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Echinacea Side Effects, Interactions and Warnings

There is some possibility that pharmaceuticals containing Echinacea purpurea might influence fetal development in human also, because they may interfere with embrional angiogenesis, and should not be recommended for pregnant women.
- Folia Histochem Cytobiol. 2007;45 Suppl 1:S35-9. -- Influence of Echinacea purpurea intake during pregnancy on fetal growth and tissue angiogenic activity. -- Barcz E, Sommer E, Nartowska J, Balan B, Chorostowska-Wynimko J, Skopinska-Rózewska E.

Five cases of adverse reactions to echinacea were personally evaluated by the authors. Two patients suffered anaphylaxis and a third had an acute asthma attack 10 minutes after their first ever dose of echinacea. The fourth patient suffered recurrent episodes of mild asthma each time echinacea was ingested, and the fifth developed a maculopapular rash within 2 days of ingestion which recurred when rechallenged. Three of the patients had positive SPT results. Three reported repeated spontaneous "challenges" and symptoms after further ingestion of echinacea. Fifty-one Australian adverse drug reports implicating echinacea were also reviewed. There were 26 cases suggestive of possible immunoglobulin E-mediated hypersensitivity (4 anaphylaxis, 12 acute asthma, 10 urticaria/angioedema).
- Ann Allergy Asthma Immunol. 2002 Jan;88(1):42-51.

If used beyond 8 weeks, Echinacea could cause hepatotoxicity and therefore should not be used with other known hepatoxic drugs, such as anabolic steroids, amiodarone, methotrexate, and ketoconazole.
- Arch Intern Med 1998 Nov 9;158(20):2200-11 -- Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. -- Miller LG.

Use of echinacea is discouraged during pregnancy and for people with tuberculosis or autoimmune problems.

Do not use echinacea continuously for more than a few weeks.

Do not give echinacea to children younger than two years old; start with minimal doses for older children and older adults.

Should not be used by those who are allergic to plants in the sunflower family.

People are more likely to experience allergic reactions to echinacea if they are allergic to related plants in the daisy family, which includes ragweed, chrysanthemums, marigolds, and daisies. Also, people with asthma or atopy (a genetic tendency toward allergic reactions) may be more likely to have an allergic reaction when taking echinacea.
- http://nccam.nih.gov/health/echinacea/ataglance.htm

Incidences of hepatotoxicity and nephrotoxicity may be augmented by acetaminophen when concomitantly used with the potentially hepatotoxic herbs Echinacea and kava kava, and with herbs containing salicylate (willow, meadowsweet), respectively.
- J Clin Pharm Ther 2002 Dec;27(6):391-401 -- Herbal medication: potential for adverse interactions with analgesic drugs. -- Abebe W.

last update: March 2009

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