Drug Safety

, Volume 28, Issue 5, pp 387–400 | Cite as

The Safety of Herbal Medicinal Products Derived from Echinacea Species

A Systematic Review
  • Alyson L. Huntley
  • Joanna Thompson Coon
  • Edzard Ernst
Review Article


Echinacea spp. are native to North America and were traditionally used by the Indian tribes for a variety of ailments, including mouth sores, colds and snakebites. The three most commonly used Echinacea spp. are E. angustifolia, E. pallida and E. purpurea. Systematic literature searches were conducted in six electronic databases and the reference lists of all of the papers located were checked for further relevant publications. Information was also sought from the spontaneous reporting programmes of the WHO and national drug safety bodies. Twenty-three manufacturers of echinacea were contacted and asked for data held on file. Finally our own departmental files were searched. No language restrictions were imposed. Combination products and homeopathic preparations were excluded.

Data from clinical studies and spontaneous reporting programmes suggest that adverse events with echinacea are not commonly reported. Gastrointestinal upsets and rashes occur most frequently. However, in rare cases, echinacea can be associated with allergic reactions that may be severe. Although there is a large amount of data that investigates the efficacy of echinacea, safety issues and the monitoring of adverse events have not been focused on.

Short-term use of echinacea is associated with a relatively good safety profile, with a slight risk of transient, reversible, adverse events. The association of echinacea with allergic reactions is supported by the present evaluation. While these reactions are likely to be rare, patients with allergy or asthma should carefully consider their use of echinacea. The use of echinacea products during pregnancy and lactation would appear to be ill-advised in light of the paucity of data in this area.


Allergic Rhinitis Loratadine Healthcare Product Regulatory Agency Adverse Drug Reaction Advisory Committee Homeopathic Preparation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Alison Huntley was sponsored by Boots the Chemists. The authors have no conflicts of interest that are directly relevant to the content of this review.


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Copyright information

© Adis Data Information BV 2005

Authors and Affiliations

  • Alyson L. Huntley
    • 1
  • Joanna Thompson Coon
    • 1
  • Edzard Ernst
    • 1
  1. 1.Peninsula Medical School, Complementary Medicine, Universities of Exeter and PlymouthExeterUK

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