Immune Blend Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Immune Blend 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
Immune Blend is a dietary supplement by Red Moon Herbs with 4 active ingredients. Its ingredients are commonly taken for common cold, flu and respiratory infections, immune support.Based on those ingredients, 817 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Echinacea, Elderberry. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Immune Blend by Red Moon Herbs
Ask about any prescription or over-the-counter medication and we check it for interactions with Immune Blend by Red Moon Herbs — 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 Immune Blend by Red Moon Herbs
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
Immune Blend contains four active ingredients: echinacea (listed twice within the proprietary blend), elderberry, and usnea. The product is delivered as a liquid in a base of water and alcohol.
Echinacea is included to support immune function, while elderberry and usnea are traditionally used for similar purposes. The exact amounts of each ingredient aren't disclosed because they're part of a proprietary blend.
Does it work?
Not established
The evidence on these ingredients is limited. For echinacea, the data we hold shows insufficient reliable evidence to rate its effectiveness for anxiety, athletic performance, ADHD, burns, chronic fatigue syndrome, and migraine headache.
Elderberry has insufficient reliable evidence for asthma, cancer, headache, common cold, cough, and flatulence. Usnea similarly shows insufficient reliable evidence for cough, obesity, acute pain, wound healing, and tinea pedis (a fungal foot infection).
In short, the scientific support for what this blend is meant to do hasn't been established in our data.
How safe is it?
Well-documented data
Echinacea is generally well tolerated short-term, though it can cause digestive upset (abdominal pain, nausea, diarrhea, heartburn) and rashes. Allergic reactions — including severe ones like anaphylaxis — have been reported, especially in people sensitive to ragweed and related plants (ragweed, chrysanthemums, marigolds, daisies).
Rare cases of echinacea-related liver inflammation (hepatitis) have been documented. Elderberry (cooked ripe berries and flowers) is generally well tolerated but can cause dizziness, nausea, vomiting, numbness, and weakness — especially if taken in large amounts.
Usnea is concerning when taken by mouth; its active compound (usnic acid) has been linked to liver damage. Topically it's better tolerated but can cause skin irritation and contact dermatitis.
For pregnancy: echinacea is rated Possibly Safe, but elderberry and usnea are rated Likely Unsafe and advise avoidance. There isn't enough safety data for echinacea during breastfeeding; for elderberry and usnea, the data advises against use while nursing.
Meds to double-check
Moderate interaction found
Before taking Immune Blend, double-check your medications against these drug types, worst severity first: drugs metabolized by CYP1A2 enzymes (including caffeine), CYP3A4 substrates (a large group), immunosuppressants, cancer drugs like etoposide, blood thinners like warfarin, and lithium. If you're unsure whether your medication falls into these categories, use the interaction checker on this page.
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 blend combines three herbs with documented interactions with multiple medication types, particularly those metabolized by your liver. If you take any prescription drugs — especially blood thinners, immunosuppressants, mood stabilizers, or cancer medications — you need to check your specific medications before using this product.
Pregnant or nursing? The safety data advises against elderberry and usnea.
Talk to your pharmacist before you start.
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 Aug 23, 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 Immune Blend, straight from the product label.
| Brand | Red Moon Herbs |
|---|---|
| Barcode (UPC) | 857999002085 |
| Net contents | 1 Fluid Ounce(s); 30 Milliliter(s) |
| Market status | On market |
| Date entered into DSLD | Aug 23, 2023 |
| DSLD ID | 299497 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other |
| Intended target group(s) | Adult (18 - 50 Years) |
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 Immune Blend by Red Moon Herbs, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Proprietary Blend | 0 NP | -- |
| Echinacea | 0 NP | -- |
| Elderberry | 0 NP | -- |
| Echinacea | 0 NP | -- |
| Usnea | 0 NP | -- |
Other ingredients: Water, Alcohol
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions
Suggested use: shake well. Take 50-75 drops 1-3 times daily in a little water.
Brand IP Statement(s)
Est. 1994
FDA Statement of Identity
Dietary Supplement
Formula
Fresh Appalachian extracts for the whole family
General Statements
Still made the wise woman way
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Immune Blend by Red Moon Herbs 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 Immune Blend by Red Moon Herbs
These are the 4 active ingredients this product is made of. Select any to open its full monograph.
Serving size50 Drop(s) Dosage formLiquid 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.
Proprietary Blend
- › Echinacea
- › Elderberry
- › Echinacea
- › Usnea
Other (inactive) ingredients: Water, Alcohol. These complete the product’s ingredient list but are not active constituents.
Immune Blend by Red Moon Herbs Drug Interactions
HelloPharmacist Interaction Report
Red Moon Herbs Immune Blend contains echinacea and elderberry, both of which have documented interactions with medications.
The most serious concern is with echinacea and drugs metabolized by CYP1A2 enzymes (a group of liver proteins that break down certain medications) — echinacea inhibits these enzymes and can raise blood levels of affected drugs by around 30%, a Moderate severity interaction. This includes caffeine and other CYP1A2 substrates.
Read the full breakdown — every affected drug type, severity by severity
Echinacea also affects CYP3A4 substrates (another major group of liver-metabolized drugs), immunosuppressants (medications that weaken the immune system), and the blood thinner warfarin — all Moderate or Minor severity. Etoposide (a cancer drug) carries Moderate risk of higher levels and more severe side effects when combined with echinacea.
Elderberry adds a Moderate interaction with CYP3A4 substrates and lithium (a mood stabilizer), as it may inhibit liver metabolism or reduce kidney clearance.
Altogether, these interactions span 804 individual medications. Use the medication checker below to search your exact prescriptions and over-the-counter drugs before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Immune Blend?
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 Immune Blend interact with 817 drugs. Click any drug to see the details.
2 of the 4 ingredients in Immune Blend interact with drugs. Each result below shows which ingredient is responsible. Echinacea Elderberry
Acetaminophen, Pamabrom, PyrilamineMidol Max Strength PMS, Pamprin, Pamprin ES
How Acetaminophen, Pamabrom, Pyrilamine interacts with Immune Blend — 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, Pamabrom, Pyrilamine interactionAcetaminophen, PentazocineTalacen
How Acetaminophen, Pentazocine interacts with Immune Blend — 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, Pentazocine interactionAcetaminophen, Phenylephrine, ChlorpheniramineSuper Cold Tabs
How Acetaminophen, Phenylephrine, Chlorpheniramine interacts with Immune Blend — 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, Phenylephrine, Chlorpheniramine interactionElderberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elderberry + Acetaminophen, Phenylephrine, Chlorpheniramine interactionAcetaminophen, PhenylpropanolamineTetra Caps
How Acetaminophen, Phenylpropanolamine interacts with Immune Blend — 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, Phenylpropanolamine interactionAcetaminophen, Phenylpropanolamine, PhenyltoloxamineSinubid
How Acetaminophen, Phenylpropanolamine, Phenyltoloxamine interacts with Immune Blend — 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, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, PhenyltoloxaminePercogesic, Relagesic
How Acetaminophen, Phenyltoloxamine interacts with Immune Blend — 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, Phenyltoloxamine interactionAcetaminophen, Phenyltoloxamine, SalicylamideLobac
How Acetaminophen, Phenyltoloxamine, Salicylamide interacts with Immune Blend — 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, Phenyltoloxamine, Salicylamide interactionAcetaminophen, PropoxypheneDarvocet-N 100, Darvocet-N 50, E-Lor, Wygesic
How Acetaminophen, Propoxyphene interacts with Immune Blend — 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, Propoxyphene interactionAcetaminophen, PseudoephedrineChildren's Tylenol Sinus, Dristan N.D., Non-Aspirin Sinus, Ornex, Ornex-Max, Sinutab +5 more
How Acetaminophen, Pseudoephedrine interacts with Immune Blend — 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, Pseudoephedrine interactionAcetaminophen, Pseudoephedrine, TriprolidineActifed Plus ES
How Acetaminophen, Pseudoephedrine, Triprolidine interacts with Immune Blend — 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, Pseudoephedrine, Triprolidine interactionAdagrasibKrazati
How Adagrasib interacts with Immune Blend — through 2 ingredients. Tap an ingredient for the detail:
ElderberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elderberry + Adagrasib interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Adagrasib interactionAdalimumabHumira
How Adalimumab interacts with Immune Blend — 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 + Adalimumab interactionAdalimumab-adazHyrimoz
How Adalimumab-adaz interacts with Immune Blend — 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 + Adalimumab-adaz interactionAdalimumab-adbmCyltezo
How Adalimumab-adbm interacts with Immune Blend — 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 + Adalimumab-adbm interactionAdalimumab-afzbAbrilada
How Adalimumab-afzb interacts with Immune Blend — 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 + Adalimumab-afzb interactionAdalimumab-attoAmjevita
How Adalimumab-atto interacts with Immune Blend — 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 + Adalimumab-atto interactionAdalimumab-bwwdHadlima
How Adalimumab-bwwd interacts with Immune Blend — 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 + Adalimumab-bwwd interactionAdalimumab-fkjpHulio
How Adalimumab-fkjp interacts with Immune Blend — 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 + Adalimumab-fkjp interactionAgomelatineValdoxan
How Agomelatine interacts with Immune Blend — 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 + Agomelatine interactionAlefaceptAmevive
How Alefacept interacts with Immune Blend — 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 + Alefacept interactionAlemtuzumabCampath
How Alemtuzumab interacts with Immune Blend — 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 + Alemtuzumab interactionAlfentanilAlfenta
How Alfentanil interacts with Immune Blend — through 2 ingredients. Tap an ingredient for the detail:
ElderberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elderberry + Alfentanil interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Alfentanil interactionAlfuzosinUroxatral
How Alfuzosin interacts with Immune Blend — through 2 ingredients. 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 + Alfuzosin interactionElderberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elderberry + Alfuzosin interactionAliskirenTekturna
How Aliskiren interacts with Immune Blend — through 2 ingredients. Tap an ingredient for the detail:
ElderberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elderberry + Aliskiren interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Aliskiren interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with Immune Blend — through 2 ingredients. 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 + Almotriptan interactionElderberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elderberry + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with Immune Blend — through 2 ingredients. 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 + Alogliptin interactionElderberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elderberry + Alogliptin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with Immune Blend — through 2 ingredients. Tap an ingredient for the detail:
ElderberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elderberry + Alogliptin, Pioglitazone interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with Immune Blend — through 2 ingredients. 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 + Alpelisib interactionElderberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elderberry + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Immune Blend — through 2 ingredients. 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 + Alprazolam interactionElderberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elderberry + Alprazolam interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with Immune Blend — through 2 ingredients. 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 + Ambrisentan interactionElderberryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
Read the full Elderberry + Ambrisentan interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Immune Blend 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.
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.
Elderberry
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
In vitro research shows that American elder inhibits CYP3A4 enzymes.
Lithium
Theoretically, American elder might reduce excretion and increase levels of lithium.
American elder is thought to have diuretic properties. Theoretically, American elder might reduce the excretion of lithium, increasing serum levels.
Brand information
Manufacturer and brand details for Immune Blend, from the product label.
Red Moon Herbs
See all Red Moon Herbs products- Name
- Red Moon Herbs
- City
- Asheville
- State
- NC
- Phone Number
- 888-929-0777
- Web Address
- redmoonherbs.com
Immune Blend by Red Moon Herbs: Common Questions
Does Immune Blend by Red Moon Herbs interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Will this blend interact with my caffeine?
Can I use this if I'm pregnant?
Can I breastfeed while taking this?
What are the most common side effects?
Is there any proof this blend works for immune support?
What's in the base — is it safe?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Immune Blend’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Echinacea
Interacts with 816 drugsEchinacea is a popular herb taken to help prevent or shorten the common cold, but study results are mixed and the overall benefit appears small at best. It is generally well tolerated for sh...
Read the full Echinacea monograph → Herb & supplement monographAmerican Elder
Interacts with 644 drugsAmerican elder is a North American plant whose cooked, ripe berries and flowers are used mainly for colds, flu, and general immune support. The science behind these uses is limited and most...
Read the full American Elder monograph → Herb & supplement monographUsnea
Usnea is a lichen used in traditional herbal medicine, mainly for sore throats, skin infections, and as a general antimicrobial. Laboratory studies suggest its main compound, usnic acid, can...
Read the full Usnea monograph →Sources & How We Checked
Immune Blend'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 63 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
- 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
American Elder 2 references
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
- 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
Usnea 10 references
- Favreau JT, Ryu Ml, Braunstein G, et al. Severe hepatotoxicity associated with the dietary supplement LipoKinetix. Ann Intern Med 2002;136:590-5. PubMed
- Ingolfsdottir K. Usnic acid. Phytochemistry 2002;61:729-36.
- Scirpa, P., Scambia, G., Masciullo, V., Battaglia, F., Foti, E., Lopez, R., Villa, P., Malecore, M., and Mancuso, S. [A zinc sulfate and usnic acid preparation used as post-surgical adjuvant therapy in genital lesions by Human Papillomavirus]. Minerva Gin
- Mitchell, J. C. Allergy to lichens. Allergic contact dermatitis from usnic acid produced by lichenized fungi. Arch Dermatol 1965;92(2):142-146.
- Durazo, F. A., Lassman, C., Han, S. H., Saab, S., Lee, N. P., Kawano, M., Saggi, B., Gordon, S., Farmer, D. G., Yersiz, H., Goldstein, R. L., Ghobrial, M., and Busuttil, R. W. Fulminant liver failure due to usnic acid for weight loss. Am.J Gastroenterol. PubMed
- Neff, G. W., Reddy, K. R., Durazo, F. A., Meyer, D., Marrero, R., and Kaplowitz, N. Severe hepatotoxicity associated with the use of weight loss diet supplements containing ma huang or usnic acid. J Hepatol. 2004;41(6):1062-1064. PubMed
- Hsu, L. M., Huang, Y. S., Chang, F. Y., and Lee, S. D. 'Fat burner' herb, usnic Acid, induced acute hepatitis in a family. J Gastroenterol.Hepatol. 2005;20(7):1138-1139. PubMed
- Arneborn, P., Jansson, A., and Bottiger, Y. [Acute hepatitis in a woman after intake of slimming pills bought via Internet]. Lakartidningen 7-11-2005;102(28-29):2071-2072.
- Sanchez, W., Maple, J. T., Burgart, L. J., and Kamath, P. S. Severe hepatotoxicity associated with use of a dietary supplement containing usnic acid. Mayo Clin Proc 2006;81(4):541-544. PubMed
- Rafanelli, S., Bacchilega, R., Stanganelli, I., and Rafanelli, A. Contact dermatitis from usnic acid in vaginal ovules. Contact Dermatitis 1995;33(4):271-272. 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