Echinacea: Basics, Benefits, and Safety
Key Takeaways
Echinacea is a plant that has been used for centuries to treat symptoms of minor health conditions, like the common cold and certain skin conditions.
Echinacea is widely used as a treatment and prevention option for upper respiratory infections, but there is no data to support a proven benefit. There may be some benefit to using topical echinacea for skin health.
Echinacea should only be for short-term use. Safety of long-term use has not been proven and may be associated with liver problems or immune dysfunction.
Table of contents
What is echinacea?
Echinacea is derived from a group of wildflowers grown in North America. People have used it for centuries as a treatment for various minor health conditions ranging from the common cold to skin wounds.
People often use echinacea to reduce the symptoms and shorten the course of upper respiratory infections, like the flu or the common cold. It has also been used topically for skin health and acne.
Echinacea: Sources and supplements
There are multiple varieties of the echinacea plant, also called the coneflower. Echinacea purpurea, Echinacea angustifolia, and Echinacea pallida are the types that most people use as dietary supplements. It is unclear if parts of the plant have better medicinal properties than others. But the root, flowers, and leaves have all been used in supplements.
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Echinacea supplements can come in different forms, including:
Teas
Tinctures (concentrated liquid extract)
Capsules
Tablets
Dried herbs
Creams
Gels
If you are using echinacea for your skin, it is best to choose a formulation that you can apply to your skin, like a cream or gel.
Echinacea supplement dosing
There is no standard dose of echinacea. With so many different types of supplements available, doses vary widely by manufacturer and product. For treatment of upper respiratory infections, it is generally recommended that you take the supplements at the first sign of illness.
Common doses of echinacea include:
1 c of tea up to four times per day
Up to 300 mg of dried extract three times per day
Up to 3 mL (60 drops) of liquid extract three times per day
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You should use echinacea short term only. There is no scientific evidence for exactly how long you can safely use it.
Is it OK to take echinacea every day?
Echinacea has been proven to be safe for short-term use. But there is no formal recommendation for exactly how long echinacea is safe to use. Some research indicates that it may be safe to use for up to 8 weeks.
Common uses for echinacea supplements
People use echinacea to prevent and treat a variety of infections, including:
Common cold
Flu
Sore throat
People use topical echinacea to treat skin conditions such as:
Acne
Dry skin
Wounds
The science behind echinacea
It is not entirely clear how echinacea works, but laboratory studies suggest that it may boost the immune system by increasing the number and action of white blood cells. These cells fight infection and help clear it from your body. Echinacea may also work to decrease inflammation by preventing the activity of certain proteins.
However, despite extensive study, there is no scientific evidence that taking echinacea is helpful for treating upper respiratory infections. It makes no difference which variety of echinacea plant, which plant parts, or which type of supplement preparation researchers study.
What are the benefits of echinacea?
There is evidence to support the benefit of topical echinacea (applied to the skin). Studies have shown that it may help with acne.
Is echinacea good for COVID-19?
There is limited data available on the effects of echinacea on COVID-19. Preliminary research shows that there may be a potential benefit, but more data is needed before making any conclusions.
Echinacea supplement interactions
Echinacea has a low risk of drug interactions, but some are still possible. Echinacea may interact with medications such as:
Immunosuppressants, such as cyclosporine (Sandimmune)
Certain antidepressants, like duloxetine (Cymbalta), mirtazapine (Remeron), and fluvoxamine
Certain antipsychotics, like aripiprazole (Abilify), quetiapine (Seroquel), and haloperidol
Certain cholesterol medications, like lovastatin
Certain sedative medications, like midazolam
Fexofenadine (Allegra)
Itraconazole (Sporanox)
Warfarin (Coumadin)
This is not a full list of potential interactions. Check with your pharmacist or healthcare provider to see if any of your medications or supplements may interact with echinacea.
Echinacea supplement side effects
Echinacea is usually safe for adults to take, but like all other medications and supplements, side effects are possible. They’re often uncommon, but people do report:
Nausea
Vomiting
Stomach pain
Dizziness
Numbness or tingling of the tongue
Worsening asthma symptoms
Safety of echinacea supplements
Echinacea is generally safe to use. But there are a few things to keep in mind before you try it:
There is not much data about the safety of using echinacea for long periods of time. Some studies suggest that long-term use may lead to liver problems or a decreased immune response.
It’s possible that people with allergies to certain plants, such as ragweed, daisies, or marigolds, could be allergic to echinacea. Symptoms of an allergic reaction to echinacea may include difficulty breathing, swelling of the face, or skin rashes.
If you take immunosuppressants (medications that weaken your immune system) or have a health condition that impacts your immune system, you should use echinacea with caution. Echinacea can make treatments for these conditions less effective.
It’s not clear if echinacea is safe to use while pregnant or nursing.
Disclaimer: The FDA does not test supplements for safety and effectiveness. Supplements can contain harmful substances. They can also affect how your medications work. Always speak with your healthcare provider before taking any supplement.
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References
Aucoin, M., et al. (2021). A systematic review on the effects of echinacea supplementation on cytokine levels: Is there a role in COVID-19? Metabolism Open.
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Gurley, B. J., et al. (2012). Pharmacokinetic herb-drug interactions (part 2): Drug interactions involving popular botanical dietary supplements and their clinical relevance. Planta Medica.
Karsch-Völk, M., et al. (2014). Echinacea for preventing and treating the common cold. Cochrane Database of Systematic Reviews.
Kemp, D. E., et al. (2002). Possible leukopenia associated with long-term use of echinacea. Journal of the American Board of Family Practice.
Kligler, B. (2003). Echinacea. American Family Physician.
Low, Y., et al. (2018). Drug–drug interactions involving antidepressants: Focus on desvenlafaxine. Neuropsychiatric Disease and Treatment.
Manayi, A., et al. (2015). Echinacea purpurea: Pharmacology, phytochemistry and analysis methods. Pharmacognosy Reviews.
National Center for Complementary and Integrative Health. (2020). Echinacea.
Shane-McWhorter, L. (2022). Echinacea. Merck Manual Consumer Version.
Sharma, M., et al. (2010). The potential use of echinacea in acne: Control of Propionibacterium acnes growth and inflammation. Phytotherapy Research.
U.S. Food and Drug Administration. (2022). What you need to know about dietary supplements.
Yale, S. H., et al. (2004). Echinacea purpurea therapy for the treatment of the common cold: A randomized, double-blind, placebo-controlled clinical trial. JAMA Internal Medicine.
