Echinacea & Goldenseal Root Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Echinacea & Goldenseal Root 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 Root is a dietary supplement by Herbal Secrets with 5 active ingredients. Its ingredients are commonly taken for loss of appetite, indigestion and bloating, digestive bitter tonic.Based on those ingredients, 1,337 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Goldenseal, Echinacea, Cayenne Pepper. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Echinacea & Goldenseal Root by Herbal Secrets
Ask about any prescription or over-the-counter medication and we check it for interactions with Echinacea & Goldenseal Root by Herbal Secrets — 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 & Goldenseal Root by Herbal Secrets
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
Low disclosure
This product contains five active ingredients: gentian, cayenne pepper, burdock, goldenseal, and echinacea. The product also includes three inactive ingredients—gelatin (capsule material), silica, and magnesium stearate (a flow agent)—which are excipients used to form and stabilize the capsule.
Does it work?
Not established
The evidence for most of these ingredients is limited. Cayenne pepper shows the strongest data—it is rated Likely Effective for two conditions: postherpetic neuralgia (nerve pain after shingles) and diabetic neuropathy (nerve damage from diabetes), and Possibly Effective for cluster headaches, back pain, and nausea after surgery.
For the other ingredients, effectiveness ratings are either insufficient or the evidence hasn't been well established in our data. Gentian, burdock, goldenseal, and echinacea do not have strong evidence for their traditional uses in this product.
How safe is it?
Well-documented data
Cayenne pepper is generally well tolerated in food amounts but commonly causes burning and irritation; concentrated supplements are less well studied. Gentian can upset the stomach, especially at high doses.
Burdock is likely safe as a food and for short-term use, but human safety data are sparse. Goldenseal safety data are limited, and it should only be used short-term.
Echinacea is well tolerated short-term but may cause allergic reactions, especially in people sensitive to ragweed and related plants. Rare serious effects reported across these ingredients include hepatitis (echinacea), allergic reactions, and in one case, liver disease (burdock).
Common minor side effects include nausea, diarrhea, constipation, abdominal discomfort, and headache.
Meds to double-check
Moderate interaction found
Before taking this product, check with your pharmacist if you're on blood thinners or antiplatelet drugs like warfarin, clopidogrel, or aspirin; diabetes medications; blood pressure drugs; sedating medications; or drugs metabolized by your liver's cytochrome P450 enzymes (CYP3A4, CYP2D6, CYP2C9, CYP1A2). Echinacea can raise caffeine levels by about 30%.
If you take immunosuppressants, theophylline (for asthma or breathing problems), or HIV drugs, mention those too.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
This product has interactions with many drug classes—particularly blood thinners, diabetes medications, blood pressure drugs, and drugs metabolized by your liver. If you take any prescription medication, run it through the checker on this page before starting.
Cayenne does have solid evidence for nerve pain and diabetic neuropathy, but the other ingredients lack strong supporting data. Talk to your pharmacist about whether this blend is right for your specific situation.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 5 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated May 24, 2023.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Echinacea & Goldenseal Root, straight from the product label.
| Brand | Herbal Secrets |
|---|---|
| Barcode (UPC) | 819209021842 |
| Net contents | 500 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | May 24, 2023 |
| DSLD ID | 284934 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Women (not pregnant or lactating), 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 & Goldenseal Root by Herbal Secrets, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Gentian | 0 NP | -- |
| Cayenne Pepper | 0 NP | -- |
| Burdock | 0 NP | -- |
| Goldenseal | 0 NP | -- |
| Echinacea | 0 NP | -- |
| Echinacea/Goldenseal Blend | 450 mg | -- |
Other ingredients: Gelatin, Silica, Magnesium Stearate
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formulation
Herbal Secrets Echinacea & Goldenseal Root all-natural supplement combines two well-known powerhouse herbs known for their antibiotic and anti-inflammatory properties. The combination supports immune function by simulating the production of T-cells. It may help fight the inflammatory and congestive elements of the common cold by soothing conditions in the inner membranes of the nose and throat. It supports wound healing and may help reduce inflammation in arthritis and inflammatory skin conditions. This combination has been used to aid in healing everything from sunburns to the common cold.
100% natural
Antibiotic & anti-inflammatory properties Promotes healthy immune function Helps fight off infections & the common cold Supports overall health & well-being
Contains no: Preservatives, artificial colors, flavors or sweeteners, sugar, starch, milk, lactose, soy, gluten, wheat, yeast, fish or sodium.
An FDA regulated facility
Suggested/Recommended/Usage/Directions
Suggested use: As a dietary supplement, adults take one (1) capsule twice daily, preferably with a meal. (Capsules may be opened and prepared as a tea).
Precautions
Caution: Not intended for use by pregnant or nursing women. If you are taking any medication(s) or have any medical condition, consult your doctor before use.
Avoid this product if you are allergic to sunflowers or daisy-like flowers.
Discontinue use and consult your doctor if any adverse reactions occur.
Not intended for uses by persons under the age of 18. Keep out of reach of children.
Do not use if safety seal is damaged or missing.
Storage
Store in a cool, dry place.
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.
General Statements
Visit us online @ amazingnutrition.com
Vitamin angels Proud supporter
Seals/Symbols
Made in the USA
GMP Good Manufacturing Practice quality product
FDA Statement of Identity
Natural Dietary Supplement
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Echinacea & Goldenseal Root by Herbal Secrets 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 Root by Herbal Secrets
These are the 5 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container500 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/Goldenseal Blend
- › Gentian
- › Cayenne Pepper
- › Burdock
- › Goldenseal
- › Echinacea
Other (inactive) ingredients: Gelatin, Silica, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.
Echinacea & Goldenseal Root by Herbal Secrets Drug Interactions
HelloPharmacist Interaction Report
Echinacea & Goldenseal Root by Herbal Secrets has documented interactions with a wide range of medications.
The most serious concern is with goldenseal and cytochrome P450 enzyme inhibitors—specifically CYP3A4, CYP2D6, and CYP2C9 substrates—which are Moderate-severity interactions that can raise the levels of affected drugs in your bloodstream. These substrates include everything from certain statins and blood pressure medications to some cancer drugs and HIV antiretrovirals.
Read the full breakdown — every affected drug type, severity by severity
Cayenne pepper in this product interacts with blood thinners (anticoagulants and antiplatelet drugs) at Moderate severity, raising bleeding risk. It also has Moderate interactions with diabetes medications (risk of low blood sugar), theophylline (an asthma/breathing drug), and aspirin.
Goldenseal adds Moderate-severity risks with blood thinners, diabetes drugs, blood pressure medications, sedating drugs, and P-glycoprotein substrates (a large group of drugs moved in and out of cells by a transporter protein). Gentian and burdock both carry Moderate interactions with blood pressure drugs and blood thinners respectively.
Echinacea can increase caffeine levels by about 30% and has Moderate interactions with CYP1A2 and CYP3A4 substrates, immunosuppressants, and the cancer drug etoposide.
Additionally, echinacea has Minor interactions with warfarin, lopinavir/ritonavir, and midazolam. Cayenne has Minor interactions with ACE inhibitor blood pressure drugs and the antibiotic ciprofloxacin.
Altogether, these interactions span 1,319 individual medications. Please check your exact medications with the search tool below before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Echinacea & Goldenseal Root?
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 Root interact with 1,337 drugs. Click any drug to see the details.
5 of the 5 ingredients in Echinacea & Goldenseal Root interact with drugs. Each result below shows which ingredient is responsible. Goldenseal Echinacea Cayenne Pepper Gentian Burdock
Acetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome 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, Dextromethorphan Hydrobromide interactionEchinaceaCytochrome 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 + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionGoldensealCytochrome 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, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome 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, Dextromethorphan, Pseudoephedrine interactionEchinaceaCytochrome 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 + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
How Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide 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, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
How Acetaminophen, Chlorpheniramine, Phenylephrine interacts with Echinacea & Goldenseal Root — 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, Chlorpheniramine, Phenylephrine interactionEchinaceaCytochrome 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 + Acetaminophen, Chlorpheniramine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylephrine, SalicylamideRhinogesic, Rhinogesic JR
How Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide 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, Chlorpheniramine, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylpropanolamineAlumadrine, Conex, Sinadrin Max Strength, Sinulin
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine interacts with Echinacea & Goldenseal Root — 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, Chlorpheniramine, Phenylpropanolamine interactionEchinaceaCytochrome 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 + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionGoldensealCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, PhenyltoloxamineNorel Plus
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interacts with Echinacea & Goldenseal Root — 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, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, Chlorpheniramine, PseudoephedrineAlka-Seltzer PLUS Liquid Gels, Children's Tylenol Cold, Codimal, Comtrex, Extra Strength Tylenol Allergy Sinus, Lorsin +3 more
How Acetaminophen, Chlorpheniramine, Pseudoephedrine interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Chlorpheniramine, Pseudoephedrine 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, Chlorpheniramine, Pseudoephedrine interactionAcetaminophen, ChlorzoxazoneAcetazone Forte, Extra Strength Tylenol Aches & Strains, Parafon Forte
How Acetaminophen, Chlorzoxazone interacts with Echinacea & Goldenseal Root — 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, Chlorzoxazone interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Chlorzoxazone interactionAcetaminophen, Chlorzoxazone, CodeineAcetazone Forte C8, Parafon Forte C8
How Acetaminophen, Chlorzoxazone, Codeine interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Chlorzoxazone, Codeine interactionGoldensealCytochrome 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, Chlorzoxazone, Codeine interactionAcetaminophen, CodeineTylenol No.3, Tylenol w/ Codeine
How Acetaminophen, Codeine interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 2d6 (cyp2d6) Substrates, Cns Depressants +1 Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Read the full Goldenseal + Acetaminophen, Codeine interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Codeine interactionAcetaminophen, Codeine, DoxylamineMersyndol
How Acetaminophen, Codeine, Doxylamine interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Codeine, Doxylamine interactionGoldensealCytochrome 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, Codeine, Doxylamine interactionAcetaminophen, Codeine, MethocarbamolAcetaminophen, Codeine, Methocarbamol, Robaxacet 8
How Acetaminophen, Codeine, Methocarbamol interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 2d6 (cyp2d6) Substrates, Cns Depressants +1 Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Read the full Goldenseal + Acetaminophen, Codeine, Methocarbamol interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Codeine, Methocarbamol interactionAcetaminophen, Dexbrompheniramine, PseudoephedrineSinadrin Plus
How Acetaminophen, Dexbrompheniramine, Pseudoephedrine interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Dexbrompheniramine, Pseudoephedrine interactionGoldensealCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal + Acetaminophen, Dexbrompheniramine, Pseudoephedrine interactionAcetaminophen, DextromethorphanTylenol Cough Ex Strength
How Acetaminophen, Dextromethorphan interacts with Echinacea & Goldenseal Root — 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, Dextromethorphan interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Dextromethorphan interactionAcetaminophen, Dextromethorphan, Doxylamine, PseudoephedrineVicks NyQuil
How Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interacts with Echinacea & Goldenseal Root — 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, Dextromethorphan, Doxylamine, Pseudoephedrine interactionEchinaceaCytochrome 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 + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylephrineConar-A
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome 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, Dextromethorphan, Guaifenesin, Phenylephrine interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylpropanolamineAnatuss
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interacts with Echinacea & Goldenseal Root — 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, Dextromethorphan, Guaifenesin, Phenylpropanolamine interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PseudoephedrineRobitussin Cold, Severe Cold, Suphedrine Cold/Cough
How Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Read the full Goldenseal + Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Phenylpropanolamine, PyrilamineTheracaps
How Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interacts with Echinacea & Goldenseal Root — 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, Dextromethorphan, Phenylpropanolamine, Pyrilamine interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interactionAcetaminophen, Dextromethorphan, PseudoephedrineAlka-Seltzer PLUS Flu Liquid Gels, Non Aspirin Cold Caps, Tylenol Cold, Tylenol Flu Daytime Ex Strength, Tylenol Flu Ex Strength
How Acetaminophen, Dextromethorphan, Pseudoephedrine interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome 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, Dextromethorphan, Pseudoephedrine interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Dichloralantipyrine, IsomethepteneAmidrine, Midchlor, Migquin, Migratine
How Acetaminophen, Dichloralantipyrine, Isometheptene interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal + Acetaminophen, Dichloralantipyrine, Isometheptene interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Dichloralantipyrine, Isometheptene interactionAcetaminophen, Dichloralphenazone, IsomethepteneMidrin
How Acetaminophen, Dichloralphenazone, Isometheptene interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCns Depressants, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Read the full Goldenseal + Acetaminophen, Dichloralphenazone, Isometheptene interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Dichloralphenazone, Isometheptene interactionAcetaminophen, Dichlorophenazone, IsometheptaneIsocom
How Acetaminophen, Dichlorophenazone, Isometheptane interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal + Acetaminophen, Dichlorophenazone, Isometheptane interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Dichlorophenazone, Isometheptane interactionAcetaminophen, DiphenhydramineTylenol PM, Tylenol PM Ex Strength
How Acetaminophen, Diphenhydramine interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCns Depressants, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Read the full Goldenseal + Acetaminophen, Diphenhydramine interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Diphenhydramine interactionAcetaminophen, Diphenhydramine, PseudoephedrineChildren's Tylenol Allergy, Cold Control, Contac Night Allergy Relief
How Acetaminophen, Diphenhydramine, Pseudoephedrine interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
GoldensealCytochrome P450 2e1 (cyp2e1) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal + Acetaminophen, Diphenhydramine, Pseudoephedrine interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Diphenhydramine, Pseudoephedrine interactionAcetaminophen, Doxylamine, PseudoephedrineEx Strength Tylenol Sinus Nighttime
How Acetaminophen, Doxylamine, Pseudoephedrine interacts with Echinacea & Goldenseal Root — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Doxylamine, Pseudoephedrine interactionGoldensealCytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
Read the full Goldenseal + Acetaminophen, Doxylamine, Pseudoephedrine interactionAcetaminophen, HydrocodoneAnexsia, Anodynos DHC, Azdone, Co-Gesic, Doucet, Lorcet +9 more
How Acetaminophen, Hydrocodone interacts with Echinacea & Goldenseal Root — 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, Hydrocodone interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Hydrocodone interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Echinacea & Goldenseal Root 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
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.
Cayenne Pepper
Anticoagulant/Antiplatelet Drugs
Theoretically, capsicum may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro research shows that capsicum might increase the effects of antiplatelet drugs. Also, population research shows that capsicum is associated with an increased risk of self-reported bleeding in patients taking warfarin. However, clinical research shows that taking a single dose of capsaicin (Asian Herbex Ltd.), the active ingredient in capsicum, 400-800 mcg orally in combination with aspirin 500 mg does not decrease platelet aggregation when compared with taking aspirin 500 mg alone. Also, there was no notable effect on measures of platelet aggregation with capsaicin. It is unclear whether capsaicin must be used in more than a single dose to affect platelet aggregation.
Antidiabetes Drugs
Theoretically, taking capsicum with antidiabetes drugs might increase the risk of hypoglycemia.
Preliminary clinical research shows that consuming capsicum 5 grams along with a glucose drink attenuates the rise in plasma glucose after 30 minutes by 21%, decreases the 2-hour postprandial area under the curve of plasma glucose by 11%, and increases the 2-hour postprandial area under the curve of plasma insulin by 58% in healthy individuals when compared with placebo. Other clinical research shows that taking capsicum 5 mg daily for 28 days significantly reduces postprandial blood glucose and insulin levels, but not fasting blood glucose and insulin levels, in patients with gestational diabetes.
Aspirin
Theoretically, taking capsicum with aspirin might reduce the bioavailability of aspirin.
Animal research shows that acute or chronic intake of capsicum pepper reduces oral aspirin bioavailability. This has not been shown in humans.
Theophylline
Theoretically, taking capsicum with theophylline might increase the levels and adverse effects of theophylline.
In animal research, oral administration of capsicum reduced excretion of theophylline. However, capsicum does not seem to affect the pharmacokinetics of theophylline when administered intravenously.
Ace Inhibitors (Aceis)
Theoretically, using topical capsaicin may increase the risk of ACE inhibitor-induced cough.
There is one case report of a topically applied capsaicin cream contributing to the cough reflex in a patient using an ACEI. However, it is unclear if this interaction is clinically significant.
Ciprofloxacin (Cipro)
Theoretically, taking capsicum with ciprofloxacin might increase levels and adverse effects of ciprofloxacin.
Animal research shows that concomitant use of capsaicin, the active constituent of capsicum, and ciprofloxacin increases the bioavailability of ciprofloxacin by up to 70%.
Gentian
Antihypertensive Drugs
Theoretically, taking gentian with antihypertensive drugs might increase the risk of hypotension.
In vitro research shows that gentian can cause vasodilation and lower blood pressure.
Burdock
Anticoagulant/Antiplatelet Drugs
Theoretically, taking burdock with anticoagulant or antiplatelet drugs might increase the risk of bleeding.
In vitro research shows that lignans from burdock reduce rabbit platelet aggregation by inhibiting platelet activating factor. This interaction has not been reported in humans.
Brand information
Manufacturer and brand details for Echinacea & Goldenseal Root, from the product label.
Herbal Secrets
See all Herbal Secrets products- Name
- Herbal Secrets
- Street Address
- 629 Grove Street
- City
- Jersey City
- State
- NJ
- ZipCode
- 07310
- Web Address
- amazingnutrition.com
Echinacea & Goldenseal Root by Herbal Secrets: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Echinacea & Goldenseal Root’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Gentian
Interacts with 172 drugsGentian is a very bitter root traditionally used to stimulate appetite and ease mild digestive complaints, often as part of "bitters" before meals. The evidence is mostly traditional and pre...
Read the full Gentian monograph → Herb & supplement monographCapsicum
Interacts with 239 drugsCapsicum (chili pepper) contains capsaicin, which is best known and best studied as a topical treatment for certain types of pain. Topical capsaicin products are supported by reasonable evid...
Read the full Capsicum monograph → Herb & supplement monographBurdock
Interacts with 122 drugsBurdock is a traditional herb most often used for skin problems and as a so-called 'blood purifier,' but high-quality human studies are lacking and most claims are not well proven. It is wid...
Read the full Burdock 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 → 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 Root'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 190 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.
Gentian 5 references
- Neubauer N, Marz RW. Placebo-controlled, randomized, double-blind, clincal trial with Sinupret sugar coated tablets on the basis of a therapy with antibiotics and decongestant nasal drops in acute sinusitis. Phytomedicine 1994;1:177-81.
- Marz RW, Ismail C, Popp MA. Action profile and efficacy of a herbal combination preparation for the treatment of sinusitis. Wien Med Wochenschr 1999;149:202-8.
- Uncini Manganelli RE, Chericoni S, Baragatti B. Ethnopharmacobotany in Tuscany: plants used as antihypertensives. Fitoterapia 2000;71:S95-100. PubMed
- Baragatti B, Calderone V, Testai L, et al. Vasodilator activity of crude methanolic extract of Gentiana kokiana Perr. et Song. (Gentianaceae). J Ethnopharmacol 2002;79:369-72. PubMed
- Sanatani M, Younus J, Stitt L, et al. Tolerability of the combination of ginger (Zingiber officinalis), gentian (Gentiana lutea) and turmeric (Curcuma longa) in patients with cancer-associated anorexia. J Complement Integr Med. 2015;12(1):57-60.
Capsicum 89 references
- Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
- Cooper RL, Cooper MM. Red pepper-induced dermatitis in breast-fed infants. Dermatol 1996;93:61-2. PubMed
- Millqvist E. Cough provocation with capsaicin is an objective way to test sensory hyperreactivity in patients with asthma-like symptoms. Allergy 2000;55:546-50. DOI
- Locock RA. Capsicum. Can Pharm J 1985;118:517-9.
- Mason L, Moore RA, Derry S, et al. Systematic review of topical capsaicin for the treatment of chronic pain. BMJ 2004;328:991. PubMed
- Schmulson MJ, Valdovinos MA, Milke P. Chili pepper and rectal hyperalgesia in irritable bowel syndrome. Am J Gastroenterol 2003;98:1214-5. PubMed
- Surh YJ, Lee SS. Capsaicin in hot chili pepper: carcinogen, co-carcinogen or anticarcinogen? Food Chem Toxicol 1996;34:313-6. PubMed
- Bouraoui A, Brazier JL, Zouaghi H, Rousseau M. Theophylline pharmacokinetics and metabolism in rabbits following single and repeated administration of Capsicum fruit. Eur J Drug Metab Pharmacokinet 1995;20:173-8.
- Hogaboam CM, Wallace JL. Inhibition of platelet aggregation by capsaicin. An effect unrelated to actions on sensory afferent neurons. Eur J Pharmacol 1991;202:129-31. PubMed
- Wang JP, Hsu MF, Teng CM. Antiplatelet effect of capsaicin. Thromb Res 1984;36:497-507. PubMed
- Williams SR, Clark RF, Dunford JV. Contact dermatitis associated with capsaicin: Hunan hand syndrome. Ann Emerg Med 1995;25:713-5. PubMed
- Zollman TM, Bragg RM, Harrison DA. Clinical effects of oleoresin capsicum (pepper spray) on the human cornea and conjunctiva. Ophthalmology 2000;107:2186-9. PubMed
- Bortolotti M, Coccia G, Grossi G, Miglioli M. The treatment of functional dyspepsia with red pepper. Aliment Pharmacol Ther 2002;16:1075-82. PubMed
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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