Esberitox Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Esberitox 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
Esberitox is a dietary supplement by Integrative Therapeutics with 4 active ingredients. Its ingredients are commonly taken for colds and flu, immune support, sore throat and upper respiratory infections.Based on those ingredients, 1,118 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Purple Coneflower Root Extract, Eastern White Cedar Leaf Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Esberitox by Integrative Therapeutics
Ask about any prescription or over-the-counter medication and we check it for interactions with Esberitox by Integrative Therapeutics — 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 Esberitox by Integrative Therapeutics
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
Esberitox has 4 ingredients. The active ones are two forms of echinacea (Purple Coneflower Root Extract and Pale Purple Coneflower Root Extract), plus Wild Indigo Root Extract and Eastern White Cedar Leaf Extract — each a dry root or leaf extract.
The product also contains inactive ingredients: lactose, sugar, macrogol, and magnesium stearate.
Does it work?
Not established
The evidence for what this product does isn't established in the data we hold. Wild indigo, echinacea, and Eastern White Cedar are all rated as having insufficient reliable evidence for treating the common cold or the other conditions studied.
That doesn't mean they don't work — it means the studies we have aren't strong enough to say one way or the other.
How safe is it?
Well-documented data
Echinacea is generally well tolerated short-term, though some people report abdominal pain, diarrhea, nausea, rashes, or stomach upset. Rare cases of severe allergic reactions (including anaphylaxis) and liver inflammation have been reported, especially in people sensitive to ragweed and related plants.
Wild indigo in large doses can be toxic and cause vomiting, diarrhea, and stomach cramps — the product uses smaller amounts, but it's not something to exceed. Eastern White Cedar contains thujone, which at high doses causes headache, nerve agitation, seizures, and stomach problems; large doses have caused liver and kidney damage.
Avoid this product during pregnancy: wild indigo and Eastern White Cedar are likely unsafe, and echinacea is possibly safe but evidence is limited. While breastfeeding, safety data isn't available for any of these three ingredients — talk with your doctor or pharmacist.
Meds to double-check
Moderate interaction found
Check these medication types before taking Esberitox: seizure threshold lowering drugs and anticonvulsants (because of thujone in the Eastern White Cedar), immunosuppressants, CYP1A2 substrate drugs and caffeine products, CYP3A4 substrate drugs (including some sedatives and antivirals), etoposide (VePesid), blood thinners like warfarin, and HIV medications like lopinavir/ritonavir. The checker below will scan your list.
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.
If you're on a seizure medication, blood thinner, sedative, HIV drug, or immunosuppressant, you need to check your specific medications before taking this. Echinacea can boost your immune system, which might interfere with transplant or autoimmune therapy.
Most people tolerate it short-term, but allergic reactions and rare liver problems have occurred. Talk with your pharmacist, especially if you're pregnant, breastfeeding, or on any prescription drugs.
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 Jul 18, 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 Esberitox, straight from the product label.
| Brand | Integrative Therapeutics |
|---|---|
| Barcode (UPC) | 871791000117 |
| Net contents | 100 Chewable Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Jul 18, 2023 |
| DSLD ID | 292742 |
| Product type | Botanical |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Children 4 or More Years of Age, Adult (18 - 50 Years), 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 Esberitox by Integrative Therapeutics, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 5 Calorie(s) | -- |
| Total Carbohydrate | 2 Gram(s) | 1% |
| Total Sugars | 2 Gram(s) | -- |
| added Sugars | 2 Gram(s) | 4% |
| Dry Extract Blend | 19.2 mg | -- |
| Wild Indigo Root Extract, Dry | 0 NP | -- |
| Purple Coneflower Root Extract | 0 NP | -- |
| Pale Purple Coneflower Root Extract | 0 NP | -- |
| Eastern White Cedar Leaf Extract | 0 NP | -- |
Other ingredients: Lactose, Sugar, Macrogol, 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.
Formula
Echinacea Combination
FDA Statement of Identity
Dietary Supplement
Precautions
Contains milk
Warning: Do not use if you are pregnant, nursing, or under 4 years of age. Not recommended for individuals with autoimmune diseases, immunodeficiencies, progressive systemic disease, diseases of the white blood cell system, or those who are taking immunosuppressive therapy.
Warning: Do not use if you are pregnant, nursing, or under 4 years of age.
Individuals who are allergic to Echinacea or other flowers in the Compositae (Asteraceae) family, or any of the other ingredients of Esberitox, should not use this product.
If you are taking any medications, consult a healthcare professional before use.
Hypersensitivity, gastrointestinal discomfort, or dizziness may occur. If you observe these or other side effects, discontinue use and consult a healthcare professional.
Keep out of reach of children.
This product has a tamper-evident foil pouch. Do not use if foil or plastic is punctured.
Formulation
Contains no wheat, gluten, soy, or artificial colors, flavors, or preservatives.
Product of Germany
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Suggested/Recommended/Usage/Directions
Recommendation: Take 6 tablets three times daily initially for faster results. Reduce to 4 tablets three times daily as you begin to feel better, or as recommended by a healthcare professional. Adults 4-6 tablets, 3 times daily Children Over 12 Years 4-6 tablets, 3 times daily Age 7-11 years 2-3 tablets, 3 times daily Age 4-6 years 1-2 tablets, 3 times daily
General Statements
For more information, please visit integrativepro.com
Brand IP Statement(s)
Esberitox is a registered trademark of Schaper & Brummer GmbH & Co. KG
Copyright 2022 Distributed in North America by Integrative Therapeutics, LLC
Storage
Store at room temperature. Avoid excessive heat and direct sunlight.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Esberitox by Integrative Therapeutics 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 Esberitox by Integrative Therapeutics
These are the 4 active ingredients this product is made of. Select any to open its full monograph.
Serving size4 Chewable Tablet(s) Dosage formTablet Or Pill Servings per container16 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.
Other (inactive) ingredients: Lactose, Sugar, Macrogol, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.
Esberitox by Integrative Therapeutics Drug Interactions
HelloPharmacist Interaction Report
Esberitox by Integrative Therapeutics contains two echinacea extracts and an extract of Eastern White Cedar that interact with a number of medications.
The most serious concern is with seizure threshold lowering drugs (anesthetics and others) — Eastern White Cedar can contain thujone, a nerve toxin that may lower your seizure threshold, making seizures more likely if you're already on a drug that carries that risk.
Read the full breakdown — every affected drug type, severity by severity
Both echinacea extracts may slow or speed up how your liver processes certain medications. They can increase levels of caffeine and drugs metabolized by CYP1A2 enzymes (Moderate severity), and they have unpredictable effects on CYP3A4 substrates — a large group that includes some sedatives, antivirals, and chemotherapy drugs (Moderate severity).
Echinacea also has immune-boosting activity that could interfere with immunosuppressant therapy (Moderate severity). A separate concern: one case report linked echinacea to a serious increase in levels of the cancer drug etoposide (VePesid) (Moderate severity).
With blood thinners like warfarin, echinacea may speed up clearance, though the effect is small (Minor severity). HIV medications like lopinavir/ritonavir and sedatives like midazolam (Versed) may also be affected (Minor severity).
Wild indigo root was not able to be checked for interactions — we don't hold interaction data for it. Altogether, these interactions span 1,104 individual medications.
Run your exact medications through the checker on this page before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Esberitox?
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 Esberitox interact with 1,118 drugs. Click any drug to see the details.
2 of the 4 ingredients in Esberitox interact with drugs. Each result below shows which ingredient is responsible. Purple Coneflower Root Extract Eastern White Cedar Leaf Extract
Acetaminophen, Pamabrom, PyrilamineMidol Max Strength PMS, Pamprin, Pamprin ES
How Acetaminophen, Pamabrom, Pyrilamine interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Pale Purple Coneflower Root Extract + Acetaminophen, Pamabrom, Pyrilamine interactionAcetaminophen, PentazocineTalacen
How Acetaminophen, Pentazocine interacts with Esberitox — through 2 ingredients. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Pale Purple Coneflower Root Extract + Acetaminophen, Pentazocine interactionEastern White Cedar Leaf ExtractSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Thuja products can contains significant amounts of thujone, a neurotoxin.
Read the full Eastern White Cedar Leaf Extract + Acetaminophen, Pentazocine interactionAcetaminophen, Phenylephrine, ChlorpheniramineSuper Cold Tabs
How Acetaminophen, Phenylephrine, Chlorpheniramine interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Pale Purple Coneflower Root Extract + Acetaminophen, Phenylephrine, Chlorpheniramine interactionAcetaminophen, PhenylpropanolamineTetra Caps
How Acetaminophen, Phenylpropanolamine interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Pale Purple Coneflower Root Extract + Acetaminophen, Phenylpropanolamine interactionAcetaminophen, Phenylpropanolamine, PhenyltoloxamineSinubid
How Acetaminophen, Phenylpropanolamine, Phenyltoloxamine interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Pale Purple Coneflower Root Extract + Acetaminophen, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, PhenyltoloxaminePercogesic, Relagesic
How Acetaminophen, Phenyltoloxamine interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Pale Purple Coneflower Root Extract + Acetaminophen, Phenyltoloxamine interactionAcetaminophen, Phenyltoloxamine, SalicylamideLobac
How Acetaminophen, Phenyltoloxamine, Salicylamide interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Pale Purple Coneflower Root Extract + Acetaminophen, Phenyltoloxamine, Salicylamide interactionAcetaminophen, PropoxypheneDarvocet-N 100, Darvocet-N 50, E-Lor, Wygesic
How Acetaminophen, Propoxyphene interacts with Esberitox — through 2 ingredients. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Pale Purple Coneflower Root Extract + Acetaminophen, Propoxyphene interactionEastern White Cedar Leaf ExtractSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Thuja products can contains significant amounts of thujone, a neurotoxin.
Read the full Eastern White Cedar Leaf Extract + Acetaminophen, Propoxyphene interactionAcetaminophen, PseudoephedrineChildren's Tylenol Sinus, Dristan N.D., Non-Aspirin Sinus, Ornex, Ornex-Max, Sinutab +5 more
How Acetaminophen, Pseudoephedrine interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Pale Purple Coneflower Root Extract + Acetaminophen, Pseudoephedrine interactionAcetaminophen, Pseudoephedrine, TriprolidineActifed Plus ES
How Acetaminophen, Pseudoephedrine, Triprolidine interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Pale Purple Coneflower Root Extract + Acetaminophen, Pseudoephedrine, Triprolidine interactionAcetazolamideAk-Zol, Diamox
How Acetazolamide interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Eastern White Cedar Leaf ExtractAnticonvulsants Moderate
Interaction Summary
Thuja products can contain thujone, which might lower the seizure threshold.
Read the full Eastern White Cedar Leaf Extract + Acetazolamide interactionAcyclovirAvaclyr, Sitavig, Zovirax, Zovirax Injection
How Acyclovir interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Eastern White Cedar Leaf ExtractSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Thuja products can contains significant amounts of thujone, a neurotoxin.
Read the full Eastern White Cedar Leaf Extract + Acyclovir interactionAdagrasibKrazati
How Adagrasib interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Pale Purple Coneflower Root Extract + Adagrasib interactionAdalimumabHumira
How Adalimumab interacts with Esberitox — through 2 ingredients. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Pale Purple Coneflower Root Extract + Adalimumab interactionEastern White Cedar Leaf ExtractImmunosuppressants Moderate
Interaction Summary
Thuja might stimulate immune function.
Read the full Eastern White Cedar Leaf Extract + Adalimumab interactionAdalimumab-adazHyrimoz
How Adalimumab-adaz interacts with Esberitox — through 2 ingredients. Tap an ingredient for the detail:
Eastern White Cedar Leaf ExtractImmunosuppressants Moderate
Interaction Summary
Thuja might stimulate immune function.
Read the full Eastern White Cedar Leaf Extract + Adalimumab-adaz interactionPale Purple Coneflower Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Pale Purple Coneflower Root Extract + Adalimumab-adaz interactionAdalimumab-adbmCyltezo
How Adalimumab-adbm interacts with Esberitox — through 2 ingredients. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Pale Purple Coneflower Root Extract + Adalimumab-adbm interactionEastern White Cedar Leaf ExtractImmunosuppressants Moderate
Interaction Summary
Thuja might stimulate immune function.
Read the full Eastern White Cedar Leaf Extract + Adalimumab-adbm interactionAdalimumab-afzbAbrilada
How Adalimumab-afzb interacts with Esberitox — through 2 ingredients. Tap an ingredient for the detail:
Eastern White Cedar Leaf ExtractImmunosuppressants Moderate
Interaction Summary
Thuja might stimulate immune function.
Read the full Eastern White Cedar Leaf Extract + Adalimumab-afzb interactionPale Purple Coneflower Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Pale Purple Coneflower Root Extract + Adalimumab-afzb interactionAdalimumab-attoAmjevita
How Adalimumab-atto interacts with Esberitox — through 2 ingredients. Tap an ingredient for the detail:
Eastern White Cedar Leaf ExtractImmunosuppressants Moderate
Interaction Summary
Thuja might stimulate immune function.
Read the full Eastern White Cedar Leaf Extract + Adalimumab-atto interactionPale Purple Coneflower Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Pale Purple Coneflower Root Extract + Adalimumab-atto interactionAdalimumab-bwwdHadlima
How Adalimumab-bwwd interacts with Esberitox — through 2 ingredients. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Pale Purple Coneflower Root Extract + Adalimumab-bwwd interactionEastern White Cedar Leaf ExtractImmunosuppressants Moderate
Interaction Summary
Thuja might stimulate immune function.
Read the full Eastern White Cedar Leaf Extract + Adalimumab-bwwd interactionAdalimumab-fkjpHulio
How Adalimumab-fkjp interacts with Esberitox — through 2 ingredients. Tap an ingredient for the detail:
Eastern White Cedar Leaf ExtractImmunosuppressants Moderate
Interaction Summary
Thuja might stimulate immune function.
Read the full Eastern White Cedar Leaf Extract + Adalimumab-fkjp interactionPale Purple Coneflower Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Pale Purple Coneflower Root Extract + Adalimumab-fkjp interactionAgomelatineValdoxan
How Agomelatine interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Pale Purple Coneflower Root Extract + Agomelatine interactionAlefaceptAmevive
How Alefacept interacts with Esberitox — through 2 ingredients. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Pale Purple Coneflower Root Extract + Alefacept interactionEastern White Cedar Leaf ExtractImmunosuppressants Moderate
Interaction Summary
Thuja might stimulate immune function.
Read the full Eastern White Cedar Leaf Extract + Alefacept interactionAlemtuzumabCampath
How Alemtuzumab interacts with Esberitox — through 2 ingredients. Tap an ingredient for the detail:
Eastern White Cedar Leaf ExtractImmunosuppressants Moderate
Interaction Summary
Thuja might stimulate immune function.
Read the full Eastern White Cedar Leaf Extract + Alemtuzumab interactionPale Purple Coneflower Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Pale Purple Coneflower Root Extract + Alemtuzumab interactionAlfentanilAlfenta
How Alfentanil interacts with Esberitox — through 2 ingredients. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Pale Purple Coneflower Root Extract + Alfentanil interactionEastern White Cedar Leaf ExtractSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Thuja products can contains significant amounts of thujone, a neurotoxin.
Read the full Eastern White Cedar Leaf Extract + Alfentanil interactionAlfuzosinUroxatral
How Alfuzosin interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Pale Purple Coneflower Root Extract + Alfuzosin interactionAliskirenTekturna
How Aliskiren interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Pale Purple Coneflower Root Extract + Aliskiren interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Pale Purple Coneflower Root Extract + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Pale Purple Coneflower Root Extract + Alogliptin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Pale Purple Coneflower Root Extract + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with Esberitox — through 1 ingredient. Tap an ingredient for the detail:
Pale Purple Coneflower Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Pale Purple Coneflower Root Extract + Alpelisib interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Esberitox 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.
Purple Coneflower Root Extract
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.
Eastern White Cedar Leaf Extract
Anticonvulsants
Thuja products can contain thujone, which might lower the seizure threshold. Theoretically, this could decrease the effectiveness of anticonvulsants drugs.
Immunosuppressants
Thuja might stimulate immune function. Theoretically, taking thuja might decrease the effects of immunosuppressive therapy. Immunosuppressant drugs include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), and other corticosteroids (glucocorticoids).
Seizure Threshold Lowering Drugs
Thuja products can contains significant amounts of thujone, a neurotoxin. Theoretically, patients taking drugs that lower the seizure threshold might be at greater risk of seizure if they also take thuja. Advise patients taking these drugs to avoid thuja products. Some drugs that lower the seizure threshold include anesthetics (propofol, others), antiarrhythmics (mexiletine), antibiotics (amphotericin, penicillin, cephalosporins, imipenem), antidepressants (bupropion, others), antihistamines (cyproheptadine, others), immunosuppressants (cyclosporine), narcotics (fentanyl, others), stimulants (methylphenidate), theophylline, and others.
Brand information
Manufacturer and brand details for Esberitox, from the product label.
Integrative Therapeutics
See all Integrative Therapeutics products- Name
- Schaper and Brummer GmbH & Co. KG
Esberitox by Integrative Therapeutics: Common Questions
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The Full Monographs Behind Esberitox’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Wild Indigo
Wild Indigo (Baptisia tinctoria) is a traditional herb most often used in combination products for colds and immune support, but high-quality human evidence is very limited. It can be toxic...
Read the full Wild Indigo 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 → Herb & supplement monographThuja
Interacts with 576 drugsThuja, also called northern white cedar or arborvitae, is a tree whose leaf and oil have a long history in folk and homeopathic medicine, especially for warts and immune support. Solid human...
Read the full Thuja monograph →Sources & How We Checked
Esberitox'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 64 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.
Wild Indigo 3 references
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Henneicke-von Zepelin H, Hentschel C, Schnitker J, et al. Efficacy and safety of a fixed combination phytomedicine in the treatment of the common cold (acute viral respiratory tract infection): results of a randomised, double blind, placebo-controlled, m
Echinacea 51 references
- Mullins RJ. Echinacea-associated anaphylaxis. Med J Aust 1998;168:170-1. PubMed
- Mullins RJ. Allergic reactions to Echinacea. J Allergy Clin Immunol 2000;104:S340-341 (Abstract 1003).
- Chavez ML, Chavez PI. Echinacea. Hosp Pharm 1998;33:180-8.
- Grimm W, Muller HH. A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections. Am J Med 1999;106:138-43. PubMed
- Taylor JA, Weber W, Standish L, et al. Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial. JAMA 2003;290:2824-30.. PubMed
- Luettig B, Steinmuller C, Gifford GE, et al. Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst 1989;81:669-75. PubMed
- Stimpel M, Proksch A, Wagner H, et al. Macrophage activation and induction of macrophage cytotoxicity by purified polysaccharide fractions from the plant Echinacea purpurea. Infect Immun 1984;46:845-9. PubMed
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- Gallo M, Sarkar M, Au W, et al. Pregnancy outcome following gestational exposure to echinacea: A prospective controlled study. Arch Intern Med 2000;160:3141-3. PubMed
- Soon SL, Crawford RI. Recurrent erythema nodosum associated with echinacea herbal therapy. J Am Acad Dermatol 2001;44:298-9. PubMed
- Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51. PubMed
- Logan JL, Ahmed J. Critical hypokalemic renal tubular acidosis due to Sjogren's syndrome: association with the purported immune stimulant echinacea. Clin Rheumatol 2003;22:158-9.
- Schulten B, Bulitta M, Ballering-Bruhl B, et al. Efficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trial. Arzneimittelforschung 2001;51:563-8.. PubMed
- Yale SH, Glurich I. Analysis of the inhibitory potential of Ginkgo biloba, Echinacea purpurea, and Serenoa repens on the metabolic activity of cytochrome P450 3A4, 2D6, and 2C9. J Altern Complement Med 2005;11:433-9.
- Yale SH, Liu K. Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med 2004;164:1237-41. PubMed
- Gorski JC, Huang S, Zaheer NA, et al. The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo.Clin Pharmacol Ther 2003;73 (Abstract PDII-A-8):P94. PubMed
- Lee AN, Werth VP. Activation of autoimmunity following use of immunostimulatory herbal supplements. Arch Dermatol 2004;140:723-7. PubMed
- Goel V, Lovlin R, Barton R, et al. Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther 2004;29:75-83.
- Barrett B. Medicinal properties of Echinacea: a critical review. Phytomedicine 2003;10:66-86. PubMed
- Huntley AL, Thompson Coon J, Ernst E. The safety of herbal medicinal products derived from Echinacea species: a systematic review. Drug Saf 2005;28:387-400. PubMed
- Turner RB, Bauer R, Woelkart K, et al. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. N Engl J Med 2005;353:341-8.
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-40. .
- Perri D, Dugoua JJ, Mills E, Koren G. Safety and efficacy of echinacea (Echinacea augustafolia, e. purpurea and e. pallida) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e262-7.
- Kocaman O, Hulagu S, Senturk O. Echinacea-induced severe acute hepatitis with features of cholestatic autoimmune hepatitis. Eur J Intern Med 2008;19:148. PubMed
- Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77. PubMed
- Press Release: Echinacea herbal products should not be used in children under 12 years old. Medicines and Healthcare Products Regulatory Agency (UK). August 20, 2012. Available at: www.mhra.gov.uk/NewsCentre/Pressreleases/CON180627. (Accessed 21 October
- Barrett B, Brown R, Rakel D, Rabago D, et al. Placebo effects and the common cold: a randomized controlled trial. Ann.Fam.Med 2011;9:312-22. PubMed
- Haller J, Freund, TF, Pelczer, KG, et al. The anxiolytic potential and psychotropic side effects of an echinacea preparation in laboratory animals and healthy volunteers. Phytother.Res. 2013;27:54-61.
- Grbic J, Wexler I, Celenti R, et al. A phase II trial of a transmucosal herbal patch for the treatment of gingivitis. J Am Dent.Assoc. 2011;142:1168-75. PubMed
- Schapowal A, Berger D, Klein P, et al. Echinacea/sage or chlorhexidine/lidocaine for treating acute sore throats: a randomized double-blind trial. Eur.J Med Res 9-1-2009;14:406-12. PubMed
- Bossaer JB and Odle BL. Probable etoposide interaction with Echinacea. J.Diet.Suppl 2012;9:90-5.
- Abdul MI, Jiang X, Williams KM, et al. Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects. Br J Clin.Pharmacol. 2010;69:508-15. PubMed
- Kemp, D. E. and Franco, K. N. Possible leukopenia associated with long-term use of echinacea. J Am Board Fam.Pract. 2002;15(5):417-419.
- Liatsos, G., Elefsiniotis, I., Todorova, R., and Moulakakis, A. Severe thrombotic thrombocytopenic purpura (TTP) induced or exacerbated by the immunostimulatory herb Echinacea. Am J Hematol. 2006;81(3):224.
- Penzak, S. R., Robertson, S. M., Hunt, J. D., Chairez, C., Malati, C. Y., Alfaro, R. M., Stevenson, J. M., and Kovacs, J. A. Echinacea purpurea significantly induces cytochrome P450 3A activity but does not alter lopinavir-ritonavir exposure in healthy s
- Maskatia, Z. K. and Baker, K. Hypereosinophilia associated with echinacea use. South.Med J 2010;103(11):1173-1174. PubMed
- Parnham MJ. Benefit-risk assessment of the squeezed sap of the purple coneflower (Echinacea purpurea) for long-term oral immunostimulation. Phytomed 1996;3:95-102. PubMed
- Schroder-Aasen T, Molden G, Nilsen OG. In vitro inhibition of CYP3A4 by the multiherbal commercial product Sambucus Force and its main constituents Echinacea purpurea and Sambucus nigra. Phytother Res 2012;26(11):1606-13.
- Moltó J, Valle M, Miranda C, et al. Herb-drug interaction between Echinacea purpurea and darunavir-ritonavir in HIV-infected patients. Antimicrob Agents Chemother 2011;55(1):326-30.
- Goey AK, Meijerman I, Rosing H, et al. The effect of Echinacea purpurea on the pharmacokinetics of docetaxel. Br J Clin Pharmacol 2013;76(3):467-74.
- Moltó J, Valle M, Miranda C, et al. Herb-drug interaction between Echinacea purpurea and etravirine in HIV-infected patients. Antimicrob Agents Chemother 2012;56(10):5328-31. PubMed
- Lawrenson JA, Walls T, Day AS. Echinacea-induced acute liver failure in a child. J Paediatr Child Health 2014;50(10):841.
- Hansen TS, Nilsen OG. In vitro CYP3A4 metabolism: inhibition by Echinacea purpurea and choice of substrate for the evaluation of herbal inhibition. Basic Clin Pharmacol Toxicol 2008;103:445-9.
- Gabranis I, Koufakis T1, Papakrivos I, Batala S. Echinacea-associated acute cholestatic hepatitis. J Postgrad Med. 2015;61(3):211-2. PubMed
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Karsch-Völk M, Barrett B, Kiefer D, Bauer R, Ardjomand-Woelkart K, Linde K. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev.2014;(2):CD000530. doi: 10.1002/14651858.CD000530.pub3. PubMed
- Hoban CL, Byard RW, Musgrave IF. Analysis of spontaneous adverse drug reactions to echinacea, valerian, black cohosh and ginkgo in Australia from 2000 to 2015. J Integr Med. 2019;17(5):338-343. PubMed
- Ogal M, Johnston SL, Klein P, Schoop R. Echinacea reduces antibiotic usage in children through respiratory tract infection prevention: a randomized, blinded, controlled clinical trial. Eur J Med Res. 2021 Apr 8;26(1):33. PubMed
- Lopresti AL, Smith SJ. An investigation into the anxiety-relieving and mood-enhancing effects of Echinacea angustifolia (EP107 ™): A randomised, double-blind, placebo-controlled study. J Affect Disord 2021;293:229-237.
- Weishaupt R, Buchkov A, Kolev E, Klein P, Schoop R. Reduction of viral load in patients with acute sore throats: Results from an observational clinical trial with Echinacea / Salvia lozenges [published online ahead of print, 2023 Mar 8]. Complement Med Re
- Sumer J, Keckeis K, Scanferla G, et al. Novel Echinacea formulations for the treatment of acute respiratory tract infections in adults-A randomized blinded controlled trial. Front Med (Lausanne) 2023;10:948787. PubMed
Thuja 10 references
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Millet Y, Jouglard J, Steinmetz MD, et al. Toxicity of some essential plant oils. Clinical and experimental study. Clin Toxicol 1981;18:1485-98. PubMed
- Gohla SH, Haubeck HD, Neth RD. Mitogenic activity of high molecular polysaccharide fractions isolated from the Cupressaceae Thuja occidentale L. I. Macrophage-dependent induction of CD-4-positive T-helper (Th+) lymphocytes. Leukemia 1988;2:528-33.
- Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 1999.
- Henneicke-von Zepelin H, Hentschel C, Schnitker J, et al. Efficacy and safety of a fixed combination phytomedicine in the treatment of the common cold (acute viral respiratory tract infection): results of a randomised, double blind, placebo-controlled, m
- Naser, B., Bodinet, C., Tegtmeier, M., and Lindequist, U. Thuja occidentalis (Arbor vitae): A Review of its Pharmaceutical, Pharmacological and Clinical Properties. Evid.Based Complement Alternat.Med 2005;2(1):69-78.
- Patel R, Alavi F, Ortega S, Matela A. Herb-Induced Liver Injury by Cimicifuga racemosa and Thuja occidentalis Herbal Medications for Fertility. Case Rep Gastrointest Med 2021;2021:8858310. PubMed
- Ambooken B, Thomas M, Jisha KT. Papillary Eccrine Adenoma in a 5-year-old Girl Altered by Application of Thuja Ointment. J Cutan Aesthet Surg 2020;13(4):370-371. PubMed
- Badaoui A, Fougerousse AC. Contact dermatitis to linalool and limonene: Unusual sources of exposure. Ann Dermatol Venereol 2023;150(2):167-168. PubMed
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC