What is it?
Echinacea is an herb. Several species of the echinacea plant are used to make medicine from its leaves, flower, and root.
Echinacea is widely used to fight infections, especially the common cold and other upper respiratory infections. Some people take echinacea at the first sign of a cold, hoping they will be able to keep the cold from developing. Other people take echinacea after cold symptoms have started, hoping they can make symptoms less severe. The people who use echinacea to treat symptoms have the right idea. Research to date shows that echinacea probably modestly reduces cold symptoms, but it’s not clear whether it helps prevent colds from developing.
Echinacea is also used against many other infections including the flu, urinary tract infections, vaginal yeast infections, genital herpes, bloodstream infections (septicemia), gum disease, tonsillitis, streptococcus infections, syphilis, typhoid, malaria, and diphtheria.
Other uses not related to infection include chronic fatigue syndrome (CFS), rheumatism, migraines, acid indigestion, pain, dizziness, rattlesnake bites, and attention deficit-hyperactivity disorder (ADHD).
Sometimes people apply echinacea to their skin to treat boils, abscesses, skin wounds, ulcers, burns, eczema, psoriasis, UV radiation skin damage, herpes simplex, bee stings, and hemorrhoids.
Echinacea species are native to North America and were used as traditional herbal remedies by the Great Plains Indian tribes. Later, settlers followed the Indians’ example and began using echinacea for medicinal purposes as well. For a time, echinacea enjoyed official status as a result of being listed in the US National Formulary from 1916-1950. However, use of echinacea fell out of favor in the United States with the discovery of antibiotics and due to the lack of scientific evidence supporting its use. But now, people are becoming interested in echinacea again because some antibiotics don’t work as well as they used to against certain bacteria.
Commercially available echinacea products come in many forms including tablets, juice, and tea.
There are concerns about the quality of some echinacea products on the market. Echinacea products are frequently mislabeled, and some may not even contain echinacea, despite label claims. Don’t be fooled by the term “standardized.” It doesn’t necessarily indicate accurate labeling. Also, some echinacea products have been contaminated with selenium, arsenic, and lead.
How effective is it?
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
The effectiveness ratings for ECHINACEA are as follows:
Possibly effective for...
- Common cold. Many scientific studies show that taking some echinacea products when cold symptoms are first noticed can modestly reduce symptoms of the common cold in adults. But other scientific studies show no benefit. The problem is that scientific studies have used different types of echinacea plants and different methods of preparation. Since the studies have not been consistent, it is not surprising that different studies show different results. If it helps for treating a cold, the benefit will likely be modest at best. It also isn’t clear whether echinacea can help PREVENT colds. Any benefit is likely to be modest.
- Vaginal yeast infections. Taking echinacea and applying a medicated cream to the skin seems to lower the recurrence rate of infection to about 16% compared to 60.5% with econazole alone.
Possibly ineffective for...
- Ear infection. Early research suggests that taking a liquid echinacea extract does not prevent ear infections in children who are prone to ear infections. The risk of ear infection was actually increased by 1.59 times in children receiving echinacea.
Insufficient evidence to rate effectiveness for...
- Anxiety. Early research suggests that taking 40 mg of echinacea daily for one week reduces anxiety. It does not seem to reduce anxiety when taken at a lower dose.
- Exercise performance. Early research shows that taking 8 grams of echinacea daily for 28 days improves breathing capacity during exercise in healthy men.
- Gingivitis. Early research suggests that applying a patch in the mouth or using a mouth rinse containing Centella asiatica, Echinacea purpurea, and Sambucus nigra for 14 days improves gingivitis in people with long-term gum disease.
- Genital herpes (Herpes simplex virus, HSV). Evidence on the effect of echinacea for the treatment of HSV is unclear. Some research shows that taking a specific echinacea extract (Echinaforce by Bioforce AG) 800 mg twice daily for 6 months does not seem to prevent or reduce the frequency or duration of recurrent genital herpes. However, other research shows that taking a combination product containing echinacea (Esberitox) 3-5 times daily reduces itchiness, tension, and pain in most people with HSV.
- Human papilloma virus (HPV). Early research shows that taking a combination product containing echinacea, Andrographis paniculata, grapefruit, papaya, Tabebuia, and Uncaria (Erbavita) daily for one month reduces the recurrence of anal warts in people who had surgical removal of anal warts.
- Influenza (flu). Taking echinacea by mouth might slightly reduce some symptoms of the flu. However, there is not enough evidence to know if echinacea can treat or prevent the flu.
- Low white blood cell count (Leukopenia). Administering a part of echinacea through the vein (intravenously) might reduce white blood cell loss caused by chemotherapy. In early research, taking 275 mg of echinacea by mouth twice daily for two weeks also reduced blood cell damage caused by radiation. In other research, taking 50 drops of an echinacea product (Esberitox N) three times daily in between chemoradiation treatments improved blood cell numbers in people who had received chemotherapy for 6 months or less, but not in people who had received chemotherapy for longer periods of time.
- Tonsillitis. Early research shows that spraying a specific product containing sage and echinacea every two hours up to 10 times daily for up to five days improved sore throat symptoms as well as commonly used drug sprays in people with tonsillitis. Other early research suggests that taking 50 drops of a product containing echinacea (Esberitox) three times daily for two weeks, along with an antibiotic, reduced sore throat and increased overall well-being in people with tonsillitis.
- Eye inflammation (Uveitis). Early research suggests that taking 150 mg of an echinacea product (Iridium, SOOFT, Montegiorgio, Ageoli, Italy) twice daily, in addition to eye drops and a steroid used to treat inflammation, for four weeks, does not improve vision any more than eye drops and steroids alone in people with eye inflammation.
- Warts. Early research suggests that taking 60 mg of echinacea by mouth daily for up to 3 months does not clear warts on the skin.
- Urinary tract infections (UTIs).
- Migraine headaches.
- Chronic fatigue syndrome (CFS).
- Bee stings.
- Attention deficit-hyperactivity disorder (ADHD).
- Other conditions.
More evidence is needed to rate echinacea for these uses.
Echinacea seems to activate chemicals in the body that decrease inflammation, which might reduce cold and flu symptoms.
Laboratory research suggests that echinacea can stimulate the body’s immune system, but there is no evidence that this occurs in people.
Echinacea also seems to contain some chemicals that can attack yeast and other kinds of fungi directly.
Echinacea is LIKELY SAFE for most people when used short-term. There is not enough information to know if echinacea is safe for long-term use. Some side effects have been reported such as fever, nausea, vomiting, unpleasant taste, stomach pain, diarrhea, sore throat, dry mouth, headache, numbness of the tongue, dizziness, insomnia, disorientation, and joint and muscle aches.
Echinacea is POSSIBLY SAFE in children. It seems to be safe in most children ages 2-11 years. However, about 7% of these children may experience a rash that could be due to an allergic reaction. There is some concern that allergic reactions to echinacea could be more severe in some children. For this reason, some regulatory organizations have recommended against giving echinacea to children under 12 years of age.
Echinacea is most likely to cause allergic reactions in children and adults who are allergic to ragweed, mums, marigolds, or daisies. If you have allergies, be sure to check with your healthcare provider before taking echinacea.
Applying echinacea to the skin can cause redness, itchiness, or a rash.
Special precautions & warnings:
Pregnancy or breast-feeding: Not enough is known about the use of echinacea during pregnancy and breast-feeding. Stay on the safe side and avoid use.
“Auto-immune disorders” such as such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), a skin disorder called pemphigus vulgaris, or others: Echinacea might have an effect on the immune system that could make these conditions worse. Don’t take echinacea if you have an auto-immune disorder.
An inherited tendency toward allergies (atopy): People with this condition are more likely to develop an allergic reaction to echinacea. It’s best to avoid exposure to echinacea if you have this condition.
Be cautious with this combination.
The body breaks down caffeine to get rid of it. Echinacea might decrease how quickly the body breaks down caffeine. Taking echinacea along with caffeine might cause too much caffeine in the bloodstream and increase the risk of side effects. Common side effects include jitteriness, headache, and fast heartbeat.
Etoposide is changed and broken down by the body. Echinacea might change how the body breaks down some medications. Taking echinacea along with etoposide might increase the side effects of etoposide. Before taking echinacea, talk to your healthcare provider if you are taking any medications that are changed by the body.
Medications changed by the body (Cytochrome P450 3A4 (CYP3A4) substrates)
Some medications are changed and broken down by the body. Echinacea might change how the body breaks down some medications. Taking echinacea along with some medications might increase the effects and side effects of some medications. Before taking echinacea, talk to your healthcare provider if you are taking any medications that are changed by the body.
Some medications changed by the body include lovastatin (Mevacor), clarithromycin (Biaxin), cyclosporine (Neoral, Sandimmune), diltiazem (Cardizem), estrogens, indinavir (Crixivan), triazolam (Halcion), and many others.
Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates)
Some medications are changed and broken down by the liver. Echinacea might decrease how quickly the liver breaks down some medications. Taking echinacea along with some medications might increase the effects and side effects of some medications. Before taking echinacea, talk to your healthcare provider if you are taking any medications that are changed by the liver.
Some of the medications that are changed by the liver include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, zileuton (Zyflo), zolmitriptan (Zomig), and others
Medications that decrease the immune system (Immunosuppressants)
Echinacea can increase the activity of the immune system. Taking echinacea along with some medications that decrease the immune system might decrease these medications' effectiveness.
Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.
Be watchful with this combination.
Taking midazolam (Versed) with echinacea increases how much midazolam (Versed) the body absorbs. This might increase the effects and side effects of midazolam (Versed), but more information is needed.
Warfarin (Coumadin) is used to slow blood clotting. The body breaks down warfarin (Coumadin) to get rid of it. Echinacea might increase the breakdown and decrease the effectiveness of warfarin (Coumadin). Decreasing the effectiveness of warfarin (Coumadin) might increase the risk of clotting. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.
There are no known interactions with herbs and supplements.
There are no known interactions with foods.
The following doses have been studied in scientific research:
For treatment of upper respiratory infections including the common cold and influenza, a wide variety of doses have been used depending on how the echinacea is prepared. These preparations include:
- A tablet containing 6.78 mg of Echinacea purpurea crude extract based on 95% herb and 5% root (Echinaforce, Bioforce AG): two tablets given 3 times daily.
- Freeze-dried echinacea juice extract capsules: 100 mg three times daily.
- Echinacea purpurea herb juice: a daily dose of 6-9 mL for up to a maximum of 8 weeks. Echinacea purpurea herb juice has also been used in a dose of 20 drops every 2 hours for the first day followed by 20 drops three times daily until cold or flu symptoms improve.
- An echinacea pallida root tincture equivalent to 900 mg herb daily.
- An echinacea herbal compound tea (Echinacea Plus, Traditional Medicinals), consisting of leaves, flowers, and stems of Echinacea purpurea and Echinacea angustifolia plus dried extract of Echinacea purpurea root, has been used by drinking 5-6 cups of tea on the first day of symptoms and titrating down to 1 cup per day over the next 5 days. The tea is prepared by pouring 8 ounces of boiling water over one tea bag and steeping, covered, for 10-15 minutes.
- Echinacea liquid (Echinagard): 20 drops every 2 hours for the first day of symptoms, then 3 times daily for up to 10 days.
- A tablet containing 100 mg of a proprietary Echinacea angustifolia root extract (Monoselect Echinacea, PharmExtracta, Italy): 2 tablets daily for 15 days, then 1 tablet daily for 15 days, then 1 tablet every other day for 60 days to help prevent colds and the flu.
- Echinacea purpurea liquid: 0.9 mL 3 times daily for 4 months to help prevent colds.
American Cone Flower, Black Sampson, Black Susans, Brauneria Angustifolia, Brauneria Pallida, Comb Flower, Coneflower, Echinacea Angustifolia, Echinacea Pallida, Echinacea Purpurea, Echinaceawurzel, Échinacée, Échinacée Angustifolia, Échinacée Pallida, Échinacée Pourpre, Échinacée Purpurea, Equinácea, Fleur à Hérisson, Hedgehog, Igelkopfwurzel, Indian Head, Kansas Snakeroot, Narrow-Leaved Purple Cone Flower, Pale Coneflower, Purple Cone Flower, Purpursonnenhutkraut, Purpursonnenhutwurzel, Racine d'echininacea, Red Sunflower, Rock-Up-Hat, Roter Sonnenhut, Rudbeckie Pourpre, Schmallblaettrige Kegelblumenwurzel, Schmallblaettriger Sonnenhut, Scurvy Root, Snakeroot, Sonnenhutwurzel.
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).
To see all references for the Echinacea page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/981.html.
- Abdul MI, Jiang X, Williams KM, et al. Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects.
Br J Clin.Pharmacol. 2010;69:508-15.
- Bossaer JB and Odle BL. Probable etoposide interaction with Echinacea. J.Diet.Suppl 2012;9:90-5.
- Zedan H, Hofny ER, and Ismail SA. Propolis as an alternative treatment for cutaneous warts. Int.J Dermatol 2009;48:1246-49.
- Neri PG, Stagni R, Filippello M, et al. Oral Echinacea purpurea extract in low-grade, steroid-dependent, autoimmune idiopathic uveitis: a pilot study. J Ocul.Pharmacol Ther 2006;22:431-36.
- von Blumroeder, W. O. [Angina lacunaris. An investigation on how to stimulate the endogenous defense system] (German). Z.Allg.Med. 1985;61:271-273.
- Schapowal A, Berger D, Klein P, et al. Echinacea/sage or chlorhexidine/lidocaine for treating acute sore throats: a randomized double-blind trial. Eur.J Med Res 9-1-2009;14:406-12.
- Bendel R, Bendel V, Renner K, et al. [Supplementary treatment with Esberitox of female patients undergoing curative adjuvant irradiation following breast cancer]. Strahlenther.Onkol. 1988;164:278-83.
- Bendel R, Bendel V, Renner K, et al. [Additional treatment with Esberitox N in patients with chemo- radiotherapy treatment of advanced breast cancer]. Onkologie. 1989;12 Suppl 3:32-8.
- Joksic G, Petrovic S, Joksic I, et al. Biological effects of Echinacea purpurea on human blood cells. Arh.Hig.Rada Toksikol. 2009;60:165-72.
- Mistrangelo M, Cornaglia S, Pizzio M, et al. Immunostimulation to reduce recurrence after surgery for anal condyloma acuminata: a prospective randomized controlled trial. Colorectal Dis 2010;12:799-803.
Bockhorst H, Gollnick N, Guran S, et al. [Therapy of herpes simplex in practice. Report on the treatment of herpes simplex labialis with Esberitox]. ZFA.(Stuttgart.) 11-20-1982;58:1795-98.
- Grbic J, Wexler I, Celenti R, et al. A phase II trial of a transmucosal herbal patch for the treatment of gingivitis. J Am Dent.Assoc. 2011;142:1168-75.
- Samuels N, Grbic JT, Saffer AJ, et al. Effect of an herbal mouth rinse in preventing periodontal inflammation in an experimental gingivitis model: a pilot study. Compend.Contin.Educ.Dent. 2012;33:204-11.
- Samuels N, Saffer A, Wexler ID, et al. Localized reduction of gingival inflammation using site-specific therapy with a topical gingival patch. J.Clin.Dent. 2012;23:64-7.
- Whitehead MT, Martin TD, Scheett TP, et al. Running economy and maximal oxygen consumption after 4 weeks of oral Echinacea supplementation. J.Strength.Cond.Res. 2012;26:1928-33.
- Haller J, Freund, TF, Pelczer, KG, et al. The anxiolytic potential and psychotropic side effects of an echinacea preparation in laboratory animals and healthy volunteers. Phytother.Res. 2013;27:54-61.
- Wahl RA, Aldous MB, Worden KA, et al. Echinacea purpurea and osteopathic manipulative treatment in children with recurrent otitis media: a randomized controlled trial. BMC.Complement Altern.Med 2008;8:56.
- Goel V, Lovlin R, Chang C, et al. A proprietary extract from the echinacea plant (Echinacea purpurea) enhances systemic immune response during a common cold. Phytother.Res 2005;19:689-94.
- Del-Rio-Navarro BE, Espinosa, Rosales F, et al. Immunostimulants for preventing respiratory tract infection in children. Cochrane Database.Syst.Rev. 2006;:CD004974.
- Bräunig B, Dorn M, Limburg E, and et al. Enhancement of resistance in common cold by Echinacea purpurea radix. Zeitschrift fur Phytotherpie 1992;13:7-13.
- Barrett B, Brown R, Rakel D, Rabago D, et al. Placebo effects and the common cold: a randomized controlled trial. Ann.Fam.Med 2011;9:312-22.
- Di Pierro F, Rapacioli G, Ferrara T, Togni S. Use of a standardized extract from Echinacea angustifolia (Polinacea) for the prevention of respiratory tract infections. Altern Med Rev 2012;17:36-41.
- Jawad M, Schoop R, Suter A, et al. Safety and efficacy profile of Echinacea purpurea to prevent common cold episodes: A randomized, double-blind, placebo-controlled trial. Evid Based Complement Alternat Med 2012;2012:841315. Epub 2012 Sep 16.
- Press Release: Echinacea herbal products should not be used in children under 12 years old. Medicines and Healthcare Products Regulatory Agency (UK). August 20, 2012. Available at: www.mhra.gov.uk/NewsCentre/Pressreleases/CON180627. (Accessed 21 October 2012)
- Schoop R, Klein P, Suter A, Johnston SL. Echinacea in the prevention of induced rhinovirus colds: a meta-analysis. Clin Ther 2006;28:174-83.
- O'Neil J, Hughes S, Lourie A, Zweifler J. Effects of echinacea on the frequency of upper respiratory tract symptoms: a randomized, double-blind, placebo-controlled trial. Ann Allergy Asthma Immunol 2008;100:384-8.
- Shah SA, Sander S, White CM, et al. Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis. Lancet Infect Dis 2007;7:473-80.
- Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77.
- Kocaman O, Hulagu S, Senturk O. Echinacea-induced severe acute hepatitis with features of cholestatic autoimmune hepatitis. Eur J Intern Med 2008;19:148.
- Perri D, Dugoua JJ, Mills E, Koren G. Safety and efficacy of echinacea (Echinacea augustafolia, e. purpurea and e. pallida) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e262-7.
- Linde K, Barrett B, Wolkart K, et al. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev 2006;:CD000530.
- Caruso TJ, Gwaltney JM Jr. Treatment of the common cold with echinacea: a structured review. Clin Infect Dis 2005;40:807-10.
- Krochmal R, Hardy M, Bowerman S, et al. Phytochemical assays of commercial botanical dietary supplements. Evid Based Complement Alternat Med 2004;1:305-3.
- Anon. Echinacea: cold comfort. Consum Rep 2004;69:30-2.
- Turner RB, Bauer R, Woelkart K, et al. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. N Engl J Med 2005;353:341-8.
- Huntley AL, Thompson Coon J, Ernst E. The safety of herbal medicinal products derived from Echinacea species: a systematic review. Drug Saf 2005;28:387-400.
- Speroni E, Govoni P, Guizzardi S, et al. Anti-inflammatory and cicatrizing activity of Echinacea pallida Nutt. root extract. J Ethnopharmacol 2002;79:265-72.
- Coeugniet EG, Kuhnast R. Recurrent candidiasis: Adjuvant immunotherapy with different formulations of Echinacin. Therapiewoche 1986;36:3352-8.
- Barrett B. Medicinal properties of Echinacea: a critical review. Phytomedicine 2003;10:66-86.
- Gilroy CM, Steiner JF, Byers T, et al. Echinacea and truth in labeling. Arch Intern Med 2003;163:699-704.
- Turner RB. Echinacea for the common cold: can alternative medicine be evidence-based medicine? Ann Intern Med 2002;137:1001-2.
- Goel V, Lovlin R, Barton R, et al. Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther 2004;29:75-83.
- Sperber SJ, Shah LP, Gilbert RD, et al. Echinacea purpurea for prevention of experimental rhinovirus colds. Clin Infect Dis 2004;38:1367-71.
- Lee AN, Werth VP. Activation of autoimmunity following use of immunostimulatory herbal supplements. Arch Dermatol 2004;140:723-7.
- Gorski JC, Huang S, Zaheer NA, et al. The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo.Clin Pharmacol Ther 2003;73 (Abstract PDII-A-8):P94.
- Yale SH, Liu K. Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med 2004;164:1237-41.
- Yale SH, Glurich I. Analysis of the inhibitory potential of Ginkgo biloba, Echinacea purpurea, and Serenoa repens on the metabolic activity of cytochrome P450 3A4, 2D6, and 2C9. J Altern Complement Med 2005;11:433-9.
- Schulten B, Bulitta M, Ballering-Bruhl B, et al. Efficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trial. Arzneimittelforschung 2001;51:563-8.
- Barrett BP, Brown RL, Locken K, et al. Treatment of the common cold with unrefined echinacea. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 2002;137:939-46.
- Muller-Jakic B, Breu W, Probstle A, et al. In vitro inhibition of cyclooxygenase and 5-lipoxygenase by alkamides from Echinacea and Achillea species. Planta Med 1994;60:37-40.
- Tragni E, Tubaro A, Melis S, Galli CL. Evidence from two classic irritation tests for an anti-inflammatory action of a natural extract, Echinacina B. Food Chem Toxicol 1985;23:317-9.
- Schwarz E, Metzler J, Diedrich JP, et al. Oral administration of freshly expressed juice of Echinacea purpurea herbs fail to stimulate the nonspecific immune response in healthy young men: results of a double-blind, placebo-controlled crossover study. J Immunother 2002;25:413-20.
- Melchart D, Linde K, Fischer P, Kaesmayr J. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev 2000;2:CD000530.
- Hoheisel O, Sandberg M, Bertram S, et al. Echinagard treatment shortens the course of the common cold: a double blind, placebo-controlled clinical trial. Eur J Clin Res 1997;9:261-268.
- Logan JL, Ahmed J. Critical hypokalemic renal tubular acidosis due to Sjogren's syndrome: association with the purported immune stimulant echinacea. Clin Rheumatol 2003;22:158-9.
- Melchart D, Clemm C, Weber B, et al. Polysaccharides isolated from Echinacea purpurea herba cell cultures to counteract undesired effects of chemotherapy--a pilot study. Phytother Res 2002;16:138-42.
- Turner RB, Riker DK, Gangemi JD. Ineffectiveness of echinacea for prevention of experimental rhinovirus colds. Antimicrob Agents Chemother 2000;44:1708-9.
- Facino RM, Carini M, Aldini G, et al. Echinacoside and caffeoyl conjugates protect collagen from free radical-induced degradation: a potential use of echinacea extracts in the prevention of skin photodamage. Planta Med 1995;61:510-4.
- Percival SS. Use of echinacea in medicine. Biochem Pharmacol 2000;60:155-8.
- Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51.
- Vonau B, Chard S, Mandalia S, et al. Does the extract of the plant Echinacea purpurea influence the clinical course of recurrent genital herpes? Int J STD AIDS 2001;12:154-8.
- Soon SL, Crawford RI. Recurrent erythema nodosum associated with echinacea herbal therapy. J Am Acad Dermatol 2001;44:298-9.
- Gallo M, Sarkar M, Au W, et al. Pregnancy outcome following gestational exposure to echinacea: A prospective controlled study. Arch Intern Med 2000;160:3141-3.
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82.
- Pepping J. Echinacea. Am J Health Syst Pharm 1999;56:121-3.
- Giles JT, Palat CT III, Chien SH, et al. Evaluation of Echinacea for treatment of the common cold. Pharmacother 2000;20:690-7.
- Henneicke-von Zepelin H, Hentschel C, Schnitker J, et al. Efficacy and safety of a fixed combination phytomedicine in the treatment of the common cold (acute viral respiratory tract infection): results of a randomised, double blind, placebo-controlled, multicentre study. Curr Med Res Opin 1999;15:214-27.
- Perry NB, van Klink JW, Burgess EJ, et al. Alkamide levels in Echinacea purpurea: effects of processing, drying and storage. Planta Med 2000;66:54-6.
- Binns SE, Purgina B, Bergeron C. Light-mediated antifungal activity of Echinacea extracts. Plant Med 2000;66:241-4.
- Stimpel M, Proksch A, Wagner H, et al. Macrophage activation and induction of macrophage cytotoxicity by purified polysaccharide fractions from the plant Echinacea purpurea. Infect Immun 1984;46:845-9.
- Luettig B, Steinmuller C, Gifford GE, et al. Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst 1989;81:669-75.
- Parnham MJ. Benefit-risk assessment of the squeezed sap of the purple coneflower (Echinacea purpurea) for long-term oral immunostimulation. Phytomedicine 1996;3:95-102.
- Melchart D, Walther E, Linde K, et al. Echinacea root extracts for the prevention of upper respiratory tract infections: a double-blind, placebo-controlled randomized trial. Arch Fam Med 1998;7:541-5.
- Dorn M, Knick E, Lewith G. Placebo-controlled, double-blind study of Echinaceae pallidae radix in upper respiratory tract infections. Complement Ther Med 1997;5:40-2.
- Lindenmuth GF, Lindenmuth EB. The efficacy of echinacea compound herbal tea preparation on the severity and duration of upper respiratory and flu symptoms: a randomized, double-blind, placebo-controlled study. J Altern Complement Med 2000;6:327-34.
- Taylor JA, Weber W, Standish L, et al. Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial. JAMA 2003;290:2824-30.
- Ondrizek RR, Chan PJ, Patton WC, King A. An alternative medicine study of herbal effects on the penetration of zona-free hamster oocytes and the integrity of sperm deoxyribonucleic acid. Fertil Steril 1999;71:517-22.
- Ondrizek RR, Chan PJ, Patton WC, King A. Inhibition of human sperm motility by specific herbs used in alternative medicine. J Assist Reprod Genet 1999;16:87-91.
- Grimm W, Muller HH. A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections. Am J Med 1999;106:138-43.
- Barrett B, Vohmann M, Calabrese C. Echinacea for upper respiratory infection. J Fam Pract 1999;48:628-35.
- Gunning K. Echinacea in the treatment and prevention of upper respiratory tract infections. West J Med 1999;171:198-200.
- Chavez ML, Chavez PI. Echinacea. Hosp Pharm 1998;33:180-8.
- Awang DVC, Kindack DG. Echinacea. Can Pharm J 1991; 124:512-6.
- Mengs U, Clare CB, Poiley JA. Toxicity of Echinacea purpurea. Acute, subacute and genotoxicity studies. Arzneimittelforschung 1991;41:1076-81.
- Brinkeborn RM, Shah DV, Degenring FH. Echinaforce and other Echinacea fresh plant preparations in the treatment of the common cold. A randomized, placebo controlled, double-blind clinical trial. Phytomedicine 1999;6:1-6.
- Mullins RJ. Allergic reactions to Echinacea. J Allergy Clin Immunol 2000;104:S340-341 (Abstract 1003).
- Mullins RJ. Echinacea-associated anaphylaxis. Med J Aust 1998;168:170-1.
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