echinacea

Echinacea is a group of flowering wild plants belonging to the daisy family (Asteraceae/Compositae), commonly called coneflowers. Echinacea species including Echinacea purpurea, E. angustifolia and E. pallida are medicinal herbs native to North America.

Extracts from echinacea have been traditionally used to treat various ailments including common cold, skin disorders, wounds, and respiratory and other infections.

The therapeutic properties of echinacea may come from its bioactive compounds including echinacosides, caffeic acids, alkylamides, polysaccharides, and glycoproteins. Echinacea is believed to have anti-inflammatory, antibacterial, antiviral, antioxidant, antitumor, and immune-boosting properties. Echinacea may have some effect in reducing symptoms and preventing cold, however, there is no scientific evidence for its therapeutic efficacy in any of its other uses.

Suggested uses of echinacea include:

Oral:

• Common cold
• Immunostimulant
• Upper respiratory infections
• Urinary tract infections
• Vaginal candidiasis

Topical:

• Skin ulcers
• Skin wounds
• Psoriasis
• Herpes simplex infection

• Do not use echinacea if you are hypersensitive to the aster family of plants including daisies, chrysanthemums, marigolds, and ragweed.
• Do not use echinacea if you have any of the following conditions:
  • Autoimmune disorders
  • Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)
  • Leukosis, a leukemia-like malignant viral disease
  • Collagen diseases
  • Tuberculosis
  • Multiple sclerosis
• Do not use echinacea if you are pregnant or breastfeeding.
• Use echinacea with caution if you are:
  • Prone to allergic diseases
  • Taking other medications that are metabolized by the enzyme CYP3A4

Common side effects of echinacea include:

Oral:

• Nausea
• Vomiting
• Abdominal pain
• Diarrhea
• Unpleasant taste
• Sore throat
• Fever
• Dizziness
• Altered fertility
• Allergic reactions
• Severe allergic reaction (anaphylaxis)

Topical:

• Redness (erythema)
• Itching (pruritus)
• Widespread rash (exanthema)

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

There isn’t enough reliable information to know what an appropriate dose of echinacea might be. Suggested dosing:

Herb juice

• 6-9 ml orally daily or
• 20 drops per minute orally every 2 hours for 24 hours then continue three times daily

Crude herb extract

• 2 tabs (6.78 mg) orally three times daily

Echinacea pallida root tincture

• 900 mg orally daily

Herbal compound tea

• 5-6 cups orally on day 1, then decrease by 1 cup/day over 5 days

Dosing considerations

• No more than 8 weeks of continuous use

Topical

• Apply to the affected area

Overdose

• Echinacea overdose may cause gastrointestinal upset and skin rashes, but is unlikely to cause any serious or life-threatening adverse effects.
• There have been a few rare cases of allergic reactions including anaphylaxis. Overdose treatment is symptomatic and supportive.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

Echinacea has no known severe interactions with other drugs.

Serious interactions of echinacea include:

• beclomethasone, inhaled

Echinacea has moderate interactions with at least 34 different drugs.

Mild interactions of echinacea include:

• astragalus
• maitake

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider about all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or healthcare provider if you have any questions about the medication.

• Available data suggest echinacea may not cause fetal harm or adverse pregnancy outcomes, however, there are no well-controlled studies on the safety of echinacea use during pregnancy, avoid use.
• There is no information on the presence of echinacea in breast milk, avoid use if you are breastfeeding.
• Never take any herbal supplement without first checking with your healthcare provider if you are pregnant or breastfeeding.

• Echinacea extracts are possibly safe for most adults when taken orally in recommended doses, or when topically applied.
• Check with your healthcare provider before taking any herbal supplement, including echinacea.
• Use echinacea exactly as per label instructions.
• Herbal products often contain many ingredients. Check labels for the components in the echinacea product you choose.
• Echinacea is marketed as an herbal supplement and is not regulated by the FDA. Products may differ in formulations and strengths, and labels may not always match contents; exercise caution in choosing your product.
• Store safely out of reach of children.