Common Name Echinacea, Coneflower

Latin Binomial Echinacea purpurea L. MOENCH

Part(s) Used Rhizome, root

Pharmacopoeial & Other Monographs

AHP (15)
BHC 1992 (19)
BHMA 2003 (30)
BHP 1996 (21)
BP 2007 (33)
Complete German Commission E 1998 (17)
ESCOP 2003 (31)
Expanded German Commission E 1998 (18)
Martindale 35th Edition (34)
Ph Eu 2007 (32)
US 29/NF24 (35)
WHO Volume 1 1999 (28)

Active Constituents

Alkamides
1,2 Dodeca-2E,4E,8Z,10E-tetraenoic acid isobutylamide
1,2 Dodeca-2E,4E,8Z,10Z-tetraenoic acid isobutylamide

Phenylpropanoids
Caffeic acid esters of quinic acid
1,3-Dicaffecylquinic acid

Tartaric acid
Caftaric acid

Caffeic acid glycosides Echinacoside

Side Effects E. purpurea root can inhibit CYP1A2 and selectively modulate CYP3a. Read More

Echinacea should be used with caution in patients receiving therapeutic agents with a narrow therapeutic range and which are substrates for these CYP enzymes. (1) Echinacea species belong to the Asteraceae family, which are known to cause allergic reactions.

Mild gastrointestinal symptoms.

Quality Control of Commercial Products Several commercial echinacea products have performed poorly in examinations of quality. Only 56% or 14/25 commercial products sold in the US passed assessments for quality. (1)
Fresh echinacea herb contains three times the amount of alkamide than does the dried plant echinacea. Furthermore, the concentrations fo active constituents vary due to growing, drying, and storage conditions. Finally, commercial echinacea samples and marketed echinacea products may contain one or more of three echinacea species. (1)

Herbal Use/Indication Current interest in the medicinal use of echinacea is focused on its use as an immunostimulant. Echinacea is used to treat and prevent the common cold, influenza, and upper respiratory tract infections (URTIs). (1)

Dosage 900 mg per day. Should not exceed an 8 week duration. (17)(26)

Therapeutic Effects Many clinical trials of echinacea preparations have reported effects superior to those of placebo in the prevention and treatment of URTIs. Read More

However, evidence of efficacy is not definitive as studies have included different patient groups and tested various different preparations and dosing regiments. As such, there is insufficient evidence to recommend any specific echinacea products, or to advise an optimal dose and therapeutic duration. (1)

Contra-Indications

General
Contra-indicated in patients with progressive systemic disease, such as tuberculosis, leukemia, collagen disorders, multiple sclerosis, and other autoimmune diseases. (27)

Caution should be used in patients taking immunosuppressant drugs.

E. purpurea root inhibits CYP1A2 and selectively modulates CYP3A activity. Intestinal CYP3A is inhibited while hepatic CYP3A activity is induced. (1)

Pregnancy and lactation Since there is a lack of data on the safety of echinacea preparations taken during pregnancy and lactation, and given that the benefits of specific echinacea preparations have not been established definitely, excessive use during these periods should be avoided as a general precaution. (1)

AHP

BHC 1992

BHMA 2003

BHP 1996

BP 2007

Complete German Commission E 1998

ESCOP 2003

Expanded German Commission E 1998

Martindale 35th Edition

Ph Eu 2007

US 29/NF24

WHO Volume 1 1999

Barnes J, Anderson LA, Phillipson DJ. Herbal Medicines. Third edition. Grayslake, Il Phrmaceutical Press; 2007. 710p.

Monographs on the Medicinal Uses of Plant Drugs, Fascicules 1 and 2 (1996), Fascicules 3, 4 and 5 (1997), Fascicule 6 (1999). Exeter: European Scintific Cooperative on Phytotherapy.

Schulz V, Hansel R, Tyler V. Rational Phytotherapy. A Physicians' Guide to Herbal Medicine. Berlin: Springer-Verlag, 1998.