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echinacea (generic name)

an herbal product - treats Genital herpes, Uveitis, Treatment of upper respiratory tract infections, Low white blood cell counts after X-ray tr...
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Interactions with Drugs

Natural medicine practitioners sometimes caution that echinacea may lead to liver inflammation. There is not clear information from laboratory or human studies in this area. Nonetheless, caution should be used when combining echinacea by mouth with other medications that can harm the liver. Examples of such agents include anabolic steroids, amiodarone, methotrexate, acetaminophen (Tylenol®), and antifungal medications taken by mouth (such as ketoconazole). Echinacea may affect the way certain drugs are broken down by the liver.

In theory, echinacea's ability to stimulate the immune system may interfere with drugs that suppress the immune system (including azathioprine, cyclosporine, and steroids such as prednisone). Because clear human studies are lacking, people taking these drugs should consult a healthcare professional or pharmacist before using echinacea.

Based on one vague case report, taking echinacea along with amoxicillin may cause life-threatening reactions. However, the details of this case are not very clear.

Early information suggests that the use of echinacea with econazole nitrate cream (Spectazole®) on the skin may lower the frequency of vaginal yeast infections after treatment.

Many tinctures contain high levels of alcohol, and may cause nausea or vomiting when taken with metronidazole (Flagyl®) or disulfiram (Antabuse®).

Echinacea may also interact with anesthetics, antineoplastics, and caffeine. However, these potential interactions are not fully understood.

Interactions with Herbs and Dietary Supplements

Natural medicine practitioners sometimes caution that echinacea may lead to liver inflammation. Although there is no clear information from laboratory or human studies, in theory echinacea may add to liver toxicity caused by other agents, such as kava. Echinacea may affect the way certain herbs and supplements are broken down by the liver.

Echinacea is sometimes used in combination products that are thought to stimulate the immune system. For example, Esberitox® (PhytoPharmica, Germany) contains Echinacea purpurea, Echinacea pallida, wild indigo root (Baptisia tinctoria), and thuja (white cedar). Echinacea may be combined with goldenseal or other herbs in some cold relief preparations. There is a lack of high-quality human studies that have shown added benefits or interactions of these combinations.

Echinacea is sometimes sold in combination with goldenseal (Hydrastis canadensis), an herb that may reduce the body's ability to absorb vitamin B.

Anesthetics, antineoplastics, antioxidants, and caffeine may interact with echinacea. However, these potential interactions are not fully understood.


This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration ( Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Samuel Basch, MD (Mt. Sinai Medical Center, NY); Wendy Chao, PhD (Natural Standard Research Collaboration); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Sean Dalton, MD, MPH, PhD; Edzard Ernst, MD, PhD (University of Exeter); Ivo Foppa, MD, ScD (Harvard University); Dana A. Hackman, BS (Northeastern University): Carolyn Williams Orlando, MA; Philippe Szapary, MD (University of Pennsylvania); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Natasha Tiffany, MD (Harvard Medical School); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Mamta Vora, PharmD (Northeastern University); Wendy Weissner, BA (Natural Standard Research Collaboration).

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