it?
Well-documented data
Goldenseal is generally used short-term by healthy adults, though human safety data are limited. Because goldenseal contains berberine, which may harm the fetus and trigger contractions, the data advise against it during pregnancy.
It's also advised against while breastfeeding because berberine may pass to an infant and cause harm. The most common side effects from berberine include abdominal pain, distension, constipation, diarrhea, flatulence, headache, nausea, vomiting, and bitter taste—though these haven't been formally documented with goldenseal itself.
Echinacea is generally well tolerated short-term but may cause allergic reactions, especially in people sensitive to ragweed and plants in the daisy family (ragweed, chrysanthemums, marigolds, daisies). Common side effects are abdominal pain, constipation, diarrhea, heartburn, nausea, vomiting, rashes, and stomach upset.
Rarely, severe allergic reactions and hepatitis have been reported. The data note there isn't enough reliable safety information for echinacea in pregnancy or lactation; talk with your doctor or pharmacist about whether it's right for you if you're pregnant or breastfeeding.
Meds to double-check
Moderate interaction found
Before taking this product, check whether you're on any medications metabolized by the liver enzymes CYP3A4, CYP2D6, CYP2C9, or CYP1A2—a large group that includes many common drugs. Also double-check if you take blood pressure medications, blood thinners (anticoagulants), diabetes medications, sedatives (CNS depressants), immunosuppressants, or the chemotherapy drug etoposide.
Discuss the results with your own doctor or pharmacist.
The bottom line
Scorecard at a glanceFully disclosed formula with insufficient evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
This is a combination product with significant documented interactions across multiple medication types, especially drugs your liver processes. If you take prescription medications for blood pressure, bleeding, diabetes, sedation, immune function, or any CYP3A4, CYP2D6, CYP2C9, or CYP1A2 substrates, check with your own doctor or pharmacist before starting it.
Neither ingredient has established effectiveness for a specific condition in our data. People who are pregnant, breastfeeding, allergic to ragweed, or taking immunosuppressants should avoid it.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 4 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Dec 22, 2019.
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 Goldenseal, straight from the product label.
| Brand | Thymely Solutions |
|---|---|
| Barcode (UPC) | 788332154706 |
| Net contents | 90 Veggie Cap(s) |
| Market status | On market |
| Date entered into DSLD | Dec 22, 2019 |
| DSLD ID | 211879 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other |
| Intended target group(s) | Vegetarian, Adult (18 - 50 Years), Kosher, Women (not pregnant or lactating), Gluten Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Echinacea Goldenseal by Thymely Solutions, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Goldenseal | 100 mg | -- |
| Echinacea angustifolia | 150 mg | -- |
| Echinacea purpurea | 100 mg | -- |
| Echinacea purpurea | 100 mg | -- |
Other ingredients: Modified Vegetable 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.
Suggested/Recommended/Usage/Directions
Suggested Use: Take 1 cap, 1-3 times per day or as directed by a health care professional.
Precautions
Warnings: Do not take during pregnancy or while nursing.
Keep out of the reach of children.
Formulation
100% Gluten free
100% Vegetarian
FDA Statement of Identity
Herbal Supplement
Seals/Symbols
K Parve K-1604
Formula
K Parve K-1604
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Echinacea Goldenseal by Thymely Solutions 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 Goldenseal by Thymely Solutions
These are the 4 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Veggie Cap(s) Dosage formCapsule Servings per container90 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.
Goldenseal
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 & interactionsEchinacea angustifolia
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 monograph & interactionsEchinacea 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 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 & interactionsOther (inactive) ingredients: Modified Vegetable Cellulose. These complete the product’s ingredient list but are not active constituents.
Echinacea Goldenseal by Thymely Solutions Drug Interactions
HelloPharmacist Interaction Report
Echinacea Goldenseal by Thymely Solutions has documented interactions through its goldenseal and echinacea content.
The most serious interactions are Moderate in severity. Goldenseal can inhibit several liver enzymes (CYP2D6, CYP2C9, and CYP3A4) and theoretically may increase the sedative effects of drugs like benzodiazepines or opioids, lower blood pressure when combined with blood pressure medications, increase bleeding risk with blood thinners (anticoagulants) like warfarin, or raise low blood sugar (hypoglycemia) risk with diabetes medications.
Read the full breakdown — every affected drug type, severity by severity
Echinacea also affects liver enzymes and can increase caffeine levels by roughly 30%. It may interfere with immunosuppressants used after organ transplants and theoretically could raise levels of the chemotherapy drug etoposide.
Both ingredients carry Moderate interactions with drugs metabolized by CYP3A4—a large group that includes many common medications.
Echinacea carries Minor interactions with warfarin (a blood thinner), the HIV medication lopinavir/ritonavir, and midazolam (a sedative). Altogether, these interactions span 1,337 individual medications.
Before taking this product, check your exact prescriptions against the medication checker on this page, and discuss the results with your own doctor or pharmacist.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Echinacea Goldenseal?
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 Goldenseal interact with 1,336 drugs. Click any drug to see the details.
2 of the 4 ingredients in Echinacea Goldenseal interact with drugs. Each result below shows which ingredient is responsible. Goldenseal Echinacea angustifolia
Ammonium ChlorideAmmonium Chloride
How Ammonium Chloride interacts with Echinacea Goldenseal — 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 + Ammonium Chloride interactionAmobarbitalAmytal
How Amobarbital interacts with Echinacea Goldenseal — 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 + Amobarbital interactionAmobarbital, Ephedrine SulfateEphedrine & Amytal
How Amobarbital, Ephedrine Sulfate interacts with Echinacea Goldenseal — 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 + Amobarbital, Ephedrine Sulfate interactionAmobarbital, SecobarbitalTuinal
How Amobarbital, Secobarbital interacts with Echinacea Goldenseal — 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 + Amobarbital, Secobarbital interactionAmoxicillin, Omeprazole Magnesium, RifabutinTalicia
How Amoxicillin, Omeprazole Magnesium, Rifabutin interacts with Echinacea Goldenseal — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2C9.
Read the full Goldenseal + Amoxicillin, Omeprazole Magnesium, Rifabutin interactionEchinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Amoxicillin, Omeprazole Magnesium, Rifabutin interactionAmphetamineAdensys XR-ODT, Adzenys ER, Dyanavel XR, Mydayis
How Amphetamine interacts with Echinacea Goldenseal — through 1 ingredient. Tap an ingredient for the detail:
GoldensealCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Read the full Goldenseal + Amphetamine interactionAmphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine SulfateAdderall, Adderall XR
How Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate interacts with Echinacea Goldenseal — through 1 ingredient. Tap an ingredient for the detail:
GoldensealCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Read the full Goldenseal + Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate interactionAmphetamine SulfateBenzedrine, Evekeo ODT
How Amphetamine Sulfate interacts with Echinacea Goldenseal — through 1 ingredient. Tap an ingredient for the detail:
GoldensealCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Read the full Goldenseal + Amphetamine Sulfate interactionAmphotericin, TetracyclineMysteclin-F
How Amphotericin, Tetracycline interacts with Echinacea Goldenseal — through 1 ingredient. Tap an ingredient for the detail:
GoldensealP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase or decrease serum levels of P-glycoprotein (P-gp) substrates.
Read the full Goldenseal + Amphotericin, Tetracycline interactionAmprenavirAgenerase
How Amprenavir interacts with Echinacea Goldenseal — through 2 ingredients. Tap an ingredient for the detail:
GoldensealP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase or decrease serum levels of P-glycoprotein (P-gp) substrates.
Read the full Goldenseal + Amprenavir interactionEchinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Amprenavir interactionAnacaulase-bcdbNexoBrid
How Anacaulase-bcdb interacts with Echinacea Goldenseal — 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 + Anacaulase-bcdb interactionAnagrelideAgrylin
How Anagrelide interacts with Echinacea Goldenseal — through 2 ingredients. 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 + Anagrelide 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 + Anagrelide interactionAnifrolumab-fniaSaphnelo
How Anifrolumab-fnia interacts with Echinacea Goldenseal — 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 + Anifrolumab-fnia interactionAnisindioneMiradon
How Anisindione interacts with Echinacea Goldenseal — 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 + Anisindione interactionAntidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) InhibitorGlyxambi
How Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) Inhibitor interacts with Echinacea Goldenseal — through 1 ingredient. Tap an ingredient for the detail:
GoldensealAntidiabetes Drugs, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase the risk of hypoglycemia when used with antidiabetes drugs.
Read the full Goldenseal + Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) Inhibitor interactionAntithrombin IiiThrombate III
How Antithrombin Iii interacts with Echinacea Goldenseal — 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 + Antithrombin Iii interactionAntithymocyte GlobulinThymoglobulin
How Antithymocyte Globulin interacts with Echinacea Goldenseal — 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 + Antithymocyte Globulin interactionApalutamideErleada
How Apalutamide interacts with Echinacea Goldenseal — 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 + Apalutamide interactionEchinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Apalutamide interactionApixabanEliquis
How Apixaban interacts with Echinacea Goldenseal — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal + Apixaban interactionEchinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Apixaban interactionApomorphineAPO-go, APO-go Pen, APO-go PFS, Apokyn, Uprima
How Apomorphine interacts with Echinacea Goldenseal — through 1 ingredient. Tap an ingredient for the detail:
GoldensealP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase or decrease serum levels of P-glycoprotein (P-gp) substrates.
Read the full Goldenseal + Apomorphine interactionApomorphine HydrochlorideKynmobi
How Apomorphine Hydrochloride interacts with Echinacea Goldenseal — through 1 ingredient. Tap an ingredient for the detail:
GoldensealP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase or decrease serum levels of P-glycoprotein (P-gp) substrates.
Read the full Goldenseal + Apomorphine Hydrochloride interactionApremilastOtezla
How Apremilast interacts with Echinacea Goldenseal — 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 + Apremilast interactionGoldensealCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal + Apremilast interactionAprepitantCinvanti, Emend
How Aprepitant interacts with Echinacea Goldenseal — 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 + Aprepitant interactionEchinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Aprepitant interactionAprobarbital, Butabarbital, PhenobarbitalTriple Barbital
How Aprobarbital, Butabarbital, Phenobarbital interacts with Echinacea Goldenseal — 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 + Aprobarbital, Butabarbital, Phenobarbital interactionAprocitentanTryvio
How Aprocitentan interacts with Echinacea Goldenseal — 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 + Aprocitentan interactionArgatrobanArgatroban
How Argatroban interacts with Echinacea Goldenseal — 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 + Argatroban interactionAripiprazoleAbilify, Abilify Maintena, Abilify Mycite
How Aripiprazole interacts with Echinacea Goldenseal — 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 + Aripiprazole interactionEchinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Aripiprazole interactionAripiprazole LauroxilAristada, Aristada Initio Kit
How Aripiprazole Lauroxil interacts with Echinacea Goldenseal — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +1 Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Read the full Goldenseal + Aripiprazole Lauroxil interactionEchinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Aripiprazole Lauroxil interactionArmodafinilNuvigil
How Armodafinil interacts with Echinacea Goldenseal — 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 + Armodafinil interactionEchinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Armodafinil interactionAsenapineSaphris, Secuado
How Asenapine interacts with Echinacea Goldenseal — through 1 ingredient. Tap an ingredient for the detail:
Echinacea 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 + Asenapine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Echinacea Goldenseal 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 angustifolia
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 Goldenseal, from the product label.
Thymely Solutions
See all Thymely Solutions products- Name
- Thymely Solutions
- Street Address
- 104 N Court St.
- City
- Fairfield
- State
- IA
- ZipCode
- 52556
- Phone Number
- (641) 472-9815
Echinacea Goldenseal by Thymely Solutions: Common Questions
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The Full Monographs Behind Echinacea Goldenseal’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Goldenseal
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 → Herb & supplement monographEchinacea
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 →Sources & How We Checked
Echinacea Goldenseal'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.
Goldenseal 34 references
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Echinacea 51 references
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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