Echinacea

Precautions

Allergy: cases of anaphylaxis, acute asthma and urticaria have been reported in Australia, especially in atopic individuals (allergic background), who may react from the very first intake; a case of anaphylaxis confirmed by tests is published in an atopic woman. If you are allergic or asthmatic, the safety review calls for particular caution. In 407 children aged 2 to 11 years, skin rashes were more frequent with echinacea (7.1% vs 2.7% under placebo); the most common adverse effects are digestive disorders and rashes. In the prevention trials of the Cochrane review, slightly more participants stopped due to adverse effects. Medications: in 12 volunteers, a root extract accelerated the elimination of drugs eliminated by the CYP3A enzyme and slowed down that of drugs eliminated by CYP1A2; in 13 volunteers, CYP3A activity increased without changing lopinavir-ritonavir levels. Pregnancy: in 206 women who took it during pregnancy, including 112 in the first trimester, no more malformations or miscarriages than in the control group, but the safety review considers the data insufficient for pregnancy and breastfeeding. Limitations: to cure a cold, neither the Cochrane review nor four trials (128 to 713 people) find any effect on duration or severity, and the 2019 meta-analysis does not find any on duration either. Induced colds contradict each other: one meta-analysis finds 55% less risk with standardized extracts, the trial on 399 volunteers finds nothing. A 12-week prevention trial in 302 volunteers finds no significant effect, and the effects of the 2007 meta-analysis (58% fewer colds, 1.4 days less) are much larger than those of the Cochrane review.