Echinacea
American coneflower, black sampson, black susans, cockup hat, comb flower, Echinacea angustifolia, E. pallida,
E.purpurea, hedgehog, Indian head, Missouri snakeroot, purple coneflower, purple Kansas coneflower, red sunflower, rudbeckia, scurvy root, snakeroot
Echinacea is obtained from the dried rhizomes and roots of Echinacea angustifolia and E. pallida, and the roots or aerial
parts of E. purpurea. It may enhance immune system function, with the lipophilic fraction in the roots and leaves producing the most effective immunostimulation. When taken internally, echinacea may increase the number of circulating leukocytes, enhance phagocytosis, stimulate cytokine production, and trigger the alternate complement pathway. In vitro, some components are directly bacteriostatic and exhibit antiviral activity. Applied topically, echinacea can exert local anesthetic activity, antimicrobial activity, and antiinflammatory activity, and it can stimulate fibroblasts.
Echinacea is available as capsules, glycerite, expressed juice, hydroalcoholic extract, lozenges, tablets, tea, tinctures (1:5, 15% to 90% alcohol), and whole dried root. Common trade names include EchinaCare Liquid, Echinacea Glycerite, Echinacea Herbal Comfort, Echinacea Xtra, Echina Fresh, Echinagel, EchinaGuard Liquid, EchinaGuard Pro, and Echinex.
Reported uses
Echinacea is used primarily for treating and preventing upper respiratory tract infections. It’s also used to stimulate the immune system and heal wounds, including abscesses, burns, eczema, and skin ulcers. Echinacea may be used as an
adjunct to a conventional antineoplastic therapy and may provide prophylaxis against upper respiratory tract infections
and the common cold. In addition, it may be used for treatment of urinary tract and yeast infections (recurring vaginal candidiasis). Intravenous and intramuscular use has been reported in some studies to prolong survival time of patients with hepatocellular carcinoma.
Administration
- Capsules containing powdered E. pallida root extract: Equivalent to 300 mg by mouth three times a day
- Expressed juice of E. purpurea (2.5:1, 22% alcohol): 6 to 9 ml by mouth every day, not to exceed 8 weeks
- Hydroalcoholic tincture (15% to 90% alcohol): 3 to 4 ml by mouth three times a day
- Tea (simmer tsp of coarsely powdered herb in 1 cup of boiling water for 10 minutes): 1 cup of freshly made tea taken several times daily for colds
- Whole dried root: 1 to 2 g by mouth three times a day.
Hazards
Echinacea has been associated with unpleasant taste, nausea, vomiting, minor GI symptoms, diuresis, allergic reaction, fever, and tachyphylaxis. The intravenous use of echinacea may lead to shivering, muscle weakness, and pain at injection site. Herbal products that contain alcohol may precipitate a disulfiram-like reaction when used with disulfiram or metronida zole. Decreased effectiveness may be observed when used with immunosuppressants such as cyclosporine. Preliminary evidence shows that echinacea can inhibt cytochrome P450 3A4 enzyme, affecting drugs metabolized by this system.
Echinacea preparations containing alcohol may enhance CNS depression when used with alcohol.
Patients with HIV infection, AIDS, tuberculosis, collagen disease, multiple sclerosis, or autoimmune disease should avoid use. Pregnant and breast-feeding patients should also avoid use.
Clinical considerations
- Daily dose depends on the preparation and potency but use shouldn’t continue for more than 8 weeks. Consult specific manufacturer’s instructions for parenteral administration, if applicable.
- Echinacea is considered supportive treatment for infection; it shouldn’t be used in place of antibiotic therapy.
- Some active components may be waterinsoluble.
- Echinacea is usually taken at the first sign of illness and continued for up to 14 days. Regular prophylactic use isn’t recommended.
- Herbalists recommend using liquid preparations because it is believed that echinacea functions in the mouth and should have direct contact with the lymph tissues at the back of the throat.
- Some tinctures contain between 15% and 90% alcohol, which may be unsuitable for children and adolescents, alcoholics, and patients with hepatic disease.
- Advise patient not to delay seeking appropriate medical evaluation for a prolonged illness.
- Advise patient that prolonged use may result in overstimulation of the immune system and possible immune suppression. Echinacea shouldn’t be used for more than 14 days for supportive treatment of infection.
- The herb should be stored away from direct light.
- Advise patient to keep this and other herbal products out of reach of children.
- Tell patient to remind pharmacist of any herbal or dietary supplement that he’s taking when obtaining a new prescription.
- Advise patient to consult his health care provider before using an herbal preparation because a treatment with proven efficacy may be available.
Research summary
Approximately 15 double-blind, placebocontrolled studies provided evidence strongly suggesting that various echinacea species can significantly reduce the duration and severity of illness. However, regular prophylactic use of echinacea has not been found to significantly reduce the incidence of infections.
Tagged under:anesthetic activity black susans echinacea echinacea angustifolia herbal comfort Herbs purple coneflower respiratory tract infections snakeroot upper respiratory tract infections yeast infections Posted by editor on March 6th, 2008 | Filed under Herbs
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