Echinacea

Echinacea purpurea · Echinacea angustifolia · Purple Coneflower

Snapshot

Indications	Contraindications
Common cold prevention¹ Respiratory infections in children² Fewer antibiotic courses in children³ Common cold symptom relief⁴ Atopic eczema (topical)⁵ Immune cytokine modulation^6–9	Asteraceae family allergy⁴ Autoimmune disease⁴ Immunosuppressive therapy¹⁰

Echinacea is a sunflower-family genus; Echinacea purpurea, Echinacea angustifolia, and Echinacea pallida are the species commonly used in herbal medicine¹¹. It is taken as a nonspecific immune stimulant, acting through immune modulation and cytokine regulation¹¹. People use it for the common cold and other respiratory infections, and topically for eczema, where the trials are few¹².

The evidence is split. A Cochrane review found no demonstrated benefit for treating colds and a possible weak preventive effect¹³. A 2019 meta-analysis found fewer upper respiratory tract infections but no clear effect on duration. In children, a 2025 meta-analysis found fewer infections and less antibiotic use, though mild side effects were somewhat more common². A 2025 systematic scoping review named echinacea among fifteen herbal supplements with immunostimulatory properties that may trigger or exacerbate autoimmune skin disease¹⁴. Products are mostly capsules and liquids, and preparations differ by species and plant part; see Form comparison¹³.

The most consequential caution is hypersensitivity: the European Medicines Agency traditional-use monograph lists allergy to Asteraceae plants as a contraindication and advises against use in autoimmune disease and immunosuppression⁴. Health Canada labels ask for a practitioner's advice before use alongside immunosuppressants¹⁰.

Last updated October 16, 2026. Read how we make monographs.

In the full monograph

70 sources, 59 studies

When to useThe situations practitioners use it for, each with the reason and the study behind it.
SafetyWho should avoid it, who needs extra care, and the side effects reported in studies.
InteractionsThe medicines and supplements it interacts with, the effect of each, and what labeling says to watch.
Protocol notesThe doses used in studies, how and when they were taken, and how the forms on the market compare.
How it worksWhat it is and how it works in the body, in plain terms.
Published studiesThe studies behind each use, popular claims checked against them, and trials still under way.
Word of mouthWhat patients and practitioners report online, kept separate from the clinical evidence.
Clinical perspectiveA closing read of where the evidence is solid, where it is thin, and what has not been studied.

Snapshot

In the full monograph

Sources