Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release 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
Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release is a dietary supplement by Nature's Plus with 1 active ingredient. Its ingredients are commonly taken for common cold, flu and respiratory infections, immune support.Based on those ingredients, 816 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Echinacea. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release by Nature's Plus
Ask about any prescription or over-the-counter medication and we check it for interactions with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release by Nature's Plus — 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 Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release by Nature's Plus
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
This product contains one active ingredient: echinacea at 375 mg per tablet, standardized to 4% echinacosides (the plant's active compounds). The remaining ingredients are inactive—di-calcium phosphate, stearic acid, microcrystalline cellulose, hydroxypropyl methylcellulose, magnesium stearate, silica, and pharmaceutical glaze—which serve as binders, fillers, and capsule material.
Does it work?
Not established
The evidence for echinacea in the conditions listed in this product's facts—anxiety, athletic performance, ADHD, burns, chronic fatigue syndrome, and migraine headache—is insufficient to establish that it works. The data we hold does not establish reliable effectiveness for any of these uses.
How safe is it?
Well-documented data
Echinacea is generally well tolerated when taken by mouth short-term. The most common side effects reported are abdominal pain, constipation, diarrhea, heartburn, nausea, vomiting, rashes, and stomach upset.
Rare serious effects include severe allergic reactions (including anaphylaxis, swelling, and breathing problems) and hepatitis (liver inflammation). People allergic to ragweed or related plants in the daisy family (chrysanthemums, marigolds, daisies) are at higher risk for allergic reactions.
For pregnancy, the safety data rates echinacea as possibly safe—there isn't enough information to say it's definitely safe or unsafe. There is limited lactation safety data on file.
Since the safety information is limited overall, it's best to talk with your doctor or pharmacist before taking it.
Meds to double-check
Moderate interaction found
Before taking this echinacea product, check with your own doctor or pharmacist if you take any drugs metabolized by liver enzymes CYP1A2 or CYP3A4 (a very broad category—include caffeine supplements), immunosuppressants, the chemotherapy drug etoposide, warfarin (a blood thinner), lopinavir/ritonavir (an HIV medication), or midazolam (a sedative). Echinacea may raise or lower the levels of these drugs in your bloodstream, which could affect how well they work or how safe they are.
The bottom line
Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
Echinacea may be worth considering if your doctor or pharmacist approves it for your situation, but it's not established to work for the conditions listed here. The main concern is that it affects how your body breaks down many medications, potentially making some stronger or weaker.
Check your exact medications with the tool on this page, and talk with your own doctor or pharmacist before starting—especially if you take anything for immune system support, blood thinning, HIV, or anxiety.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated Mar 25, 2013.
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 Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release, straight from the product label.
| Brand | Nature's Plus |
|---|---|
| Barcode (UPC) | 097467073180 |
| Net contents | 30 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Mar 25, 2013 |
| DSLD ID | 19955 |
| Product type | Botanical |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegetarian, Adult (18 - 50 Years), No Allergies, Gluten Free, Dairy 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 Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release by Nature's Plus, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Echinacea | 375 mg | -- |
Other ingredients: Di-Calcium Phosphate, Stearic Acid, Microcrystalline Cellulose, Hydroxypropyl Methylcellulose, Magnesium Stearate, Silica, Pharmaceutical Glaze
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.
Storage
KEEP TIGHTLY CLOSED IN A COOL, DRY PLACE.
General
Product No. 7318 LBL. 1128384
Brand IP Statement(s)
(C)NATURAL ORGANICS(R)
The Energy Supplements(R)
General Statements
Printed HerbaShield inner seal and full bottle seal.
THIS IS NOT A PRESCRIPTION PRODUCT. It is a dietary supplement made with the highest possible quality standards.
Nutritional Support for Healthy Immune Function.* Each Herbal Actives extended-release formula provides rapid and sustained results. Supplying the greatest concentration of active botanical principles, Herbal Actives Echinacea maximizes the synergistic benefits of the whole root and rhizome. Guaranteed Maximum Potency: Each Herbal Actives formula is scientifically standardized to the highest level of active principles. HerbaShield: An exclusive purity and safety system providing light-resistant bottle, airtight inner seal, moisture-absorbing packet, tamper-evident safety cap and tamper-proof full bottle seal.
PRESCRIPTION QUALITY
Precautions
KEEP OUT OF REACH OF CHILDREN.
Note: If you are pregnant or nursing, consult your health care professional before using any herbal product.
Do not use if either seal is missing or broken.
Suggested/Recommended/Usage/Directions
Directions: As a dietary supplement offering the consistent benefits of exact potency, one tablet daily or as recommended by your health care professional.
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.
Seals/Symbols
HerbaShield(R)
MAXIMUM POTENCY GUARANTEED(R)
GLUTEN Free
FDA Statement of Identity
Standardized Botanical Supplement
Formulation
VEGETARIAN
Free from artificial colors and preservatives.
Free from the common allergens yeast, wheat, soy and milk.
Formula
HYPO-ALLERGENIC
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release by Nature's Plus 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 Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release by Nature's Plus
This is the 1 active ingredient this product is made of. Select it to open its full monograph.
Serving size1 Tablet(s) Dosage formTablet Or Pill Amounts shown are per serving.
Echinacea
Interacts with816 drugs
Echinacea is a popular herb taken to help prevent or shorten the common cold, but study results are mixed and the overall benefit appears small at bes...
Echinacea monograph & interactionsOther (inactive) ingredients: Di-Calcium Phosphate, Stearic Acid, Microcrystalline Cellulose, Hydroxypropyl Methylcellulose, Magnesium Stearate, Silica, Pharmaceutical Glaze. These complete the product’s ingredient list but are not active constituents.
Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release by Nature's Plus Drug Interactions
HelloPharmacist Interaction Report
Nature's Plus Herbal Actives Echinacea has documented interactions through its single active ingredient, echinacea.
The most serious interactions are Moderate in severity and affect several drug types. Echinacea can inhibit or induce liver enzymes (specifically CYP1A2 and CYP3A4) that break down many medications, potentially raising or lowering their blood levels unexpectedly.
It also has immunostimulant activity that may interfere with drugs that suppress the immune system.
Read the full breakdown — every affected drug type, severity by severity
The Moderate-severity interactions include drugs metabolized by CYP1A2 enzymes (like caffeine, which may increase by around 30%), CYP3A4 substrates (a broad category of medications), immunosuppressants, and the chemotherapy drug etoposide. Additionally, there are Minor interactions documented with the blood thinner warfarin, the HIV medication lopinavir/ritonavir, and the sedative midazolam.
Echinacea is the ingredient we checked, and it carries all the interactions listed above. Altogether, these interactions span 817 individual medications.
Before starting this product, use the search tool below to check your exact medications against these enzyme and immune effects.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release?
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 Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release interact with 816 drugs. Click any drug to see the details.
1 of the 1 ingredient in Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release interact with drugs. Each result below shows which ingredient is responsible. Echinacea
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Ado-trastuzumab Emtansine interactionAbemaciclibVerzenio
How Abemaciclib interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Acalabrutinib interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates, Caffeine +1 Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates, Caffeine +1 Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome 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 Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome 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 Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
How Acetaminophen, Chlorpheniramine, Phenylephrine interacts with Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaCytochrome 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 interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.
Echinacea
Caffeine
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Echinacea seems to increase plasma concentrations of caffeine by around 30%. This is likely due to inhibition of cytochrome P450 1A2 (CYP1A2) by echinacea.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Echinacea appears to inhibit CYP1A2 enzymes in humans. Additionally, echinacea seems to increase plasma concentrations of caffeine, a CYP1A2 substrate, by around 30%. Theoretically, echinacea might increase levels of other drugs metabolized by CYP1A2.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4. This may increase or decrease levels of drugs metabolized by CYP3A4.
Several clinical trials have shown that taking echinacea for up to one month does not significantly affect the metabolism of various CYP3A4 substrates, including midazolam, docetaxel, etravirine, lopinavir-ritonavir, and darunavir-ritonavir. However, other clinical research shows that echinacea may increase the clearance of midazolam, suggesting that echinacea might induce CYP3A4. The discrepancy is thought to be due to differing effects of echinacea on intestinal versus hepatic CYP3A4 enzymes. Echinacea appears to induce hepatic CYP3A4 but inhibit intestinal CYP3A4. In some cases, these effects might cancel each other out, but in others, drug levels may be increased or decreased depending on the level of effect at hepatic and intestinal sites. The effect of echinacea on CYP3A4 activity may differ depending on the CYP3A4 substrate.
Etoposide (Vepesid)
Echinacea may increase levels of etoposide.
In one report, concomitant use of etoposide and echinacea was associated with more severe thrombocytopenia than the use of etoposide alone, suggesting inhibition of etoposide metabolism. Etoposide is a cytochrome P450 3A4 (CYP3A4) substrate. Echinacea has variable effects on CYP3A4, but some studies have reported inhibition of the enzyme.
Immunosuppressants
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Theoretically, echinacea may interfere with immunosuppressant therapy because of its immunostimulant activity.
Darunavir (Prezista)
Theoretically, echinacea may interfere with the metabolism of darunavir; however, a small clinical study found no effect.
Darunavir is metabolized by cytochrome P450 3A4 (CYP3A4) and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Echinacea has variable effects on CYP3A4, but administration of an E. purpurea root extract (Arkocapsulas Echinacea, Arkopharma) 500 mg four times daily for 14 days did not affect darunavir/ritonavir pharmacokinetics in 15 HIV-infected patients.
Dayquil Severe
Echinacea is reported to have varying effects on a number of Cytochrome P450 metabolizing enzymes in the liver, including CYP1A2 and CYP3A4, which play a role in acetaminophen and dextromethorphan metabolism (both contained in DayQuil Severe), respectively. Studies have reported both enzyme inhibition and induction, making it difficult to predict clinically significant drug interactions with reliability. Specific drug interaction studies reporting definitive results are rare, and potential drug interactions involving echinacea should likely be taken on a case-by-case basis. Based on what we know about how acetaminophen and dextromethorphan are metabolized, the risk of a clinically significant interaction between echinacea and DayQuil Severe is low.
Docetaxel (Taxotere)
Theoretically, echinacea may interfere with the metabolism of docetaxel; however, a small clinical study found no effect.
Docetaxel is metabolized by cytochrome P450 3A4 (CYP3A4). Echinacea has variable effects on CYP3A4, but taking E. purpurea whole plant extract (Echinaforce, A. Vogel Biopharma AG) 20 drops three times daily for 2 weeks did not alter the pharmacokinetics of docetaxel in one clinical study.
Etravirine (Intelence)
Theoretically, echinacea may interfere with the metabolism of etravirine; however, a small clinical study found no effect.
Etravirine is metabolized by cytochrome P450 3A4 (CYP3A4). Echinacea has variable effects on CYP3A4, but taking E. purpurea root extract (Arkocapsulas Echinacea, Arkopharma) 500 mg three times daily for 14 days did not alter the pharmacokinetics of etravirine in HIV-infected patients.
Lopinavir/Ritonavir (Kaletra)
Theoretically, echinacea may interfere with the metabolism of lopinavir; however, a small clinical study found no effect.
Lopinavir is metabolized by cytochrome P450 3A4 (CYP3A4) and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Echinacea has variable effects on CYP3A4, but taking E. purpurea (Echinamide, Natural Factors Nutritional Products, Inc.) 500 mg three times daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in healthy volunteers.
Midazolam (Versed)
Theoretically, echinacea may increase the metabolism of intravenous midazolam.
Echinacea induces hepatic CYP3A4 and might decrease plasma levels of midazolam by about 20%, reducing the effectiveness of intravenous midazolam. Echinacea also appears to inhibit intestinal CYP3A4, which could theoretically increase the bioavailability of oral midazolam. This may cancel out the decrease in availability caused by induction of hepatic CYP3A4, such that overall plasma levels after oral administration of midazolam are not affected by echinacea.
Warfarin (Coumadin)
Echinacea seems to increase the clearance of warfarin, although the effect may not be clinically significant.
Preliminary clinical research in healthy male volunteers suggests that taking echinacea increases the clearance of the active S-isomer of warfarin after a single dose of warfarin, but there was not a clinically significant effect on the INR.
Brand information
Manufacturer and brand details for Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release, from the product label.
Nature's Plus
See all Nature's Plus products- Name
- Natural Organics Laboratories, Inc. makers of Nature's Plus
- Street Address
- 9500 New Horizons Blvd.
- City
- Amityville
- State
- New York
- ZipCode
- 11701
- Web Address
- www.naturesplus.com
Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release by Nature's Plus: Common Questions
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The Full Monographs Behind Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sources & How We Checked
Herbal Actives Echinacea 375 mg/4% Echinacosides Extended Release'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.
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The 51 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Echinacea 51 references
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- 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
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC