American Cone Flower, Black Sampson, Black Susans, Brauneria Angustifolia, Brauneria Pallida, Brauneria Purpurea, Comb Flower, Coneflower, Echinacea Angustifolia, Echinacea Pallida, Echinacea Purpurea, Echinacea Serotine, Echinacea Speciose, Echinaceawurzel, Échinacée, Échinacée Angustifolia, Échinacée Pallida, Échinacée Pourpre, Échinacée Purpurea, Equinácea, Fleur À Hérisson, Hedgehog, Helichroa Purpurea, Igelkopfwurzel, Indian Head, Kansas Snakeroot, Narrow-Leaved Purple Cone Flower, Pale Coneflower, Purple Cone Flower, Purpursonnenhutkraut, Purpursonnenhutwurzel, Racine D'echininacea, Red Sunflower, Rock-Up-Hat, Roter Sonnenhut, Rudbeckia Purpurea, Rudbeckie Pourpre, Schmallblaettrige Kegelblumenwurzel, Schmallblaettriger Sonnenhut, Scurvy Root, Snakeroot, Sonnenhutwurzel.
Echinacea is an herb that is native to areas east of the Rocky Mountains in the United States. It is also grown in western States, as well as in Canada and Europe. Several species of the echinacea plant are used to make medicine from its leaves, flower, and root. Echinacea was used in traditional herbal remedies by the Great Plains Indian tribes. Later, settlers followed the Indians' example and began using echinacea for medicinal purposes as well. For a time, echinacea enjoyed official status as a result of being listed in the US National Formulary from 1916-1950. However, use of echinacea fell out of favor in the United States with the discovery of antibiotics. But now, people are becoming interested in echinacea again because some antibiotics don't work as well as they used to against certain bacteria.
Echinacea is widely used to fight infections, especially the common cold, the flu, and other upper respiratory infections. Some people take echinacea at the first sign of a cold, hoping they will be able to keep the cold from developing. Other people take echinacea after cold symptoms have started, hoping they can make symptoms less severe.
Echinacea is also used against many other infections including urinary tract infections, vaginal yeast infections, herpes, HIV/AIDS, human papilloma virus (HPV), bloodstream infections (septicemia), tonsillitis, streptococcus infections, syphilis, typhoid, malaria, ear infection, swine flu, warts, and nose and throat infections called diphtheria.
Other uses include anxiety, low white blood cell count, chronic fatigue syndrome (CFS), rheumatoid arthritis, migraines, acid indigestion, pain, dizziness, rattlesnake bites, attention deficit-hyperactivity disorder (ADHD), and improving exercise performance.
Sometimes people apply echinacea to their skin to treat boils, gum disease, abscesses, skin wounds, ulcers, burns, eczema, psoriasis, sun-related skin damage, herpes simplex, yeast infections, bee stings, snake and mosquito bites, and hemorrhoids.
Commercially available echinacea products come in many forms including tablets, juice, and tea.
There are concerns about the quality of some echinacea products on the market. Echinacea products are frequently mislabeled, and some may not even contain echinacea, despite label claims. Don't be fooled by the term "standardized." It doesn't necessarily indicate accurate labeling. Also, some echinacea products have been contaminated with selenium, arsenic, and lead.
How does it work?
Echinacea seems to activate chemicals in the body that decrease inflammation, which might reduce cold and flu symptoms.
Laboratory research suggests that echinacea can stimulate the body's immune system, but there is no evidence that this occurs in people.
Echinacea also seems to contain some chemicals that can attack yeast and other kinds of fungi directly.
Possibly Effective for...
- Common cold. Many scientific studies show that taking some echinacea products when cold symptoms are first noticed can modestly reduce symptoms of the common cold in adults. But other scientific studies show no benefit. The problem is that scientific studies have used different types of echinacea plants and different methods of preparation. Since the studies have not been consistent, it is not surprising that different studies show different results. If it helps for TREATING a cold, the benefit will likely be modest at best. Research on the effects of echinacea for PREVENTING the common cold is also mixed. Some research shows that taking echinacea can reduce the risk of catching a cold by 45% to 58%. But other research shows that taking echinacea does not prevent the common cold when you are exposed to cold viruses.
Insufficient Evidence to Rate Effectiveness for...
- Anxiety. Early research suggests that taking 40 mg of a specific echinacea extract (ExtractumPharma ZRT, Budapest, Hungary) per day for 7 days reduces anxiety. But taking less than 40 mg per day does not seem to be effective.
- Exercise performance. Early research shows that taking echinacea (Puritian's Pride, Oakdale, NY) four times daily for 28 days increases oxygen intake during exercise tests in healthy men.
- Gingivitis. Early research suggests that using a mouth rinse containing echinacea, gotu kola, and elderberry (HM-302, Izum Pharmaceuticals, New Yok, NY) three times daily for 14 days might prevent gum disease from worsening. Using a specific mouth patch containing the same ingredients (PerioPatch, Izun Pharmaceuticals, New York, NY) also seems to reduce some symptoms of gum disease, but it is not always effective.
- Herpes simplex virus (HSV). Evidence on the effect of echinacea for the treatment of HSV is unclear. Some research shows that taking a specific echinacea extract (Echinaforce, A Vogel Bioforce AG) 800 mg twice daily for 6 months does not seem to prevent or reduce the frequency or duration of recurrent genital herpes. However, other research shows that taking a combination product containing echinacea (Esberitox, Schaper & Brummer, Salzgitter-Ringelheim, Germany) 3-5 times daily reduces itchiness, tension, and pain in most people with cold sores (herpes labialis).
- Human papilloma virus (HPV). Early research shows that taking a combination product containing echinacea, andrographis, grapefruit, papaya, pau d'arco, and cat's claw (Immune Act, Erba Vita SpA, Reppublica San Marino, Italy) daily for one month reduces the recurrence of anal warts in people who had surgical removal of anal warts. But this study was not high quality, so results are questionable.
- Influenza (flu). Early research shows that taking a specific echinacea product (Monoselect Echinacea, PharmExtracta, Pontenure, Italy) daily for 15 days might improve the response to the flu vaccine in people with breathing problems such as bronchitis or asthma.
- Low white blood cell count (Leukopenia). Early research shows that using 50 drops of a combination product containing echinacea root extracts, thuja leaf extract, and wild indigo (Esberitox N, Schaper & Brummer, Salzgitter-Ringelheim, Germany) in between chemoradiotherapy can improve red and white blood cell counts in some women with advanced breast cancer. But this effect is not seen in all patients, and doses lower than 50 drops don't seem to work. Also, this product does not seem to reduce the risk of infection.
- Middle ear infection. Early research suggests that taking a specific liquid echinacea extract three times daily for 3 days at the first sign of a common cold does not prevent an ear infection in children 1-5 years-old with a history of ear infections. Ear infections actually seemed to increase.
- Tonsillitis. Early research shows that spraying a specific product containing sage and echinacea into the mouth every two hours up to 10 times per day for up to 5 days improves sore throat symptoms similar to commonly used drug sprays in people with tonsillitis. Other early research suggests that taking 50 drops of a product containing echinacea (Esberitox, Schaper & Brummer, Salzgitter-Ringelheim, Germany) three times daily for 2 weeks, along with an antibiotic, reduces sore throat and increases overall well-being in people with tonsillitis.
- Eye inflammation (Uveitis). Early research suggests that taking 150 mg of an echinacea product (Iridium, SOOFT Italia SpA) twice daily, in addition to eye drops and a steroid used to treat inflammation for 4 weeks, does not improve vision any more than eye drops and steroids alone in people with eye inflammation.
- Warts. Early research suggests that taking echinacea by mouth daily for up to 3 months does not clear warts on the skin. But taking a supplement containing echinacea, methionine, zinc, probiotics, antioxidants, and ingredients that stimulate the immune system for 6 months, in addition to using conventional treatments, seems to work better than conventional treatments alone.
- Urinary tract infections (UTIs).
- Yeast infections.
- Bloodstream infections.
- Strep infections.
- Migraine headaches.
- Chronic fatigue syndrome (CFS).
- Hay fever or other allergies.
- Bee stings.
- Attention deficit-hyperactivity disorder (ADHD).
- Swine flu.
- Rheumatoid arthritis (RA).
- Rattlesnake bites.
- Other conditions.
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).
Echinacea is LIKELY SAFE for most people when taken by mouth in the short-term. Various liquid and solid forms of Echinacea have been used safely for up to 10 days. There are also some products, such as Echinaforce (A. Vogel Bioforce AG, Switzerland) that have been used safely for up to 6 months.
Some side effects have been reported such as fever, nausea, vomiting, unpleasant taste, stomach pain, diarrhea, sore throat, dry mouth, headache, numbness of the tongue, dizziness, insomnia, disorientation, and joint and muscle aches. In rare cases, echinacea has been reported to cause inflammation of the liver.
Applying echinacea to the skin can cause redness, itchiness, or a rash.
Echinacea is most likely to cause allergic reactions in children and adults who are allergic to ragweed, mums, marigolds, or daisies. If you have allergies, be sure to check with your healthcare provider before taking echinacea.
Pregnancy: Echinacea is POSSIBLY SAFE when taken by mouth in the short-term. There is some evidence that echinacea might be safe when taken during the first trimester of pregnancy without harming the fetus. But until this is confirmed by additional research, it is best to stay on the safe side and avoid use.
Breast feeding: There is not enough reliable information about the safety of taking echinacea if you are breast feeding. Stay on the safe side and avoid use.
An inherited tendency toward allergies (atopy): People with this condition are more likely to develop an allergic reaction to echinacea. It's best to avoid exposure to echinacea if you have this condition.
"Auto-immune disorders" such as such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), a skin disorder called pemphigus vulgaris, or others: Echinacea might have an effect on the immune system that could make these conditions worse. Don't take echinacea if you have an auto-immune disorder.
CaffeineInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.
The body breaks down caffeine to get rid of it. Echinacea might decrease how quickly the body breaks down caffeine. Taking echinacea along with caffeine might cause too much caffeine in the bloodstream and increase the risk of side effects. Common side effects include jitteriness, headache, and fast heartbeat.
Etoposide (VePesid)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Etoposide (VePesid) is changed and broken down by the body. Echinacea might decrease how quickly the body breaks down etoposide (VePesid). Taking echinacea along with etoposide might increase the side effects of etoposide. Before taking echinacea, talk to your healthcare provider if you are taking any medications that are changed by the body.
Medications changed by the body (Cytochrome P450 3A4 (CYP3A4) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Some medications are changed and broken down by the body. Echinacea might affect how the body breaks down these medications. In some cases, taking echinacea along with these medications might increase the effects and side effects of the medications. In other cases, taking echinacea along with these medications might decrease the effects and side effects of the medications. Before taking echinacea, talk to your healthcare provider if you are taking any medications that are changed by the body.
Some medications changed by the body include lovastatin (Mevacor), clarithromycin (Biaxin), cyclosporine (Neoral, Sandimmune), diltiazem (Cardizem), estrogens, indinavir (Crixivan), triazolam (Halcion), and many others.
Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Some medications are changed and broken down by the liver. Echinacea might decrease how quickly the liver breaks down some medications. Taking echinacea along with some medications might increase the effects and side effects of some medications. Before taking echinacea, talk to your healthcare provider if you are taking any medications that are changed by the liver.
Some of the medications that are changed by the liver include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, zileuton (Zyflo), zolmitriptan (Zomig), and others.
Medications that decrease the immune system (Immunosuppressants)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Echinacea can increase the activity of the immune system. Taking echinacea along with some medications that decrease the immune system might decrease these medications' effectiveness.
Some medications that decrease the immune system 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), corticosteroids (glucocorticoids), and others.
Darunavir (Prezista)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.
The body breaks down darunavir (Prezista) to get rid of it. Echinacea might affect how quickly the body breaks down darunavir (Prezista). Taking echinacea along with darunavir (Prezista) might increase the risk of side effects or decrease the effects of darunavir (Prezista). However, this has not been observed in humans.
Docetaxel (Docefrez, Taxotere)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.
The body breaks down docetaxel (Taxotere) to get rid of it. Echinacea might affect how quickly the body breaks down docetaxel (Taxotere). Taking echinacea along with docetaxel (Taxotere) might increase the risk of side effects or decrease the effects of docetaxel (Taxotere). However, this has not been observed in humans.
Etravirine (Intelence)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.
Etravirine (Intelence) is changed and broken down by the body. Echinacea might affect how quickly the body breaks down etravirine (Intelence). Taking echinacea along with etravirine (Intelence) might increase the side effects or decrease the effects of etravirine (Intelence). But this has not been seen in humans.
Lopinavir / Ritonavir (Kaletra)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.
Lopinavir / ritonavir (Kaletra) is changed and broken down by the body. Echinacea might affect how quickly the body breaks down lopinavir / ritonavir (Kaletra). Taking echinacea along with etravirine (Intelence) might increase the side effects or decrease the effects of lopinavir / ritonavir (Kaletra). But this has not been seen in humans.
Midazolam (Versed)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.
Midazolam (Versed) is changed and broken down by the body. Echinacea seems to affect how quickly the body breaks down midazolam (Versed). Taking midazolam (Versed) with echinacea might increase the side effects or decrease the effects of midazolam (Versed). More information is needed to know the effects of echinacea on midazolam (Versed).
Warfarin (Coumadin)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.
Warfarin (Coumadin) is used to slow blood clotting. The body breaks down warfarin (Coumadin) to get rid of it. Echinacea might increase the breakdown and decrease the effectiveness of warfarin (Coumadin). Decreasing the effectiveness of warfarin (Coumadin) might increase the risk of clotting. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.
- For common cold TREATMENT, an extract of Echinacea purpurea (Echinacin, Madaus AG, Cologne, Germany) 5 mL twice daily for 10 days has been used. An extract of Echinacea purpurea (EchinaGuard, Madaus AG, Cologne, Germany), 20 drops in water every 2 hours on the first day of cold symptoms, followed by three times daily for up to 10 days has also been used. An extract of the whole Echinacea purpurea plant (Echinilin, Inovobiologic Inc., Calgary, Alberta, Canada), 4 mL ten times on the first day of a cold, then four times daily for 6 days, or 5 mL eight times on the first day of cold symptoms, then three times daily for 6 days has been used. A tea different species of echinacea (Echinacea Plus, Traditional Medicinals, Sebastopol, CA) five or six times on the first day of cold symptoms, then reducing by 1 cup per day over the following 5 days has been used.
- For common cold PREVENTION, a specific echinacea extract (Echinaforce, A. Vogel Bioforce AG, Switzerland) 0.9 mL three times daily (total dose: 2400 mg daily) for 4 months, with an increase to 0.9 mL five times daily (total dose: 4000 mg daily) at the first sign of a cold, has been used.
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Bensch, K., Tiralongo, J., Schmidt, K., Matthias, A., Bone, K. M., Lehmann, R., and Tiralongo, E. Investigations into the antiadhesive activity of herbal extracts against Campylobacter jejuni. Phytother.Res 2011;25(8):1125-1132. View abstract.
Hou, C. C., Chen, C. H., Yang, N. S., Chen, Y. P., Lo, C. P., Wang, S. Y., Tien, Y. J., Tsai, P. W., and Shyur, L. F. Comparative metabolomics approach coupled with cell- and gene-based assays for species classification and anti-inflammatory bioactivity validation of Echinacea plants. J Nutr.Biochem. 2010;21(11):1045-1059. View abstract.
Hu, C. and Kitts, D. D. Studies on the antioxidant activity of Echinacea root extract. J Agric Food Chem 2000;48(5):1466-1472. View abstract.
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. View abstract.
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. View abstract.
Luo, Y., Pan, J., Pan, Y., Han, Z., and Zhong, R. Evaluation of the protective effects of Chinese herbs against biomolecule damage induced by peroxynitrite. Biosci.Biotechnol.Biochem. 2010;74(7):1350-1354. View abstract.
Maskatia, Z. K. and Baker, K. Hypereosinophilia associated with echinacea use. South.Med J 2010;103(11):1173-1174. View abstract.
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.
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 subjects. Pharmacotherapy 2010;30(8):797-805. View abstract.
Saluk-Juszczak, J., Pawlaczyk, I., Olas, B., Kolodziejczyk, J., Ponczek, M., Nowak, P., Tsirigotis-Woloszczak, M., Wachowicz, B., and Gancarz, R. The effect of polyphenolic-polysaccharide conjugates from selected medicinal plants of Asteraceae family on the peroxynitrite-induced changes in blood platelet proteins. Int.J Biol.Macromol. 12-1-2010;47(5):700-705. View abstract.
Sharma, M., Schoop, R., Suter, A., and Hudson, J. B. The potential use of Echinacea in acne: control of Propionibacterium acnes growth and inflammation. Phytother.Res 2011;25(4):517-521. View abstract.
Steinmuller, C., Roesler, J., Grottrup, E., Franke, G., Wagner, H., and Lohmann-Matthes, M. L. Polysaccharides isolated from plant cell cultures of Echinacea purpurea enhance the resistance of immunosuppressed mice against systemic infections with Candida albicans and Listeria monocytogenes. Int.J Immunopharmacol. 1993;15(5):605-614. View abstract.
Thompson, K. D. Antiviral activity of Viracea against acyclovir susceptible and acyclovir resistant strains of herpes simplex virus. Antiviral Res 1998;39(1):55-61. View abstract.
Toselli, F., Matthias, A., Bone, K. M., Gillam, E. M., and Lehmann, R. P. Metabolism of the major Echinacea alkylamide N-isobutyldodeca-2E,4E,8Z,10Z-tetraenamide by human recombinant cytochrome P450 enzymes and human liver microsomes. Phytother.Res 2010;24(8):1195-1201. View abstract.
Wacker, A. and Hilbig, W. [Virus-inhibition by echinacea purpurea (author's transl)]. Planta Med 1978;33(1):89-102. View abstract.
Woelkart, K., Koidl, C., Grisold, A., Gangemi, J. D., Turner, R. B., Marth, E., and Bauer, R. Bioavailability and pharmacokinetics of alkamides from the roots of Echinacea angustifolia in humans. J Clin Pharmacol 2005;45(6):683-689. View abstract.
Woelkart, K., Marth, E., Suter, A., Schoop, R., Raggam, R. B., Koidl, C., Kleinhappl, B., and Bauer, R. Bioavailability and pharmacokinetics of Echinacea purpurea preparations and their interaction with the immune system. Int J Clin Pharmacol Ther 2006;44(9):401-408. View abstract.
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. View abstract.
Awang DVC, Kindack DG. Echinacea. Can Pharm J 1991; 124:512-6.
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. View abstract.
Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77. View abstract.
Barrett B, Vohmann M, Calabrese C. Echinacea for upper respiratory infection. J Fam Pract 1999;48:628-35. View abstract.
Barrett B. Medicinal properties of Echinacea: a critical review. Phytomedicine 2003;10:66-86. View abstract.
Barrett BP, Brown RL, Locken K, et al. Treatment of the common cold with unrefined echinacea. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 2002;137:939-46.. View abstract.
Bendel R, Bendel V, Renner K, et al. [Additional treatment with Esberitox N in patients with chemo- radiotherapy treatment of advanced breast cancer]. Onkologie. 1989;12 Suppl 3:32-8. View abstract.
Bendel R, Bendel V, Renner K, et al. [Supplementary treatment with Esberitox of female patients undergoing curative adjuvant irradiation following breast cancer]. Strahlenther.Onkol. 1988;164:278-83. View abstract.
Binns SE, Purgina B, Bergeron C. Light-mediated antifungal activity of Echinacea extracts. Plant Med 2000;66:241-4. View abstract.
Bockhorst H, Gollnick N, Guran S, et al. [Therapy of herpes simplex in practice. Report on the treatment of herpes simplex labialis with Esberitox]. ZFA.(Stuttgart.) 11-20-1982;58:1795-98. View abstract.
Bossaer JB and Odle BL. Probable etoposide interaction with Echinacea. J.Diet.Suppl 2012;9:90-5. View abstract.
Brinkeborn RM, Shah DV, Degenring FH. Echinaforce and other Echinacea fresh plant preparations in the treatment of the common cold. A randomized, placebo controlled, double-blind clinical trial. Phytomedicine 1999;6:1-6.. View abstract.
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. View abstract.
Caruso TJ, Gwaltney JM Jr. Treatment of the common cold with echinacea: a structured review. Clin Infect Dis 2005;40:807-10. View abstract.
Cassano N, Ferrari A, Fai D, et al. Oral supplementation with a nutraceutical containing Echinacea, methionine and antioxidant/immunostimulating compounds in patients with cutaneous viral warts. G.Ital Dermatol Venereol. 2011;146:191-95. View abstract.
Chavez ML, Chavez PI. Echinacea. Hosp Pharm 1998;33:180-8.
Di Pierro F, Rapacioli G, Ferrara T, Togni S. Use of a standardized extract from Echinacea angustifolia (Polinacea) for the prevention of respiratory tract infections. Altern Med Rev 2012;17:36-41. View abstract.
Facino RM, Carini M, Aldini G, et al. Echinacoside and caffeoyl conjugates protect collagen from free radical-induced degradation: a potential use of echinacea extracts in the prevention of skin photodamage. Planta Med 1995;61:510-4. View abstract.
Gabranis I, Koufakis T1, Papakrivos I, Batala S. Echinacea-associated acute cholestatic hepatitis. J Postgrad Med. 2015;61(3):211-2. View abstract.
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. View abstract.
Giles JT, Palat CT III, Chien SH, et al. Evaluation of Echinacea for treatment of the common cold. Pharmacother 2000;20:690-7. View abstract.
Gilroy CM, Steiner JF, Byers T, et al. Echinacea and truth in labeling. Arch Intern Med 2003;163:699-704. View abstract.
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. View abstract.
Goel V, Lovlin R, Chang C, et al. A proprietary extract from the echinacea plant (Echinacea purpurea) enhances systemic immune response during a common cold. Phytother.Res 2005;19:689-94. View abstract.
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. View abstract.
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. View abstract.
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. View abstract.
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. View abstract.
Gunning K. Echinacea in the treatment and prevention of upper respiratory tract infections. West J Med 1999;171:198-200. View abstract.
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. . View abstract.
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. View abstract.
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. View abstract.
Hoheisel O, Sandberg M, Bertram S, et al. Echinagard treatment shortens the course of the common cold: a double blind, placebo-controlled clinical trial. Eur J Clin Res 1997;9:261-268.
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. View abstract.
Jawad M, Schoop R, Suter A, et al. Safety and efficacy profile of Echinacea purpurea to prevent common cold episodes: A randomized, double-blind, placebo-controlled trial. Evid Based Complement Alternat Med 2012;2012:841315. Epub 2012 Sep 16. View abstract.
Kocaman O, Hulagu S, Senturk O. Echinacea-induced severe acute hepatitis with features of cholestatic autoimmune hepatitis. Eur J Intern Med 2008;19:148. View abstract.
Lawrenson JA, Walls T, Day AS. Echinacea-induced acute liver failure in a child. J Paediatr Child Health 2014;50(10):841. View abstract.
Lee AN, Werth VP. Activation of autoimmunity following use of immunostimulatory herbal supplements. Arch Dermatol 2004;140:723-7. View abstract.
Linde K, Barrett B, Wolkart K, et al. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev 2006;(1):CD000530. View abstract.
Lindenmuth GF, Lindenmuth EB. The efficacy of echinacea compound herbal tea preparation on the severity and duration of upper respiratory and flu symptoms: a randomized, double-blind, placebo-controlled study. J Altern Complement Med 2000;6:327-34. View abstract.
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. View abstract.
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. View abstract.
Melchart D, Clemm C, Weber B, et al. Polysaccharides isolated from Echinacea purpurea herba cell cultures to counteract undesired effects of chemotherapy--a pilot study. Phytother Res 2002;16:138-42.. View abstract.
Melchart D, Walther E, Linde K, et al. Echinacea root extracts for the prevention of upper respiratory tract infections: a double-blind, placebo-controlled randomized trial. Arch Fam Med 1998;7:541-5. View abstract.
Mengs U, Clare CB, Poiley JA. Toxicity of Echinacea purpurea. Acute, subacute and genotoxicity studies. Arzneimittelforschung 1991;41:1076-81. View abstract.
Mistrangelo M, Cornaglia S, Pizzio M, et al. Immunostimulation to reduce recurrence after surgery for anal condyloma acuminata: a prospective randomized controlled trial. Colorectal Dis 2010;12:799-803. View abstract.
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. View abstract.
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. View abstract.
Muller-Jakic B, Breu W, Probstle A, et al. In vitro inhibition of cyclooxygenase and 5-lipoxygenase by alkamides from Echinacea and Achillea species. Planta Med 1994;60:37-40.. View abstract.
Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51. View abstract.
Mullins RJ. Echinacea-associated anaphylaxis. Med J Aust 1998;168:170-1. View abstract.
Mullins RJ. Allergic reactions to Echinacea. J Allergy Clin Immunol 2000;104:S340-341 (Abstract 1003).
Neri PG, Stagni R, Filippello M, et al. Oral Echinacea purpurea extract in low-grade, steroid-dependent, autoimmune idiopathic uveitis: a pilot study. J Ocul.Pharmacol Ther 2006;22:431-36. View abstract.
O'Neil J, Hughes S, Lourie A, Zweifler J. Effects of echinacea on the frequency of upper respiratory tract symptoms: a randomized, double-blind, placebo-controlled trial. Ann Allergy Asthma Immunol 2008;100:384-8. View abstract.
Ondrizek RR, Chan PJ, Patton WC, King A. An alternative medicine study of herbal effects on the penetration of zona-free hamster oocytes and the integrity of sperm deoxyribonucleic acid. Fertil Steril 1999;71:517-22. View abstract.
Ondrizek RR, Chan PJ, Patton WC, King A. Inhibition of human sperm motility by specific herbs used in alternative medicine. J Assist Reprod Genet 1999;16:87-91. View abstract.
Parnham MJ. Benefit-risk assessment of the squeezed sap of the purple coneflower (Echinacea purpurea) for long-term oral immunostimulation. Phytomedicine 1996;3:95-102.
Pepping J. Echinacea. Am J Health Syst Pharm 1999;56:121-3. View abstract.
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. View abstract.
Perry NB, van Klink JW, Burgess EJ, et al. Alkamide levels in Echinacea purpurea: effects of processing, drying and storage. Planta Med 2000;66:54-6. View abstract.
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 2012)
Samuels N, Grbic JT, Saffer AJ, et al. Effect of an herbal mouth rinse in preventing periodontal inflammation in an experimental gingivitis model: a pilot study. Compend.Contin.Educ.Dent. 2012;33:204-11. View abstract.
Samuels N, Saffer A, Wexler ID, et al. Localized reduction of gingival inflammation using site-specific therapy with a topical gingival patch. J.Clin.Dent. 2012;23:64-7. View abstract.
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. View abstract.
Schoop R, Klein P, Suter A, Johnston SL. Echinacea in the prevention of induced rhinovirus colds: a meta-analysis. Clin Ther 2006;28:174-83. View abstract.
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. View abstract.
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.. View abstract.
Schwarz E, Metzler J, Diedrich JP, et al. Oral administration of freshly expressed juice of Echinacea purpurea herbs fail to stimulate the nonspecific immune response in healthy young men: results of a double-blind, placebo-controlled crossover study. J Immunother 2002;25:413-20.. View abstract.
Shah SA, Sander S, White CM, et al. Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis. Lancet Infect Dis 2007;7:473-80. View abstract.
Soon SL, Crawford RI. Recurrent erythema nodosum associated with echinacea herbal therapy. J Am Acad Dermatol 2001;44:298-9. View abstract.
Sperber SJ, Shah LP, Gilbert RD, et al. Echinacea purpurea for prevention of experimental rhinovirus colds. Clin Infect Dis 2004;38:1367-71. View abstract.
Speroni E, Govoni P, Guizzardi S, et al. Anti-inflammatory and cicatrizing activity of Echinacea pallida Nutt. root extract. J Ethnopharmacol 2002;79:265-72. View abstract.
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. View abstract.
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.. View abstract.
Tragni E, Tubaro A, Melis S, Galli CL. Evidence from two classic irritation tests for an anti-inflammatory action of a natural extract, Echinacina B. Food Chem Toxicol 1985;23:317-9.. View abstract.
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. View abstract.
Turner RB, Riker DK, Gangemi JD. Ineffectiveness of echinacea for prevention of experimental rhinovirus colds. Antimicrob Agents Chemother 2000;44:1708-9. View abstract.
von Blumroeder, W. O. [Angina lacunaris. An investigation on how to stimulate the endogenous defense system] (German). Z Allg Med 1985;61:271-273.
Vonau B, Chard S, Mandalia S, et al. Does the extract of the plant Echinacea purpurea influence the clinical course of recurrent genital herpes? Int J STD AIDS 2001;12:154-8. View abstract.
Wahl RA, Aldous MB, Worden KA, et al. Echinacea purpurea and osteopathic manipulative treatment in children with recurrent otitis media: a randomized controlled trial. BMC.Complement Altern.Med 2008;8:56. View abstract.
Whitehead MT, Martin TD, Scheett TP, et al. Running economy and maximal oxygen consumption after 4 weeks of oral Echinacea supplementation. J Strength Cond Res 2012;26:1928-33. View abstract.
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. View abstract.
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. View abstract.
Zedan H, Hofny ER, and Ismail SA. Propolis as an alternative treatment for cutaneous warts. Int.J Dermatol 2009;48:1246-49. View abstract.