Precautions
Individuals interested in taking echinacea should
consult their health care provider and other reputable
sources of information before starting the herb. Pregnant
or breastfeeding women should be especially careful to
discuss the use of echinacea and all other drugs and
supplements with their health care provider. One animal
study indicated that the increase in white blood cells
normally seen during pregnancy was reduced or elimi-
nated in women who took echinacea during pregnancy.
This suggests that women who should avoid the drug
during pregnancy. A separate study designed to evaluate
the safety of echinacea during pregnancy failed to show
any harm to either the mother or the fetus. In addition,
care should be taken in giving children echinacea. Few
studies have been done specifically on children.
As with any medication, more is not necessarily
better, and the words ‘‘natural’’ or ‘‘organic’’ on the
label do not mean the product is safe. Overdose can
cause serious side effects. In the event of side effects,
echinacea should be stopped immediately and the side
effects reported to a health care professional. People
with autoimmune diseases (e.g., AIDS, multiple scle-
rosis) are often counseled to avoid echinacea, because
of theoretical, but unproven, negative effects on the
immune system.
Interactions
Echinacea may interact with both conventional
drugs and other herbs or dietary supplements, but
few rigorous studies have been done on potential inter-
actions. Individuals should tell their health care pro-
vider about all the conventional drugs and dietary
supplements they are taking before beginning any
new drug or supplement.
Since echinacea may stimulate the immune sys-
tem, it is recommended that individuals who are tak-
ing immune system suppressant drugs following
cancer treatment or organ transplant avoid echinacea.
This interaction has not been verified experimentally,
and some trials suggest that echinacea can actually
benefit cancer patients.
Echinacea may also interact with econazole, an
antifungal drug. Individuals who take echinacea while
taking econazole to treat fungal infections appear more
likely to have reoccurrence of the fungal infection.
Complications
People who are allergic to ragweed, chrysanthe-
mums, marigolds, daisies, and related plants have a
greater chance of being allergic to echinacea. Allergic
reactions have on rare occasions been reported to be
severe and cause breathing difficulties, especially in
people with asthma. Much more common are allergic
reactions consisting of a rash, sneezing, or runny nose.Parental concerns
Parents should be aware that the safe dose of
many herbal supplements has not been established
for children. Accidental overdose may occur if chil-
dren are give adult herbal supplements.Resources
BOOKS
Miller, Sandra C. and He-ci Yu, eds.Echinacea: The Genus
Echinacea. Boca Raton, FL: CRC Press, 2004.
PDR for Herbal Medicines,3rd ed. Montvale, NJ: Thomp-
son Healthcare, 2004.
Pierce, Andrea.The American Pharmaceutical Association
Practical Guide to Natural Medicines.New York: Wil-
liam Morrow, 1999.
Wildman, Robert E. C., ed.Handbook of Nutraceuticals and
Functional Foods,2nd ed. Boca Raton, FL: CRC/Tay-
lor&Francis, 2007.
PERIODICALS
Dugoua, Perri D, E. Mills, and G. Koren. ‘‘Safety and
Efficacy of Echinacea (Echinacea angustifolia,E. pur-
pureaandE. pallida) During Pregnancy and Lacta-
tion.’’Canadian Journal of Clinical Pharmacology13,
no.3 (2006): e262-7.
Klinger, Benjamin. ‘‘Echinacea.’’American Family Physi-
cian67, no. 1 (2003): 77-80.
Messina, B. A. ‘‘Herbal Supplements: Facts and Myths—
Talking to Your Patients About Herbal Supplements.’’
Journal of PeriAnesthesia Nursing21, no 4 (2006): 268-
78.
Taylor, J. A., et al. ‘‘Efficacy and Safety of Echinacea in
Treating Upper Respiratory Tract Infections in Chil-
dren: A Randomized Controlled Trial.’’Journal of the
American Medical Association290, no.21 (December 3,
1003): 2824-30.
ORGANIZATIONS
Alternative Medicine Foundation. P.O. Box 60016, Poto-
mac, MD 20859. Telephone: (301) 340-1960. Fax: (301)
340-1936. Website:<http://www.amfoundation.org>.
National Center for Complementary and Alternative Medi-
cine Clearinghouse. P.O. Box 7923, Gathersburg, MD- Telephone: (888) 644-6226. TTY: (866) 464-3615.
Fax: (866) 464-3616. Website:http://nccam.nih.gov.
Natural Standard. 245 First Street, 18th Floor, Cambridge,
MA 02142. Telephone: (617) 444-8629. Fax: (617) 444- - Website:http://www.naturalstandards.com.
Office of Dietary Supplements, National Institutes of
Health. 6100 Executive Blvd., Room 3B01, MSC 7517,
Bethesda, MD 20892-7517 Telephone: (301)435-2920.
Fax: (301)480-1845. Website:http://dietary-
supplements.info.nih.gov.
Echinacea