Echinacea Research
42 peer-reviewed studies · Evidence score: 9/10
Efficacy and safety of Echinacea purpurea in treating upper respiratory infections and complications of otitis media in children: Systematic review and meta-analysis
Pham TP et al. • Clinical nutrition ESPEN (2025)
The meta-analysis of nine studies found that E. purpurea was effective in reducing the duration of treatment, the incidence of episodes, and antibiotic usage for URTI in children, with some positive effects on OM.
- The meta-analysis found that E. purpurea significantly benefits URTI, reducing treatment duration (SMD = -0.19, 95 % CI [-0.30; -0.09], p < 0.01), incidence (RR = 0.81, 95 % CI [0.75; 0.87]), and antibiotic use (RR = 0.18, 95 % CI [0.13; 0.25], p < 0.01).
- However, adverse events were moderately increased (RR = 1.38, 95 % CI [1.08; 1.78]), though generally mild.
- For OM, E. purpurea lowered episode incidence (RR = 0.56, 95 % CI [0.44; 0.73], p < 0.01) but did not shorten treatment duration (p = 0.10).
Cochrane review: Echinacea for colds
Karsch-Völk M et al. • Cochrane Database of Systematic Reviews (2014)
Some echinacea products may offer small benefits for colds.
- Modest benefits for some preparations
- Heterogeneity in products studied
- Safe for short-term use
Identifying immunostimulatory herbal supplements that may flare autoimmune skin diseases: a systematic scoping review
Weiner JD et al. • Lupus science & medicine (2025)
We identified 227 herbal supplements with immunostimulatory properties, of which 15 were most strongly supported by the evidence.
- We identified 227 herbal supplements with immunostimulatory properties, of which 15 were most strongly supported by the evidence.
- This article may serve as a reference to help clinicians counsel patients with autoimmune skin diseases on the risks associated with use of specific herbal supplements.
- Further research warranted to confirm findings
Echinacea Supplementation Does Not Impact Aerobic Capacity and Erythropoiesis in Athletes: A Meta-Analysis
Deccy S et al. • Nutrients (2024)
Echinacea supplementation did not influence erythropoietin, hemoglobin, hematocrit, or maximal oxygen uptake in athletes; however, the evidence base is limited.
- There was also no statistically significant change in erythropoietin (effect size -0.29, p = 0.05, 95% CI -0.75-0.17, I2 = 67%) or maximal oxygen uptake (effect size -0.20, p = 0.95, 95% CI -0.60-0.21, I2 = 0%).
- Six studies with a total of 107 athletes were included in the analysis.
- Echinacea supplementation did not influence erythropoietin, hemoglobin, hematocrit, or maximal oxygen uptake in athletes; however, the evidence base is limited.
Herbal Medicine in Children With Respiratory Tract Infection: Systematic Review and Meta-Analysis
Anheyer D et al. • Academic pediatrics (2018)
Because of conflicting evidence in the included studies no concrete conclusion on effects of Echinacea could be drawn so far.
- Because of conflicting evidence in the included studies no concrete conclusion on effects of Echinacea could be drawn so far.
- In the case of Pelargonium sidoides, meta-analysis revealed moderate evidence for efficacy and safety in the treatment of RTIs in children.
- Further research warranted to confirm findings
Interventions for preventing influenza: An overview of Cochrane systematic reviews and a Bayesian network meta-analysis
Yuan Y et al. • Journal of integrative medicine (2021)
High-quality evidence showed that garlic or vaccine had advantages in preventing influenza, and that vitamin C is not effective.
- Among these SRs, 73% scored "high" quality on AMSTAR-II rating.
- High-quality evidence showed that garlic or vaccine had advantages in preventing influenza, and that vitamin C is not effective.
- The effect of other interventions needs to be further verified with high-quality evidence.
Echinacea for the prevention and treatment of upper respiratory tract infections: A systematic review and meta-analysis
David S, Cunningham R • Complementary Therapies in Medicine (2019)
Echinacea products reduced the risk of recurrent respiratory infections and complications including pneumonia, otitis media, and tonsillitis.
- Reduced risk of recurrent respiratory infections by approximately 35%
- Significant reduction in respiratory complications (pneumonia, otitis media)
- Most consistent benefits seen with Echinacea purpurea preparations
Evaluation of documented drug interactions and contraindications associated with herbs and dietary supplements: a systematic literature review
Tsai HH et al. • International journal of clinical practice (2012)
Although HDS-drug interactions and contraindications primarily concerned a relatively small subset of commonly used medications and HDS entities, this review provides the summary to identify patients, HDS products, and medications that are more susceptible to HDS-drug interactions and contraindications.
- Of the 882 HDS-drug interactions being described its mechanism and severity, 42.3% were due to altered pharmacokinetics and 240 were described as major interactions.
- Of the 152 identified HDS contraindications, the most frequent involved gastrointestinal (16.4%), neurological (14.5%), and renal/genitourinary diseases (12.5%).
- The findings would facilitate the health-care professionals to communicate these documented interactions and contraindications to their patients and/or caregivers thereby preventing serious adverse events and improving desired therapeutic outcomes.
A systematic review of the traditional uses, chemistry, and curative aptitude of echinacoside-a phenylethanoid glycoside
Baidya R et al. • Naunyn-Schmiedeberg's archives of pharmacology (2025)
The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
- The ECH contents in the reported plants often own these multifaceted properties, highlighting their importance in clinical research.
- Evident from its therapeutic efficacy, there is a huge potential for a comprehensive understanding of the mechanisms of actions of ECH, which underscores the need for more research in this area.
- The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Medicinal plants--prophylactic and therapeutic options for gastrointestinal and respiratory diseases in calves and piglets? A systematic review
Ayrle H et al. • BMC veterinary research (2016)
Several medicinal plants bear a potential for novel treatment strategies for young livestock.
- Several medicinal plants bear a potential for novel treatment strategies for young livestock.
- There is a need for further research focused on gastrointestinal and respiratory diseases in calves and piglets, and the findings of this review provide a basis on plant selection for future studies.
- Further research warranted to confirm findings
Select Dietary Supplement Ingredients for Preserving and Protecting the Immune System in Healthy Individuals: A Systematic Review
Crawford C et al. • Nutrients (2022)
As we move toward a vision of health promotion and resilience rather than a sole focus on disease prevention and treatment, further work in this area of dietary supplements is of utmost importance.
- Immune health products represent approximately 10% of all US dietary supplement sales.
- The studies included eight of the 27 supplement ingredients identified through a market-driven scoping review.
- Those ingredients used in single ingredient products were echinacea, elderberry, garlic, vitamin A, vitamin C, vitamin D, vitamin E, and zinc.
Interaction of herbal products with prescribed medications: A systematic review and meta-analysis
Awortwe C et al. • Pharmacological research (2019)
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- John's wort (SJW) significantly decreased the AUC (p < 0.0001) and clearance (p = 0.007) of midazolam.
- Echinacea purpurea (EP) significantly increased the clearance of midazolam (p = 0.01).
- Green tea (GT) showed significant 85% decrease in plasma concentration of nadolol.
Alternative therapies for chronic rhinosinusitis: A review
Griffin AS et al. • Ear, nose, & throat journal (2018)
However, higher levels of evidence gleaned from large, well-designed, prospective, randomized, controlled trials are needed before any of these therapies can be recommended.
- We found that while many of the alternative therapies we reviewed might have a firm basis in science, they lack any clinical evidence to support their use specifically for CRS.
- Some emerging therapies, such as therapeutic ultrasonography and phonophoresis, show some promise, based on a growing body of positive evidence.
- In addition, the use of baby shampoo, thyme honey, and bromelain additives to saline lavage in CRS are all supported by clinical evidence, as is Sinupret, an oral preparation that contains echinacea.
A Critical Approach to Evaluating Clinical Efficacy, Adverse Events and Drug Interactions of Herbal Remedies
Izzo AA et al. • Phytotherapy research : PTR (2016)
Copyright © 2016 John Wiley & Sons, Ltd.Copyright © 2016 John Wiley & Sons, Ltd.
- A critical evaluation of the clinical data regarding the adverse effects has shown that herbal remedies are generally better tolerated than synthetic medications.
- Nevertheless, potentially serious adverse events, including herb-drug interactions, have been described.
- This suggests the need to be vigilant when using herbal remedies, particularly in specific conditions, such as during pregnancy and in the paediatric population.
Common cold
Arroll B • BMJ clinical evidence (2011)
In this systematic review we present information relating to the effectiveness and safety of the following interventions: analgesics or anti-inflammatory drugs, antibiotics, antihistamines, decongestants for short-term and for long-term relief, decongestants plus antihistamines, echinacea, steam inhalation, vitamin C, and zinc (intranasal gel or lozenges).
- Systematic review examining Echinacea efficacy
- Published in BMJ clinical evidence (2011)
- Further research warranted to confirm findings
A systematic review of the pharmacokinetic and pharmacodynamic interactions of herbal medicine with warfarin
Choi S et al. • PloS one (2017)
It was difficult to determine whether ten herbal medicines had significant effects on the PK-PD parameters of warfarin.
- Using CONSORT, the reporting percentages for the articles ranged from 36.5% to 61.5% and the mean percentage for all articles was 45.6%.
- It was difficult to determine whether ten herbal medicines had significant effects on the PK-PD parameters of warfarin.
- Low quality of evidence, different compounds within and different compositions of the herbs, and methodological limitations of the crossover study, which is a clinical study in which subjects receive a sequence of different interventions, made it difficult to form conclusions.
Concurrent Use of Prescription Drugs and Herbal Medicinal Products in Older Adults: A Systematic Review
Agbabiaka TB et al. • Drugs & aging (2017)
The prevalence of concurrent prescription drugs and HMP use among older adults is substantial and potential interactions have been reported.
- Prevalence of concurrent use by older adults varied widely between 5.3 and 88.3%.
- The prevalence of concurrent prescription drugs and HMP use among older adults is substantial and potential interactions have been reported.
- Knowledge of the extent and manner in which older adults combine prescription drugs will aid healthcare professionals in appropriately identifying and managing patients at risk.
Echinacea for preventing and treating colds: A meta-analysis
Shah SA et al. • Lancet Infectious Diseases (2007)
Echinacea reduced odds of developing a cold by 58%.
- 58% reduced cold incidence
- Shortened cold duration by 1.4 days
- Variable results by preparation
Efficacy of Functional Foods, Beverages, and Supplements Claiming to Alleviate Air Travel Symptoms: Systematic Review and Meta-Analysis
Chan V et al. • Nutrients (2021)
Overall, 12 of 183 ingredients contained in 199 products had evidence to support claims.
- Meta-analysis (random effects model) indicated melatonin reduced self-reported jetlag following eastbound (n = 5) and westbound (n = 4) flights: standard mean difference -0.76 (95% CI = -1.06 to -0.45, I2 0%, p < 0.00001) and -0.66 (95% CI = -1.07 to -0.26, I2 45%, p = 0.001), respectively.
- Pycnogenol also reduced edema scores (n = 3), standard mean -4.09 (95% CI = -6.44 to -1.74), I2 98%, p = 0.0006).
- Of the 3842 studies identified, 23 met selection criteria: melatonin (n = 10), Pycnogenol (n = 4), various macronutrients (n = 2), caffeine (n = 2), Centella asiatica (n = 1), elderberry (n = 1), Echinacea (n = 1), fluid (n = 1), and Pinokinase (n = 1).
Echinacea in the prevention of induced rhinovirus colds: a meta-analysis
Schoop R et al. • Clinical therapeutics (2006)
This meta-analysis suggests that standardized extracts of Echinacea were effective in the prevention of symptoms of the common cold after clinical inoculation, compared with placebo.
- Based on the analysis, the likelihood of experiencing a clinical cold was 55% higher with placebo than with Echinacea (OR, 1.55 [95% CI, 1.02-2.36]; P<0.043).
- The absolute difference in total symptom scores between groups was -1.96 (95% CI, -4.83 to 0.90; P=NS).
- This meta-analysis suggests that standardized extracts of Echinacea were effective in the prevention of symptoms of the common cold after clinical inoculation, compared with placebo.