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SCIENTIFIC NAME:
Echinacea purpurea, angustifolia and pallida
FAMILY NAME:
Asteraceae/Compositae
COMMON NAME:
Echinacea
  Evidence for Efficacy (Human Data)
   Clinical Trials  (45)
   Observational Studies/Case Reports  (57)
   Traditional and Folk Use  (48)
 Safety Data
   Adverse Effects & Toxicity   (28)
   Interactions   (7)
   Contraindications   (0)
  Evidence of Activity
   Animal Studies  (44)
   Pharmacodynamics  (68)
   Analytical Chemistry  (52)
   Pharmacokinetics (ADME)  (10)
   Genetics & Molecular Biology  (7)
 Formulas/Blends
   Contemporary Formulas   (22)
   Folk Blends   (0)
   Patents   (21)
  Other Information
   Pictures & Distribution Maps  (6)
   Cultivation, Conservation & Ecology  (9)
   Related Links  (6)
 Dynamic Updates
   Live PubMed Searches   (15)
  History of Records
   History of Record (1)
 
 
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EVIDENCE FOR EFFICACY (HUMAN DATA)
 
Clinical Trials
  Update of 2000 Cochrane evidence-based systematic review of Echinacea for preventing and treating the common cold found some evidence that preparations based on the aerial parts of Echinacea purpurea might be effective for the early treatment of colds in adults. Linde 2006
  [The bloom is off echinacea's rose. The herbal remedy for colds hasn't looked so promising in recent clinical trials.]. [No authors listed] 2005
  Echinacea supplementation in 11 healthy individuals found to invoke an immune response through the enhanced fold increase in leucocyte hsp70 expression, increased white cell counts & and improved erythrocyte antioxidant defences. Agnew 2005
  Estimation of "sufficiently important difference" using benefit harm tradeoff in the case of common cold shows that the echinacea based scenario, mean SID was estimated as 36.8 h, with 105 favoring and 41 (9%) rejecting treatment, regardless of duration benefit. Barrett 2005
  Complementary and alternative medicine use by 108 patients with advanced malignancies enrolled onto phase I clinical trials revealed that Green tea (29.8% [25 of 84]), echinacea (13.1% [11 of 84]), and essiac (9.5% [8 of 84]) were the most popular. Dy 2005
  A non-randomised, multi-centre, 2-armed health services research study, data of 995 chronic recurrent respiratory disease patients, 782 treated with echinacin-, 213 with standard-cohort shows that even non-prescription drugs can have clinical and economic benefits. [Article in German] Heinen-Kammerer 2005
  [Echinacea, vitamin C, the common cold, and blinding.]. Hemila 2005
  The clinical efficacy of KanJang oral solution, which consists of extract of Echinacea purpurea, was greater than Echinacea mixture in a controlled, double blind, randomized trial on patients with non-complicated acute respiratory tract infections. Narimanian 2005
  An evaluation of E.angustifolia in experimental rhinovirus infections in 437 volunteers indicates that extracts of Echinacea root, alone or in combination, do not have clinically significant effects on infection with a rhinovirus or on the clinical illness that results from it. Turner 2005
  [Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial.]. Barrett 2004
  [Echinacea trial.]. Blumenthal 2004
  Among 282 subjects aged 18-65 years with a history of 2 or more colds, a total of 128 subjects contracted a common cold (59 used echinacea, 69 placebo) & the total daily symptom scores were found to be 23.1% lower in the echinacea group than in placebo. Goel 2004
  Comparision of natural product use between primary care and nephrology patients revealed Echinacea was the most common product taken by those patients (26%) & more primary care patients took Echinacea compared with nephrology clinic patients (26% vs 12%). Grabe 2004
  The most common herbal medications taken by 500 hepatitis C patients were milk thistle (12.2%), ginseng (4.6%), and echinacea (3.0%). Siddiqui 2004
  A randomized, double-blind, placebo-controlled clinical trial to evaluate the ability of Echinacea purpurea to prevent infection with rhinovirus(Rv)type 39 in 48 healthy adults revealed that administration of echinacea before & after exposure to RV did not decrease the rate of infection. Sperber 2004
  Echinacea at 100 mg dose 3 times daily reduces the symptoms and duration of the common cold in 128 patients. Yale 2004
  Data analyzed on 707 upper respiratory tract infections (URIs) in 407 children, including 337 URIs treated with echinacea & 370 with placebo revealed that Echinacea purpurea was not effective in treating patients of 2 to 11 years old but was associated with an increased risk of rash. Taylor 2003
  Administration of 1gm of encapsulated mixture of unrefined Echinacea purpurea herb (25%) and root (25%) and E. angustifolia root (50%) provided no detectable benefit or harm in 148 college students who had the common cold, compared with placebo. Barrett 2002
  Among 195 patients attending the Memory Disorders Clinic at Toronto, 52 were 'current or past users', of herbal medicines and the most frequently used included ginkgo (Ginkgo biloba) [39 users], garlic (n = 10), glucosamine sulphate (n = 9) & echinacea (n = 8). Dergal 2002
  In this randomized, double-blind, placebo-controlled, four-week clinical trial, the increased complement properdin indicated one aspect of immune system stimulation in patients treated with either Echinacea purpurea/E. angustifolia or E. purpurea/E. angustifolia plus larch arabinogalactan. Kim 2002
  The results of this pilot study, with matched historical controls, suggest that polysaccharide fraction isolated from Echinacea purpurea cell cultures might be effective in reducing chemotherapy-induced leukopenia. The efficacy and safety should be investigated in further studies. Melchart 2002
  The "immune stimulation" by Echinacea purpurea observed in vitro and after parenteral administration are not confirmed in healthy humans after oral intake. Schwarz 2002
         A randomized, blinded, controlled trial will be performed to determine the efficacy of herbal therapy and craniosacral manipulation for the prevention of acute otitis media in children with recurrent otitis media. Currently (6/01) recruiting. ClinicalTrials.gov
  Review of methodological quality of randomized controlled trials in three areas of complementary medicine i.e. homeopathy, herbal medicine (Hypericum for depression, Echinacea for common cold), and acupuncture found trials often have methodological weaknesses. Linde 2001
  In this randomised, double-blind, placebo-controlled clinical trial, Echinaceae purpureae herba (Echinacin, EC31J0) was well tolerated and clinically effective in alleviating symptoms more rapidly than placebo in patients with a common cold. Schulten 2001
  Over a one-year period, 50 patients took part in the study each receiving 6 months' placebo and 6 months' Echinaforce (Echinacea purpurea extract). No statistically significant benefit could be detected in this study in the treatment of frequently recurrent genital herpes. Vonau 2001
  A prospective controlled study of 206 women with pregnancy outcome following gestational exposure to Echinacea suggests that gestational use of echinacea during organogenesis is not associated with an increased risk for major malformations. Gallo 2000
  Treatment with Echinacea Plus tea at early onset of cold or flu symptoms (runny nose, scratchy throat, fever) in 95 subjects was found to be effective for relieving these symptoms in a shorter period of time than placebo. Lindenmuth 2000
  The consensus of the studies reviewed in this article is that echinacea is effective in reducing the duration and severity of symptoms, but that this effect is noted only with certain preparations of echinacea Percival 2000
  Applications of immunomodulator complex including tincture of Echinacea Purpurea in 31 patients with purulent wound of soft tissues produced more rapid cleansing and healing of the wound. [Article in Russian] Potii 2000
  50 healthy volunteers of both sexes were subdivided and received either Eleutherococcus senticosus or Echinacea (40 drops) for 30 days. No changes were seen in total and LDL cholesterol, triglycerides and glucose Szolomicki 2000
  Survey of alternative medicine use in presurgical patients indicates that 22% of presurgical patients reported using herbal remedies, & the most commonly used compounds, from highest to lowest, included echinacea, gingko biloba, St. John's wort, garlic & ginseng. Tsen 2000
  Echinacea resulted in a non-significant reduction (compared with placebo) of infection (44 vs. 57%) and illness (36 vs. 43%) in experimental rhinovirus colds Turner 2000
  Evidence from published reports of all blinded placebo-controlled randomized trials of any Echinacea formulation used as a treatment or for the prevention of upper respiratory infection (URI) suggests that Echinacea may be beneficial for the early treatment of acute URIs. Barrett 1999
  246 healthy, adult volunteers caught a common cold and took 3 times daily 2 tablets of either Echinaforce, Echinacea purpurea, or a different Echinacea purpurea radix preparation or placebo. Brinkeborn 1999
  [Information on additional Echinacea trials.]. Ertel 1999
  109 patients were randomly assigned to receive 4 mL fluid extract of Echinacea purpurea or 4 mL placebo-juice twice a day. Side effects were observed in 20% of the Echinacea group and in 13% of the placebo group. Grimm 1999
  Results of a clinical trial in 263 patients of a commercially available fixed combination herbal remedy (Radix echinaceae, Radix baptisiae, Herba thujae) showed the superiority of the herbal remedy over placebo (p < 0.05). Henneicke-von Zepelin 1999
  Analysis of human sperm motility parameters on a Hamilton-Thorn analyzer after 1, 4, 24, and 48 hr at 37 degrees C in the presence of herbs indicated that high-concentration saw-palmetto, echinacea, or gikgo inhibited motility at 24 and 48 hr. Ondrizek 1999
  Several comparative clinical trials carried out with standardized phytopharmaceuticals, including Valeriana, Aesculus, Echinacea, and Viscum showed that they had full therapeutic equivalence with chemotherapeutics & had simultaneous advantage of being devoid of any adverse effects. Wagner 1999
  302 healthy people randomly divided into taking ethanol extract of roots of E. purpurea or E angustifolia or placebo for 12 weeks. Incidence & days until first cold: 29.3% and 69, 32.0% and 66, 36.7% and 65 days (difference not statistically significant) Melchart 1998
  Review of controlled clinical trials using extracts of E. purpurea or E. pallida Dorsch 1996
  Extract from E angustifolia, Eupatorium perfoliatum, and Thuja occidentalis for 4 weeks to 23 tumor patients gave no change in cytokines IL-1-alpha, IL-1-beta, IL-2, IL-6, TNF-alpha, and IFN-gamma Elsasser-Beile 1996
  Mosquito bite treated with a homeopathic gel of E angustifolia, Ledum palustre, Urtica urens and Hamamelis extract in a double blind trial with 100 people, reduced erythema but lacked itch relief Hill 1996
  Review of 5 studies (total of 134 healthy volunteers) concerning the effect of different Echinacea preparations on polymorphonuclear neutrophil granulocytes Melchart 1995
Observational Studies/Case Reports
  Studies show echinacea is not beneficial. [No authors listed] 2005
  Assessing the extent of nonvitamin, nonmineral supplement (NVNM) use among Turkish university students revealed that the 3 most frequently used NVNM supplements were echinacea, ginseng & gingko biloba (38.6%,36.4% & 32.8%, respectively). Ayranci 2005
  Structured review on treatment of the common cold with echinacea suggests that the possible therapeutic effectiveness of echinacea in the treatment of colds has not been established. Caruso 2005
  Among 894 completed surveys it was shown that overall, 3.5% of pediatric surgical patients had been given herbal or homeopathic medications in the 2 weeks prior to surgery & the most prevalent substance given to children presenting for elective surgery was Echinacea. Everett 2005
  A survey carried out to find the differences in herbal and dietary supplements use in the Hispanic & non-Hispanic pediatric populations showed that the most commonly used supplements were herbal teas (56%) and echinacea (14%). Guenther 2005
  In 400 postpartum women, 36% of the women reported herbal use during their pregnancy & Echinacea was the best known herb among both groups of women who had used herbal drugs in pregnancy and those not. Nordeng 2005
  A review on new considerations in the treatment and prevention of rhinovirus infections suggests there is no clear evidence that treatment with zinc or echinacea have any role in these infections. Turner 2005
  [Echinacea, colds, and children--finally, a good study.]. [No authors listed] 2004
  [Does an echinacea preparation prevent colds? The debate continues.]. [No authors listed] 2004
  Among 2,186 patients undergoing elective surgery, 57% of respondents admitted to using herbal medicine at some point in their life, eg, echinacea [48%], aloe vera [30%], ginseng [28%], garlic [27%], and ginkgo biloba [22%] were the most common. Adusumilli 2004
  Administration of Chizukit, an herbal preparation containing 3 drugs including 50 mg/mL of Echinacea in 430 children, aged 1 to 5 years showed preventive effect on the incidence of respiratory tract infections. Cohen 2004
  Among 601 children presenting consecutively for ambulatory surgery it was identified that 6.4% of children were currently taking an herbal preparation; while a further 10.1% had taken an herbal medicine in the past & Echinacea and arnica were the commonest used herbal remedies. Crowe 2004
  [Echinacea for treating colds in children.]. Firenzuoli 2004
  A review on exercise, nutrition and immune function reveals a lack of convincing research evidence that 'immune-boosting' supplements, including high doses of antioxidant vitamins, glutamine, zinc, probiotics and Echinacea, prevent exercise-induced immune impairment. Gleeson 2004
  Determination of the prevalence & patterns of use of herbal medicines and vitamin supplements by patients in preoperative period showed that the prevalence of herbal medicine use was 14.3% among 1102 questionnaires & the 5 five most popular herbs includes Garlic, Gingko, Echinacea. Grauer 2004
  [Echinacea for treating colds in children.]. Kim 2004
  [Echinacea fails to show efficacy in treating colds in a pediatric population.]. Le Tourneau 2004
  3 patients whose autoimmune disease onset and/or flares correlated with ingestion of herbal supplements with proven immunostimulatory effects like Echinacea and the alga Spirulina platensis were described. Lee 2004
  Among 83% of the surveys returned from parents of 1,100 consecutive pediatric surgical patients, it was found that an average of 2.4 different herbal medicines were in use by each child, and the most common herbal medications were echinacea, chamomile & aloe. Noonan 2004
  A survey among 400 Norwegian women related to the use of herbal drugs in pregnancy revealed that echinacea, iron-rich herbs, ginger, chamomile and cranberry were the most commonly used herbs. Nordeng 2004
  [Can an herbal preparation of echinacea, propolis, and vitamin C reduce respiratory illnesses in children?]. Sangvai 2004
  The adjuvant treatment with Kan Jang which contain standardized Andrographis paniculata, was found to more effective than Immunal, a preparation containing Echinacea purpurea extract, in 130 children with uncomplicated common colds. Spasov 2004
  [Echinacea no cure-all for kids.]. Washam 2004
  Survey of potential health risks of complementary alternative medicines in 318 cancer patients showed health warning issued to 20 patients & most warnings concerned echinacea in patients with lymphoma. Werneke 2004
  Analysis on herbal supplement use among 11,888 non-Hispanic white, 2866 non-Hispanic black, 3035 Hispanic,& 599 non-Hispanic other women revealed that nearly 1/6th of US women took at least 1 herbal supplement including use of Echinacea, Ginkgo biloba, ginseng, or St.John's wort. Yu 2004
  Numerous clinical trials carried out on echinacea preparations show that the extracts shorten the duration and severity of colds and other upper respiratory infections when given as soon as symptoms become evident. Block 2003
  Among 575 ambulatory surgery patients coming to a busy Canadian surgical day care unit, 45 different identifiable herbs were being taken in total, with echinacea being the most common. Lennox 2003
  [Critical hypokalemic renal tubular acidosis due to Sjogren's syndrome: association with the purported immune stimulant echinacea.]. Logan 2003
  Determination of use of botanical dietary supplements in peri- & postmenopausal women between the ages of 40 & 60 years at University of Illinois at Chicago, showed that commonly used botanicals included soy (42%), green tea (34.68%), Echinacea (15.44%) & St. John's wort (7.34%). Mahady 2003
  In an investigation among 500 randomly selected nurses about knowledge and use of 5 common herbal products including ginkgo and echinacea, 30% nurses addressed the frequency of use, purpose, side effects & interactions of them. Sand-Jecklin 2003
  Survey of 115 surgery patients' intake of herbal preparations and dietary supplements revealed that 50.4% had taken or still took herbal medicine, and the frequently used Traditional medicines were fish oil, ginkgo, Echinacea, Co-Q10, garlic, and hip. [Article in Danish] Vaabengaard 2003
  A survey of adult general medicine patients at a major Canadian teaching hospital on patterns of use and patients' attitudes toward complementary medications revealed that most commonly reported products used were echinacea, garlic pills and ginseng. Cook 2002
  Review on respiratory & allergic diseases reveals that patient with upper respiratory tract infections can expect a shorter duration of symptoms by taking high doses of vitamin C with zinc supplements and adding an herb such as echinacea or Andrographis. Jaber 2002
  A survey of 2723 patients presenting for anaesthesia to determine the extent of use of herbal medicines revealed that the most commonly used compounds among 4.8% patients were, in descending order, garlic, ginseng, ginkgo, St John's wort and echinacea. Skinner 2002
  Among 100 adult cancer patients in a private nonprofit South Florida hospital, with mean age of 59 years, 80% reported using some type of complementary & alternative medicine and 54% took herbal products including green tea, echinacea, grape seed extract, and milk thistle. Bernstein 2001
  Dietary supplement (DS) survey of 70 pharmacists in their personal and professional practices showed that 52.9% of them reported taking DS including echinacea, zinc, and chromium picolinate while fewer than half of pharmacists stated that they have recommended a DS to a patient. Howard 2001
  Assessment of use of nonvitamin, nonmineral (NVNM) dietary supplements among 272 college students indicates that 48.5% took an NVNM supplement & most frequently used products were echinacea, ginseng, & St John's wort. 11 of 19 participants reported some adverse reactions to NVNM. Newberry 2001
  Of 502 diabetic subjects, 78% were taking prescribed medications & 31% were taking alternative medications in which garlic, echinacea, herbal mixtures, glucosamine were the most commonly used alternative medications. Ryan 2001
  Of 150 surveys completed at an academic medical center, 20 women (13%) used dietary supplements during pregnancy to relieve nausea and vomiting. The most common products were echinacea (4/45, 8.9%), pregnancy tea (4/45, 8.9%), and ginger (3/45, 6.7%). Tsui 2001
  Determination of attitudes towards the use of complementary therapies by students of Nursing, Pharmacy and Biomedical Sciences, using a self-administered questionnaire indicates that vitamin C, multivitamins, B group vitamins, garlic, iron and Echinacea are the commonly used products. Wilkinson 2001
  Echinacea vs. the common cold. [No authors listed] 2000
  [A strategic call to utilize Echinacea-garlic in flu-cold seasons]. Abdullah 2000
  An overview of the seven most common medicinal herbs (garlic, ginkgo, ginseng, Echinacea, chamomile, valerian, and feverfew) with implications for the school nurse is discussed. Dockrell 2000
  Echinacea questionable for colds. [No authors listed] 1999
  From pharmacological data it has been assumed that Echinacea purpurea L. Moench (purple coneflower) pressed juice preparations stimulate the innate immune system and increase the resistance to common colds. Allergic reactions, mainly reversible skin reactions, may occur [Article in German] Bauer 1999
  Echinacea in the treatment and prevention of upper respiratory tract infections. Gunning 1999
  Echinacea for the prevention of upper respiratory tract infections. Gunning 1999a
  Echinacea for upper respiratory infections. Lord 1999
  Echinacea is being tried as an agent for immune stimulation but requires more study Zink 1998
  [Phenytoin suppositories and echinacea.] Kaatz 1997
  Echinacin was part of a treatment plan, along with cyclophosphamide, thymostimulin and epirubicin for terminal cancer patients Lersch 1994
  Echinacin was part of therapy for advanced colorectal cancers Lersch 1992
  Polysaccharides i.v. to humans showed early decline of PMN (indicating endothelium adherence) followed by an increase in PMN and monocytes. Myelocytes indicated migration from marrow into the peripheral blood Roesler 1991
  Advanced liver cancer patients treated with echinacin (E purpurea), thymostimulin and cyclophosphamide Lersch 1990
  Echinaceae (84 -112 mg/d) and Sabalae (78 -104 mg/d) to 30 women with incontinence (18), pollakiuria (6) and dysuria (6) provided benefit Timmermans 1990
  [Pertussis therapy with myo-echinacin in pediatric practice.][Article in German] Baetgen 1964
         "Cautions with echinacea in auto immune disease?" at Medical Herbalism
Traditional and Folk Use
  Among elderly people 65-69 years of age, purchasing over-the-counter and prescription drugs, herbal use was 13.9% +/- 0.6% & 12.8% +/- 0.6% respectively and glucosamine, echinacea, and garlic supplements represented the most common herbals used. Bruno 2005
  20 plant extracts which have been widely used as topical applications for wound-healing, anti-aging and disease treatments include ginkgo biloba, echinacea, ginseng, grape seed, green tea, lemon, etc. Hsu 2005
  [Echinacea treatment for the common cold.]. Knight 2005
  [Echinacea: cold comfort.]. [No authors listed] 2004
  [Alternative remedies may activate autoimmune disorders.]. [No authors listed] 2004
  Echinacea, one of the most common herbs used to treat symptoms of the "common cold" or upper respiratory tract allergies, has no common drug interactions but there is a risk of hepatotoxicity, exacerbation of allergies and asthma, and anaphylactic reactions. Bielory 2004
  Review on treatment of acute bacterial rhinosinusitis in adults reveals that mist, zinc salt lozenges, echinacea extract, and vitamin C have no proven benefit in the treatment of acute bacterial rhinosinusitis. Scheid 2004
  [Echinacea for the common cold.]. [No authors listed] 2003
  [Echinacea for the common cold.]. Abrahams 2003
  [Echinacea for the common cold.]. Applequist 2003
  A survey of herbal use in children with attention-deficit-hyperactivity disorder or depression shows that herbal medicines were given most frequently for a behavioral condition, including ginkgo biloba, echinacea, & St. John's wort. Cala 2003
  [Echinacea and clarification.]. Chopra 2003
  [Commonly used herbs.]. Cuddy 2003
  The consumption of the most common functional foods and supplements in 2000 included yoghurt with extra lactic acid bacteria, milk and margarine with extra Ca, Ca tablets, multivitamin and mineral supplements & Echinacea supplements. de Jong 2003
  [Upper respiratory tract infection.]. Del Mar 2003
  [Echinacea as a functional food ingredient.]. Hall 2003
  Information on use of Echinacea from traditional healers ranges from external application for wounds, burns and insect bites to the chewing of roots for toothache and throat infections, and internal application for pain, coughs, stomach cramps and snake bites. [Article in German] Hostettmann 2003
  Among 537 participants including 111 physicians, 30 advanced practice nurses, 46 pharmacists and 350 dietitians, most respondents knew the most common clinical uses of echinacea & St.John's wort. Kemper 2003
  A survey on herbal therapy use in a pediatric emergency department population revealed that the most common therapies reportedly used were aloe plant/juice (44%), echinacea (33%), and sweet oil (25%). Lanski 2003
  Herbal medicine which includes herbal drugs & dietary supplements (Bio-Strath and Echinacea) was especially used to strengthen the immune system among patients. Madsen 2003
  [Echinacea for the common cold.]. Millea 2003
  [Echinacea for the common cold.]. Mittman 2003
  The information presented and indications claimed on the Internet for the 8 best-selling herbal products including ginkgo biloba, St John's wort, echinacea, ginseng, etc, was assessed. Morris 2003
         Type "echinacea" in the search field of D. Moerman's Native American Ethnobotany
  [Echinacea for the common cold.]. Russo 2003
  Among a stratified random sample of 15,985 adult members of a large group model health maintenance organization in northern California, an estimated 32.7% of adult health plan members used at least one supplement. The most frequently used herbs were Echinacea (14.7%)& Gingko biloba (10.9%). Schaffer 2003
  [Echinacea for the common cold.]. Shober 2003
  ["Indian" echinacea.]. Strong 2003
  An evidence-based review on herbs commonly used by women indicates that Echinacea slightly decreases the duration of colds but does not prevent them. Tesch 2003
  Examination of prevalence of dietary supplement use among elite figure skaters, gender differences in supplement use, & differences in nutrient intake of supplement users versus non-users showed Echinacea and ginseng were most popular herbal supplements. Ziegler 2003
  Echinacea for prevention and treatment of upper respiratory infections. [No authors listed] 2002
  [Summaries for patients. Treatment of colds with a capsule form of the herb echinacea.] [No authors listed] 2002
  Review on advances in the Diagnosis and Management of Influenza indicates that Echinacea extracts, steam, chicken soup, ipatropium bromide, and oxymetazoline in adults are the interventions that appear to have the best empirical evidence. Jefferson 2002
  An evidence based review on herbs commonly used by women indicates that Echinacea slightly decreases the duration of colds but does not prevent them. Tesch 2002
  [Echinacea for the common cold: can alternative medicine be evidence-based medicine?] Turner 2002
  [Echinacea.] [No authors listed] 2001
  Review of plants with clinical & scientific evaluation that might be considered for adoption into orthodox medicine indicates that commonly used herbs, such as Echinacea purpura, valerian and ginseng, still do not have sufficient clinical studies to consider them for orthodox use. Pinn 2001
  Among 66 Amish women, 36% used at least one form of complementary and alternative medicine, and ten pregnant Amish women reported using echinacea, St.John's Wort, red clover, garlic and ginseng. von Gruenigen 2001
  Investigation of the use of complementary therapies in a rural region of New South Wales showed that of the vitamins, vitamin C and multivitamins were used most often, with garlic and Echinacea being the most used herbal products. Wilkinson 2001
  Among 135 health maintenance organization patients, 40% of patients had used herbal remedies to treat or prevent a health condition (e.g., common cold) and the remedies most frequently used were garlic, aloe gel, cranberry, and echinacea. Bennett 2000
  Review of immunomodulatory activities of botanicals used by native peoples of North America, focuses particularly on 3 species of purple coneflower (Echinacea) due to widespread use of Echinacea in the United States to boost immunity and prevent upper respiratory infections. Borchers 2000
  [Herbs and the common cold.]. Chichon 2000
  Survey on attitudes and practices of physicians and naturopaths toward herbal products including use during pregnancy and lactation shows the most popular product recommended by both medical doctors and naturopaths was echinacea, followed by St John's Wort. Einarson 2000
  Echinacea is often used to treat infections, especially the common cold due to its able to stimulate the immune system, but study results indicate that it weakens the immune system?s ability to control HIV.[Article in English, French]. [No authors listed] 1999
  [Echinacea: treatment or prevention?]. [No authors listed] 1999
  [From rudbeckia to echinacea: the emergence of the purple cone flower in modern therapeutics.]. Flannery 1999
  The more widely-used herbal preparations designed to help manage or prevent the onset of chronic disease, improve cognitive function, boost overall general well-being, and increase longevity include St. John's wort, ginkgo biloba, echinacea, garlic, and ginger. Ness 1999
  [Echinacea]. Pepping 1999
SAFETY DATA
 
Adverse Effects & Toxicity
  Review on Echinacea species revealed that the chemistry is well documented & the safety issues included the possibility of allergic reactions, the use of echinacea by patients with autoimmune diseases & the potential for echinacea preparations to interact with conventional medicines. Barnes 2005
  Data from clinical studies and spontaneous reporting programmes suggest that adverse events with echinacea are not commonly reported. However, in rare cases, echinacea is associated with allergic reactions that may be severe. Huntley 2005
  Review of dietary supplements which can affect surgical outcomes and follow-up: including feverfew, ginkgo biloba, garlic, ginseng, ginger, valerian, kava, St. John's wort, ephedra (Ma huang or metabolite) & echinacea. Ciocon 2004
  The National Registry of Drug-Induced Ocular Side Effects(OSE) received 263 spontaneous reports, in addition to 60 case reports from the literature. Canthaxanthine, chamomile, Datura, E. purpurea, Ginkgo biloba, licorice, niacin & vitamin A are all associated with clinically significant OSE. Fraunfelder 2004
  use of some herbal supplements has been associated with oral manifestations, including tongue numbness with echinacea. Abebe 2003
  [Chronic use of echinacea should be discouraged.]. Chua 2003
  [...And just how safe is Echinacea?]. [No authors listed] 2002
  Review on herbal medication potential for adverse interactions with analgesic drugs revealed incidences of hepatotoxicity which may be augmented by acetaminophen when concomitantly used with the potentially hepatotoxic herbs Echinacea and kava. Abebe 2002
  [Adverse reactions to complementary and alternative medicine: ragweed's cousin, the coneflower (echinacea), is "a problem more than a sneeze".]. Bielory 2002
  Review on herbal-related calls to regional California Poison Control System, San Francisco to identify herbs most relevant to toxicology, indicated 12 herbs including St John's wort, ma huang, echinacea, guarana, ginkgo, ginseng, valerian, tea tree oil, goldenseal, arnica, yohimbe and kava kava. Haller 2002
  Possible leukopenia associated with long-term use of echinacea. Kemp 2002
  A clinically oriented overview of the efficacy and safety of Ginkgo biloba, St. John's wort, ginseng, Echinacea, saw palmetto and kava were studied based on American experiences & none of them were found to be free of adverse effects. [Article in Swedish] Mattsson 2002
  [Careful with herbal medicines!]. [Article in Spanish] Molina 2002
  Some atopic subjects have positive skin prick test (SPT) results to echinacea in the absence of known exposure. Atopic subjects are overrepresented in those experiencing reactions. Cross-reactivity between echinacea and other environmental allergens is supported by the Australian data. Mullins 2002
  Review on contact sensitization from Compositae-containing herbal remedies & cosmetics revealed that at least 15 species, including German and Roman chamomile, marigold, Echinacea and elecampane have been suspected of sensitization or elicitation of Compositae dermatitis. Paulsen 2002
  Among 233 adverse drug reactions (ADRs) of which 67 occurred in children, reported to the California Poison Control, the most common products involved in ADRs were zinc (38.2%), echinacea (7.7%), chromium picolinate (6.4%) and witch hazel (6%). Yang 2002
  This review suggests that physicians should be familiar with the potential perioperative effects of the commonly used herbal medications to prevent, recognize, and treat potentially serious problems associated with their use and discontinuation. Ang-Lee 2001
  A recent Motherisk study showed that use of echinacea during the first trimester of pregnancy was not associated with increased risk of major malformations. Gallo 2001
  We report a case of recurrent erythema nodosum that is temporally and perhaps causally associated with use of echinacea herbal therapy. Soon 2001
  [Herbals--beware bleeding.]. Ananthanarayan 2000
  The possible adverse health effects associated with prolonged use or higher doses of the most popular medicinal herbs, including Ginkgo biloba, Echinacea angustifolia are identified & characterized by National Toxicology Program which studies the substances to which the population may be exposed. [No authors listed] 1999
  302 well people randomly divided to taking ethanolic extract of roots of E. purpurea or E angustifolia or placebo for 12 weeks. Adverse effects were reported by 18, 10 and 11, respectively. Treatment groups believed that they had more benefit. Melchart 1998
  Echinacea lacks the 1,2 saturated necrine ring associated with hepatoxicity of pyrrolizidine alkaloids but people warned anyway that more than 8 weeks use could be hepatoxic; don't use with steroids, amiodarone, methotrexate, or ketoconazole Miller 1998
  A woman with atopy experienced anaphylaxis after taking, with other supplements, an echinacea extract. Hypersensitivity was confirmed by skinprick and RAST. 5% of atopy patients take echinacea Mullins 1998
  [Echinacea-associated anaphylaxis.] Myers 1998
  Moderate mutagenicity in Salmonella reversion screening of Echinaceae angustifoliae (which does not contain quercetin) Schimmer 1994
  4 weeks orally of many times the human therapeutic dose or single intravenous doses of expressed juice of E purpurea proved virtually non-toxic to rats and mice Mengs 1991
         The National Toxicology Program (NTP) has announced that it will design and initiate studies to identify and characterize possible adverse health effects that may be associated with prolonged use or higher doses of some of the most popular medicinal herbs, including Echinacea angustifolia (NIEHS, NIH)
Interactions
  Clinical trial using 12 healthy volunteers (6 women, 6 men) revealed that the botanical supplements containing Citrus aurantium, milk thistle, or saw palmetto extracts & Echinacea purpurea appear to pose a minimal risk for cytochrome P450-mediated herb-drug interactions in humans. Gurley 2004
  The herb has been recommended as a prophylactic treatment for upper respiratory infection and is widely used for this indication & no significant herb-drug interactions with echinacea have been reported. Kligler 2003
  This review is a brief account of interactions involving garlic, ginkgo, ginseng, echinacea, and St John's wort. [Article in German] Morike 2003
  Anaesthetists and surgeons must be familiar with the effects of herbal medicines and should specifically enquire about the use of herbal medicines during pre-operative assessment. Currently available data suggest that herbal medicines should be ceased 2 weeks before surgery. Hodges 2002
  Many herbal remedies such as echinacea, garlic, ginseng, gingko, ephedra, and St. John's wort found to have potential for adverse interactions with medications commonly prescribed for various cardiovascular disorders. Aggarwal 2001
  No herbal-drug interactions were found for echinacea (Echinacea angustifolia, E. purpurea, E. pallida) in literature searches of the following databases: Medline (via Pubmed), Cochrane Library, Embase and Phytobase. Izzo 2001
  Review on interaction between herbal medicines and drugs shows that problematic plants include Echinacea, Allium cepa, Gingko biloba, Panax ginseng, as well as Hypericum perforatum, Valeriana officinalis, or Glycyrrhiza glabra. [Article in Czech] Tumova 2000
Contraindications
No Records
 
EVIDENCE OF ACTI