Echinacea, Cautions

• Large doses may cause nausea and dizziness. To minimize this effect combine it with a little ginger.
• Large doses may cause mild throat irritation, joint pain, gastric upset
• Do not take continuously for more that three months.
• Do not take if you have an auto-immune disorder such as lupus or multiple sclerosis as echinacea stimulates the immune system.
• Do not take if you have tuberculosis.
• Echinacea can cause an allergic reaction in a small percentage of people.
• Echinaceaif taken during pregnancy may promote spontaneous abortions.  Therefore Echinacea is contra-indicated for pregnant women. (Chow et al 2006) (Barcz et al 2007)

Echinacea significantly reduced plasma concentrations of S-warfarin. However, neither echinacea nor policosanol significantly affected warfarin pharmacodynamics, platelet aggregation or baseline clotting status in healthy subjects.

Safety Study: Gestational exposure to echinacea is not associated with malformations.

Interactions:

• Echinacea may cause inflammation of the liver if used with methotrexate.
• Evidence suggests that Echinacea angustifolia root might inhibit CYP3A4. (CYP is the abbreviation for cytochrome P450 enzymes.  The CYP is usually followed by an Arabic numeral, a letter and another Arabic numeral e.g. CYP 2D6.  These enzymes are found in and on the smooth endoplasmic reticulum of liver and other cells and are responsible for a large number of drug biotransformation reactions.)
• Echinacea may decrease the effects of immunosuppressants and should not be used immediately before, during or after transplant surgery. (LSR)
• Echinacea when combined with acetaminophen may result in increased incidences of hepatotoxicity and nephrotoxicity..