Interactions, Adverse Effects and Contraindications of Echinacea

• No significant herb-drug medications reported. May be mild inhibitor of p450 system; may increase levels of itraconazole, fexofenadine (Allegra), and lovastatin. No interactions reported in humans. May interfere with use of immunosuppressive agents, bu

• Uncommon and minor adverse effects: abdominal discomfort, nausea, dizziness. Rarely: angioedema, anaphylaxis, asthma exacerbation. Persons with allergy to ragweed/marigold at greater risk of allergic reaction.

• German commission recommends it to not be used in patients with autoimmune disorders or HIV due to immune stimulation (in HIV, may increase viral load.) However, this is only theoretical.

• Recommended dose: liquid extract 3 mL q3-4 hrs for 1st 2 days of URI, then tid for remaining week.

• Inconclusive data, but may have positive effect of reducing severity and duration of URI with no significant adverse effects or interactions. Which preparation to recommend is unclear due to lack of standardization.