Indication-specific dosing for black sampson, black Susans, Brauneria angustifolia echinacea in combination, frequency-based adverse effects, comprehensive interactions, contraindications, pregnancy & lactation schedules, and cost information.

Sections

Sections Echinacea
Suggested Dosing
Suggested Uses
Interactions
Adverse Effects
Warnings
Pregnancy
Pharmacology

Suggested Dosing

Oral

Herb juice

6-9 ml PO daily OR
20 gtts PO q2hr x 24 hours then TID

Crude herb extract

2 tabs (6.78mg) PO TID

Echinacea pallida root tincture

900 mg PO daily

Herbal compound tea

5-6 cups PO on day 1, THEN
Decrease by 1 cup/day over 5 days]

No more than 8 weeks continuous use

Topical

Apply to affected area

Suggested Uses

Common cold, herpes simplex infection (topical), immunostimulant, psoriasis (topical), upper respiratory tract infections (viral), urinary tract infections, vaginal candidiasis, skin wounds (topical), skin ulcers (topical)

Efficacy

Demonstrated effective in symptom reduction and prophylaxis of cold, flu, URI

Interaction Checker

Enter a drug name and Echinacea

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No Interactions Found

Interactions Found

Contraindicated

Serious - Use Alternative

Significant - Monitor Closely

Minor

All Interactions Sort By:

Contraindicated (0)

Serious - Use Alternative (1)

beclomethasone, inhaled
echinacea decreases effects of beclomethasone, inhaled by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Monitor for reduced efficacy of immunosuppressant when used concomitantly.

Monitor Closely (34)

adalimumab
adalimumab increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
alefacept
alefacept increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
anakinra
anakinra increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
antithymocyte globulin equine
antithymocyte globulin equine increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
antithymocyte globulin rabbit
antithymocyte globulin rabbit increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
azathioprine
azathioprine increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
basiliximab
basiliximab increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
canakinumab
canakinumab increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
cyclosporine
cyclosporine increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
etanercept
etanercept increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
everolimus
everolimus increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
glatiramer
glatiramer increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
golimumab
golimumab increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
hydroxychloroquine sulfate
hydroxychloroquine sulfate increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
hydroxyurea
echinacea decreases effects of hydroxyurea by Other (see comment). Use Caution/Monitor. Comment: Echinacea may decrease therapeutic effects of immunosuppressants.
ifosfamide
echinacea decreases effects of ifosfamide by Other (see comment). Use Caution/Monitor. Comment: Echinacea is reported possess immunostimulatory activity demonstrated by activation of macrophages (releasing interleukin-1), and proliferation of B-lymphocytes; theoretically, may oppose the therapeutic effects of immunosuppressants.
infliximab
infliximab increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
leflunomide
leflunomide increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
lomustine
echinacea decreases effects of lomustine by immunosuppressive effects; risk of infection. Use Caution/Monitor. Echinacea is reported possess immunostimulatory activity demonstrated by activation of macrophages (releasing interleukin-1), and proliferation of B-lymphocytes; theoretically, may oppose the therapeutic effects of immunosuppressants.
mechlorethamine
echinacea decreases effects of mechlorethamine by Other (see comment). Use Caution/Monitor. Comment: Echinacea is reported possess immunostimulatory activity demonstrated by activation of macrophages (releasing interleukin-1), and proliferation of B-lymphocytes; theoretically, may oppose the therapeutic effects of immunosuppressants.
melphalan
echinacea decreases effects of melphalan by Other (see comment). Use Caution/Monitor. Comment: Echinacea is reported possess immunostimulatory activity demonstrated by activation of macrophages (releasing interleukin-1), and proliferation of B-lymphocytes; theoretically, may oppose the therapeutic effects of immunosuppressants.
mercaptopurine
mercaptopurine, echinacea. immunosuppressive effects; risk of infection. Use Caution/Monitor. Theoretically echinacea may antagonize the effects of immunosuppressants.
methotrexate
methotrexate increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
muromonab CD3
muromonab CD3 increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
mycophenolate
mycophenolate increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
oxaliplatin
echinacea decreases effects of oxaliplatin by Other (see comment). Use Caution/Monitor. Comment: Echinacea is reported possess immunostimulatory activity demonstrated by activation of macrophages (releasing interleukin-1), and proliferation of B-lymphocytes; theoretically, may oppose the therapeutic effects of immunosuppressants.
procarbazine
echinacea decreases effects of procarbazine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Echinacea is reported possess immunostimulatory activity demonstrated by activation of macrophages (releasing interleukin-1), and proliferation of B-lymphocytes; theoretically, may oppose the therapeutic effects of immunosuppressants.
rilonacept
rilonacept increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
sirolimus
sirolimus increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
tacrolimus
tacrolimus increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
temsirolimus
temsirolimus increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
tocilizumab
tocilizumab increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
tongkat ali
tongkat ali increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
ustekinumab
ustekinumab increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.

Minor (2)

astragalus
astragalus and echinacea both decrease immunosuppressive effects; risk of infection. Minor/Significance Unknown.
maitake
echinacea and maitake both decrease immunosuppressive effects; risk of infection. Minor/Significance Unknown.

adalimumab
Monitor Closely (1)adalimumab increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
alefacept
Monitor Closely (1)alefacept increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
anakinra
Monitor Closely (1)anakinra increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
antithymocyte globulin equine
Monitor Closely (1)antithymocyte globulin equine increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
antithymocyte globulin rabbit
Monitor Closely (1)antithymocyte globulin rabbit increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
astragalus
Minor (1)astragalus and echinacea both decrease immunosuppressive effects; risk of infection. Minor/Significance Unknown.
azathioprine
Monitor Closely (1)azathioprine increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
basiliximab
Monitor Closely (1)basiliximab increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
beclomethasone, inhaled
Serious - Use Alternative (1)echinacea decreases effects of beclomethasone, inhaled by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Monitor for reduced efficacy of immunosuppressant when used concomitantly.
canakinumab
Monitor Closely (1)canakinumab increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
cyclosporine
Monitor Closely (1)cyclosporine increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
etanercept
Monitor Closely (1)etanercept increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
everolimus
Monitor Closely (1)everolimus increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
glatiramer
Monitor Closely (1)glatiramer increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
golimumab
Monitor Closely (1)golimumab increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
hydroxychloroquine sulfate
Monitor Closely (1)hydroxychloroquine sulfate increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
hydroxyurea
Monitor Closely (1)echinacea decreases effects of hydroxyurea by Other (see comment). Use Caution/Monitor. Comment: Echinacea may decrease therapeutic effects of immunosuppressants.
ifosfamide
Monitor Closely (1)echinacea decreases effects of ifosfamide by Other (see comment). Use Caution/Monitor. Comment: Echinacea is reported possess immunostimulatory activity demonstrated by activation of macrophages (releasing interleukin-1), and proliferation of B-lymphocytes; theoretically, may oppose the therapeutic effects of immunosuppressants.
infliximab
Monitor Closely (1)infliximab increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
leflunomide
Monitor Closely (1)leflunomide increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
lomustine
Monitor Closely (1)echinacea decreases effects of lomustine by immunosuppressive effects; risk of infection. Use Caution/Monitor. Echinacea is reported possess immunostimulatory activity demonstrated by activation of macrophages (releasing interleukin-1), and proliferation of B-lymphocytes; theoretically, may oppose the therapeutic effects of immunosuppressants.
maitake
Minor (1)echinacea and maitake both decrease immunosuppressive effects; risk of infection. Minor/Significance Unknown.
mechlorethamine
Monitor Closely (1)echinacea decreases effects of mechlorethamine by Other (see comment). Use Caution/Monitor. Comment: Echinacea is reported possess immunostimulatory activity demonstrated by activation of macrophages (releasing interleukin-1), and proliferation of B-lymphocytes; theoretically, may oppose the therapeutic effects of immunosuppressants.
melphalan
Monitor Closely (1)echinacea decreases effects of melphalan by Other (see comment). Use Caution/Monitor. Comment: Echinacea is reported possess immunostimulatory activity demonstrated by activation of macrophages (releasing interleukin-1), and proliferation of B-lymphocytes; theoretically, may oppose the therapeutic effects of immunosuppressants.
mercaptopurine
Monitor Closely (1)mercaptopurine, echinacea. immunosuppressive effects; risk of infection. Use Caution/Monitor. Theoretically echinacea may antagonize the effects of immunosuppressants.
methotrexate
Monitor Closely (1)methotrexate increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
muromonab CD3
Monitor Closely (1)muromonab CD3 increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
mycophenolate
Monitor Closely (1)mycophenolate increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
oxaliplatin
Monitor Closely (1)echinacea decreases effects of oxaliplatin by Other (see comment). Use Caution/Monitor. Comment: Echinacea is reported possess immunostimulatory activity demonstrated by activation of macrophages (releasing interleukin-1), and proliferation of B-lymphocytes; theoretically, may oppose the therapeutic effects of immunosuppressants.
procarbazine
Monitor Closely (1)echinacea decreases effects of procarbazine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Echinacea is reported possess immunostimulatory activity demonstrated by activation of macrophages (releasing interleukin-1), and proliferation of B-lymphocytes; theoretically, may oppose the therapeutic effects of immunosuppressants.
rilonacept
Monitor Closely (1)rilonacept increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
sirolimus
Monitor Closely (1)sirolimus increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
tacrolimus
Monitor Closely (1)tacrolimus increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
temsirolimus
Monitor Closely (1)temsirolimus increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
tocilizumab
Monitor Closely (1)tocilizumab increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
tongkat ali
Monitor Closely (1)tongkat ali increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.
ustekinumab
Monitor Closely (1)ustekinumab increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.

Frequency Not Defined

Abdominal pain

Allergic reactions

Altered fertility

Diarrhea

Dizziness

Erythema (topical use)

Exanthema (topical use)

Fever

Nausea/vomiting

Pruritis (topical use)

Sore throat

Unpleasant taste

Contraindications

Hypersensivity to Asteraceae/Compositae plants, chrysanthemums, daisies, marigolds, ragweed

Autoimmune disorders, collagenosis/collagen disease, HIV/AIDS, leukosis, multiple sclerosis, tuberculosis

Cautions

Atopic conditions, concurrent CYP 3A4 substrates, pregnancy

Pregnancy & Lactation

Pregnancy Category: N/A

Lactation: N/A

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Mechanism of Action

Echinacosides: stimulate T-lymphocyte and interferon production; inhibit hyaluronidase

Polysaccharides: Cytotoxic against tumor cells

Glycosides: Mild antibacterial

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

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