Echinacea
OTHER NAME(S): echinacea, American coneflower, coneflower, Echinacea angustifolia, Echinacea pallida, Echinacea purpurea, purple coneflower
Overview
Echinacea is a type of plant. It is available in many forms over the counter, including as a tea, cream, lotion, and dietary supplement, such as capsules or tablets. People often use echinacea to prevent and treat infections in the nose and throat, although its benefits are not well defined. Common side effects include nausea and upset stomach. Serious side effects are rare and include allergic reactions. Before taking echinacea, tell your health care provider about any health conditions you have or medicines you are taking.
Uses
What is echinacea used for?
Echinacea is used for many reasons. However, the benefits of echinacea are not well defined. Some common reasons for using echinacea include the following.
- To treat or prevent the common cold
- To treat or prevent other infections in the nose or throat
- Eczema (atopic dermatitis)
Note: The FDA has not reviewed echinacea for safety and effectiveness. Learn more about dietary supplements here.
How does echinacea work (mechanism of action)?
Echinacea is a genus of plants. Most dietary supplements that contain echinacea are made from Echinacea purpurea, but some products may also be made from Echinacea angustifolia or Echinacea pallida. These products may be made from all parts of the plant, including the flowers, leaves, stems, and roots.
Echinacea is commonly taken to treat or prevent infections in the nose and throat, such as the common cold. But it does not seem to help treat an existing infection. Some research suggests that taking echinacea might slightly reduce the risk of catching a cold or other infection, but not all research has shown benefit. The effects of an echinacea dietary supplement may depend on which parts of the plant it contains.
It is not clear how echinacea may work for any use. Herbal products, like echinacea, naturally contain many chemicals. The amounts of each chemical in a specific echinacea product may vary. Some, none, or all of these chemicals may have effects on the body. These effects may change depending on how much of each chemical is found in the product you are using.
How should I store echinacea?
You should store echinacea according to the product label. Most dietary supplements should be kept in a cool, dry location that is out of the reach of children and pets and not in direct sunlight.
Side Effects
What are the most common side effects of echinacea?
The most common side effects of echinacea are listed below. These side effects may vary depending on the dose you are taking or the specific product you are using. Tell your health care provider if you have any of these side effects that bother you.
- Nausea
- Upset stomach
- Rash (in children)
There may be other side effects of echinacea that are not listed here. Contact your health care provider if you think you are having a side effect of a supplement. In the U.S., you can report side effects to the FDA at www.safetyreporting.hhs.gov or by calling 888-SAFEFOOD (888-723-3366). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of echinacea?
While less common, the most serious side effects of echinacea are described below, along with what to do if they happen.
Severe Allergic Reactions. Echinacea may cause allergic reactions, which can be serious. Stop taking echinacea and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching or skin rash
- Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Precautions
Who should not use echinacea?
Allergies to Ingredients. People who are allergic to any of the following should not take echinacea.
- American coneflower
- Echinacea
- Echinacea angustifolia
- Echinacea pallida
- Echinacea purpurea
- Purple coneflower
- Any of the ingredients in the specific product
Your pharmacist can tell you all of the ingredients in the specific echinacea products they stock.
What should I know about echinacea before using it?
Echinacea is a dietary supplement. It cannot be marketed to treat or cure a disease.
Read and follow the directions on the specific product you are taking, or take it as recommended by your health care provider.
Keep echinacea out of the reach of children.
Children may have a higher risk of an allergic reaction to echinacea, especially if they have a history of other allergic reactions (atopy) or a history of allergic conditions, such as asthma or eczema. Before giving echinacea to a child, talk to your health care provider about this risk.
If you are taking echinacea as a gummy, chew the gummy well before swallowing. If you are taking liquid echinacea, use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist what measuring device to use.
Herbal products, such as echinacea, naturally contain many different chemicals. The amount of each chemical in a specific echinacea product can change for many reasons, including the area where the plant was grown, the weather during growth, the time of year when it was harvested, and the way that the plant was processed after it was harvested. Echinacea dietary supplements may also be made from different parts of the plant, including the flowers, leaves, stems, and roots. Each of these plant parts contain different chemicals that may have different effects on the body.
Echinacea is available in many forms, including as a liquid, a tea, and a dried, ground powder found in capsules or tablets. It is also available as a cream or lotion that can be applied to the skin. Each of these forms may contain different amounts of the chemicals that are naturally found in the plant. If you switch to a new product or a different brand, you may not have the same effects or side effects because of this variability. Talk to your health care provider if you have questions or concerns.
The FDA has not tested echinacea products to confirm that they contain the ingredients stated on their labels. Some dietary supplements have been tested by third-party organizations to confirm that they contain the ingredients listed on their labels and do not contain any harmful chemicals. Learn more about how to choose a safe dietary supplement product here.
What should I tell my health care provider before using echinacea?
Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if echinacea is right for you.
In particular, make sure that you discuss any of the following.
Allergic Conditions.People who have a history of allergic reactions (atopy) or who have allergic conditions like asthma or eczema may be more likely to have an allergic reaction to echinacea. This risk may also be higher in children. Talk to your health care provider if you have any of these conditions before taking echinacea.
Allergies to Certain Plants.Echinacea is part of the Asteraceae (daisy) family of plants. People who have an allergy to other plants in this family may be more likely to have an allergic reaction to echinacea. Some examples of other common plants in the Asteraceae family include arnica, marigold, chamomile, yarrow, ragweed, asters, and chrysanthemums. If you have an allergy to one of these plants, talk to your health care provider before taking echinacea.
Other Current and Past Health Conditions.Tell your health care provider if you have any of the following.
- Kidney problems
- Liver problems
Other Medicines and Supplements.Echinacea may interact with other medicines and supplements. Before taking echinacea, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Pregnancy. It is not known if or how echinacea could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.
Breastfeeding. Echinacea passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.
Interactions
Does echinacea interact with foods or drinks?
There are no known interactions between echinacea and foods or drinks.
It is unknown if drinking alcohol will affect echinacea.
Does echinacea interact with medicines (drug interactions)?
Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
Echinacea may alter the blood levels of some medicines. Tell your health care provider about all medicines that you take or have recently taken.
The interactions between echinacea and medicines are not fully understood. As with most dietary supplements, the research on drug interactions with echinacea is incomplete. Always check with your health care provider before taking echinacea with any medicines.
Dosing
What should I do if I accidentally use too much echinacea?
If you or someone else has used too much echinacea, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
Echinacea comes in a range of doses and forms. Read the product label closely and speak with a health care provider about how to take echinacea safely. Do not take double or extra doses.
References
- Blumenthal, M. The ABC Clinical Guide to Herbs, American Botanical Council, 2003.
- Clinical Pharmacology & Therapeutics: “The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo.”
- Drugs and Lactation Database (LactMed) [Internet]: “Echinacea.”
- LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]: “Echinacea.”
- National Cancer Institute NCI Dictionary of Cancer Terms: “Echinacea.”
- National Center for Complementary and Integrative Health: “Colds, Flu, and Complementary Health Approaches.”
- National Center for Complementary and Integrative Health: “Echinacea.”
- National Center for Complementary and Integrative Health: “Variations in the Types and Amounts of Bacteria in Echinacea Plants May Influence the Herb’s Effects on Infectious Disease.”