Interactions with Drugs
Echinacea may interact with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Echinacea may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be increased in the blood, and may cause increased effects or potentially serious adverse reactions. People using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
Echinacea may interact with agents that are cleared from the body by the kidneys, agents that affect the immune system, agents toxic to the liver, agents that increase light sensitivity, agents that treat muscle spasms, agents that treat retroviral infections (HIV), anesthesia, antibiotics, anticancer agents, anti-inflammatories, antiviral agents, anxiety agents, caffeine, cardiac glycosides, corticosteroids, dental agents, disulfiram (Antabuse®), econazole nitrate (Spectazole®), metronidazole (Flagyl®), P-glycoprotein-regulated agents, and steroids.
Interactions with Herbs and Dietary Supplements
Echinacea may interact with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
Echinacea may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.
Echinacea may interact with anesthesia, antibacterials, anticancer herbs and supplements, anti-inflammatory herbs and supplements, antioxidants, antivirals, astralagus, caffeine-containing herbs and supplements, cardiac glycosides, dental herbs and supplements, glycyrrhiza, herbs and supplements that are cleared from the body by the kidneys, herbs and supplements that affect the immune system, herbs and supplements toxic to the liver, herbs and supplements that increase light sensitivity, herbs and supplements that treat anxiety, herbs and supplements that treat muscle spasms, kava, P-glycoprotein-regulated agents, and vitamins.
This evidence-based monograph was prepared by The Natural Standard Research Collaboration