Echinacea
Herbal products and dietary supplements
Herbal products and dietary supplements
Daisy-family plants promoted to boost immunity against colds. It may slightly lower the chance of catching a cold; allergic reactions occur.
Also called: Echinacea purpurea, Echinacea angustifolia
Quick facts
- Group
- Herbal products and dietary supplements
- Target
- Immune cells (proposed immune stimulation)
- Used for
- Promoted to prevent or shorten colds
- Key effects
- Abdominal pain and nausea · Rash · Unpleasant taste
- Monitor
- Allergic reactions and rash
No doses: the clinician sets them by the current guideline.
Mechanism of action
Echinacea products are based on the idea that their constituents stimulate the immune system. The mechanism in people is not well defined, and its role in immune modulation is still unclear, which is why it is avoided in immune disorders and with immunosuppressants.
- Extracts of the plant are taken by mouth
- Proposed stimulation of immune cells
- Small effect on the chance of catching a cold
Indications
- Promoted to prevent or shorten colds: may slightly reduce the chance of catching one; unclear whether it shortens it Common cold (acute viral rhinopharyngitis) →
Adverse effects
Common
- Abdominal pain and nausea
- Rash, especially in children
- Unpleasant taste
Contraindications
- Allergy to plants of the daisy family
- Immunodeficiency or autoimmune disease
- Organ transplant recipients on immunosuppressants
Key interactions
- Immunosuppressants (for example ciclosporin, tacrolimus)
- Theoretical opposition to immunosuppression
- Drugs metabolised by the liver
- Conflicting evidence of interaction
What is monitored
- Allergic reactions and rash
- Immune status in transplant or autoimmune patients
Pregnancy and breastfeeding
Short courses in early pregnancy appear possibly safe in limited studies; little is known about breastfeeding.
Nursing care
- Ask every patient about herbal products and supplements and record them with the medicine list
- Ask about allergy to ragweed or daisies
- Teach that «natural» does not mean safe and that supplements are not approved as medicines before sale
Pharmacokinetics
- Absorption
- Taken by mouth as solid or liquid extracts of Echinacea purpurea or angustifolia
Test yourself
Think of the answer, then tap the question to see it.
What is the evidence for echinacea in the common cold?
It may slightly reduce the chance of catching a cold; it is unclear whether it shortens one.
In which patients is echinacea avoided because of its proposed immune effect?
Patients with immunodeficiency, autoimmune disease or on immunosuppressants such as transplant recipients.
Which allergy history matters before echinacea?
Allergy to ragweed, daisies or related plants.
Connections
← Back to the class: Herbal products and dietary supplements
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Echinacea: Usefulness and Safety (National Center for Complementary and Integrative Health (NCCIH), 2024).
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Representative model, for educational purposes only.