Echinacea

Last Updated: October 13, 2024

Echinacea purpurea is an herb commonly used either in response to or daily for prevention of the common cold. It outperforms placebo unreliably and the amount of benefit derived is similarly unreliable.

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Echinacea is most often used for

What is Echinacea?

The term "echinacea" refers to a genera of plants, and a few species in this family including purpurea and angustifolia are desired due to their alkylamide content (seen as the active ingredients). It's often taken as a tincture, but dry capsules are also common.

What are Echinacea's benefits?

Overall, echinacea appears to be somewhat effective for fighting off upper respiratory tract infections (mostly studied for the common cold), and when taken consistently as a prophylactic, it has support from research. It has also been studied for its potential ability to accelerate the rate of recovery in sickness, but the current evidence for that is highly ambiguous. There are trials suggesting remarkable recovery rates, and there are trials suggesting no benefits whatsoever. Overall, it doesn't look very potent. Limited research suggests that it can increase the levels of a variety of immune cells, but more research is needed to be confident in this.

What are Echinacea's drawbacks and downsides?

Echinacea hasn't demonstrated notably, greater adverse events in trials than placebo, however, as with herbal extracts in general, there may be a risk for drug interactions, particularly for those who take multiple medications.

What are other names for Echinacea?
Note that Echinacea is also known as:
  • Brauneria purpurea
  • Echinacea intermedia
  • Rudbeckia purpurea
  • Purple coneflower herb
  • Coneflower
  • Red sunflower
Dosage information

For dehydrated powders (including encapsulated echinacea) the species of purpuera tends to be used and oral doses are taken upwards of 300mg thrice a day (900mg daily) and 500mg thrice daily (1,500mg daily).

Tinctures of an ethanolic extract of the aerial parts (leaves and stems) appears to be used in the concentration of 2.5mL thrice a day or up to 10mL daily.

There is no much evidence as to whether these are the optimal doses, and studies seem to be very hetereogeneous in their benefits due to lack of standardization.

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References
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  2. ^Mullins RJEchinacea-associated anaphylaxis.Med J Aust.(1998 Feb 16)
  3. ^Bahar Kaymakamzade, Rana Karabudak, Aslı Tuncer Kurne, Gülay NurluAcute Disseminated Encephalomyelitis after Oral Therapy with Herbal Extracts: A Case ReportBalkan Med J.(2016 May)
  4. ^Liatsos G, Elefsiniotis I, Todorova R, Moulakakis ASevere thrombotic thrombocytopenic purpura (TTP) induced or exacerbated by the immunostimulatory herb Echinacea.Am J Hematol.(2006 Mar)
  5. ^Kocaman O, Hulagu S, Senturk OEchinacea-induced severe acute hepatitis with features of cholestatic autoimmune hepatitis.Eur J Intern Med.(2008 Mar)
  6. ^I Gabranis, T Koufakis, I Papakrivos, S BatalaEchinacea-associated acute cholestatic hepatitisJ Postgrad Med.(2015 Jul-Sep)
  7. ^Lawrenson JA, Walls T, Day ASEchinacea-induced acute liver failure in a child.J Paediatr Child Health.(2014 Oct)
  8. ^Taylor JA, Weber W, Standish L, Quinn H, Goesling J, McGann M, Calabrese CEfficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trialJAMA.(2003 Dec 3)
  9. ^Goel V, Lovlin R, Barton R, Lyon MR, Bauer R, Lee TD, Basu TKEfficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trialJ Clin Pharm Ther.(2004 Feb)
  10. ^Yale SH, Liu KEchinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trialArch Intern Med.(2004 Jun 14)
  11. ^Sumer J, Keckeis K, Scanferla G, Frischknecht M, Notter J, Steffen A, Kohler P, Schmid P, Roth B, Wissel K, Vernazza P, Klein P, Schoop R, Albrich WCNovel Echinacea formulations for the treatment of acute respiratory tract infections in adults-A randomized blinded controlled trial.Front Med (Lausanne).(2023)
  12. ^Weishaupt R, Buchkov A, Kolev E, Klein P, Schoop RReduction of Viral Load in Patients with Acute Sore Throats: Results from an Observational Clinical Trial with Echinacea/Salvia Lozenges.Complement Med Res.(2023)
  13. ^Gorski JC, Huang SM, Pinto A, Hamman MA, Hilligoss JK, Zaheer NA, Desai M, Miller M, Hall SDThe effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo.Clin Pharmacol Ther.(2004 Jan)
  14. ^Penzak SR, Robertson SM, Hunt JD, Chairez C, Malati CY, Alfaro RM, Stevenson JM, Kovacs JAEchinacea purpurea significantly induces cytochrome P450 3A activity but does not alter lopinavir-ritonavir exposure in healthy subjects.Pharmacotherapy.(2010 Aug)
  15. ^Mohi Iqbal Mohammed Abdul, Xuemin Jiang, Kenneth M Williams, Richard O Day, Basil D Roufogalis, Winston S Liauw, Hongmei Xu, Anita Matthias, Reginald P Lehmann, Andrew J McLachlanPharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjectsBr J Clin Pharmacol.(2010 May)
  16. ^Torstein Schrøder Hansen, Odd Georg NilsenEchinacea purpurea and P-glycoprotein drug transport in Caco-2 cellsPhytother Res.(2009 Jan)
  17. ^Bossaer JB, Odle BLProbable etoposide interaction with Echinacea.J Diet Suppl.(2012 Jun)
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  20. ^M Gallo, M Sarkar, W Au, K Pietrzak, B Comas, M Smith, T V Jaeger, A Einarson, G KorenPregnancy outcome following gestational exposure to echinacea: a prospective controlled studyArch Intern Med.(2000 Nov 13)
Examine Database References
  1. Common Cold Symptoms - Schoop R, Klein P, Suter A, Johnston SLEchinacea in the prevention of induced rhinovirus colds: a meta-analysisClin Ther.(2006 Feb)
  2. Common Cold Symptoms - Yale SH, Liu KEchinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trialArch Intern Med.(2004 Jun 14)
  3. Common Cold Symptoms - Turner RB, Bauer R, Woelkart K, Hulsey TC, Gangemi JDAn evaluation of Echinacea angustifolia in experimental rhinovirus infectionsN Engl J Med.(2005 Jul 28)
  4. Common Cold Symptoms - Brinkeborn RM, Shah DV, Degenring FHEchinaforce and other Echinacea fresh plant preparations in the treatment of the common cold. A randomized, placebo controlled, double-blind clinical trialPhytomedicine.(1999 Mar)
  5. Common Cold Symptoms - Barton R, Tapan B, Lyon MEfficacy of a standardized echinacea preparation (EchinilinTM) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trialJ Clin Pharm Ther.()
  6. Common Cold Symptoms - Barrett B, Brown R, Rakel D, Mundt M, Bone K, Barlow S, Ewers TEchinacea for treating the common cold: a randomized trialAnn Intern Med.(2010 Dec 21)
  7. Common Cold Symptoms - Taylor JA, Weber W, Standish L, Quinn H, Goesling J, McGann M, Calabrese CEfficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trialJAMA.(2003 Dec 3)
  8. Common Cold Symptoms - Goel V, Lovlin R, Chang C, Slama JV, Barton R, Gahler R, Bauer R, Goonewardene L, Basu TKA proprietary extract from the echinacea plant (Echinacea purpurea) enhances systemic immune response during a common coldPhytother Res.(2005 Aug)
  9. Common Cold Symptoms - Goel V, Lovlin R, Barton R, Lyon MR, Bauer R, Lee TD, Basu TKEfficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trialJ Clin Pharm Ther.(2004 Feb)
  10. Common Cold Symptoms - Turner RB, Riker DK, Gangemi JDIneffectiveness of echinacea for prevention of experimental rhinovirus coldsAntimicrob Agents Chemother.(2000 Jun)
  11. Upper Respiratory Tract Infection Risk - David S, Cunningham REchinacea for the prevention and treatment of upper respiratory tract infections: A systematic review and meta-analysisComplement Ther Med.(2019 Jun)
  12. Upper Respiratory Tract Infection Risk - Sperber SJ, Shah LP, Gilbert RD, Ritchey TW, Monto ASEchinacea purpurea for prevention of experimental rhinovirus coldsClin Infect Dis.(2004 May 15)
  13. Upper Respiratory Tract Infection Risk - Jawad M, Schoop R, Suter A, Klein P, Eccles RSafety and Efficacy Profile of Echinacea purpurea to Prevent Common Cold Episodes: A Randomized, Double-Blind, Placebo-Controlled TrialEvid Based Complement Alternat Med.(2012)
  14. Upper Respiratory Tract Infection Risk - Shah SA, Sander S, White CM, Rinaldi M, Coleman CIEvaluation of echinacea for the prevention and treatment of the common cold: a meta-analysisLancet Infect Dis.(2007 Jul 25)
  15. Upper Respiratory Tract Infection Risk - Linde K, Barrett B, Wölkart K, Bauer R, Melchart DEchinacea for preventing and treating the common coldCochrane Database Syst Rev.(2006 Jan 25)
  16. Upper Respiratory Tract Infection Risk - Grimm W, Müller HHA randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infectionsAm J Med.(1999 Feb)
  17. Upper Respiratory Tract Infection Symptoms - Schulten B, Bulitta M, Ballering-Brühl B, Köster U, Schäfer MEfficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trialArzneimittelforschung.(2001)
  18. Upper Respiratory Tract Infection Risk - Tiralongo E, Lea RA, Wee SS, Hanna MM, Griffiths LRRandomised, double blind, placebo-controlled trial of echinacea supplementation in air travellersEvid Based Complement Alternat Med.(2012)
  19. Blood Pressure - Shah SA, Schlesselman L, Cios D, Lipeika J, Patel AA, Kluger J, White CMEffects of echinacea on electrocardiographic and blood pressure measurementsAm J Health Syst Pharm.(2007 Aug 1)
  20. Upper Respiratory Tract Infection Risk - Hall H, Fahlman MM, Engels HJEchinacea purpurea and mucosal immunityInt J Sports Med.(2007 Sep)
  21. Upper Respiratory Tract Infection Risk - Melchart D, Walther E, Linde K, Brandmaier R, Lersch CEchinacea root extracts for the prevention of upper respiratory tract infections: a double-blind, placebo-controlled randomized trialArch Fam Med.(1998 Nov-Dec)
  22. Upper Respiratory Tract Infection Risk - O'Neil J, Hughes S, Lourie A, Zweifler JEffects of echinacea on the frequency of upper respiratory tract symptoms: a randomized, double-blind, placebo-controlled trialAnn Allergy Asthma Immunol.(2008 Apr)
  23. Upper Respiratory Tract Infection Symptoms - Dorn M, Knick E, Lewith GPlacebo-controlled, double-blind study of Echinaceae pallidae radix in upper respiratory tract infectionsComplement Ther Med.()
  24. Oxygen Cost of Exercise - Whitehead MT, Martin TD, Scheett TP, Webster MJRunning economy and maximal oxygen consumption after 4 weeks of oral Echinacea supplementationJ Strength Cond Res.(2012 Jul)
  25. Hemoglobin - Deccy S, Bartkowiak C, Rodricks N, Paultre KEchinacea Supplementation Does Not Impact Aerobic Capacity and Erythropoiesis in Athletes: A Meta-Analysis.Nutrients.(2024 Jun 22)