# Echinacea

Source: https://onco.cc/technologies/echinacea/  
OnCo record `echinacea` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Echinacea is sold to boost the immune system and ward off colds. There is no evidence it helps people with cancer, and Memorial Sloan Kettering advises caution during chemotherapy because it may change how some cancer drugs work; one man on chemotherapy developed a dangerously low platelet count.

## Summary

Echinacea preparations from several species are used to prevent and treat colds and as general immune stimulants, and products vary greatly in what they contain. Memorial Sloan Kettering's About Herbs summary reports that it is ineffective at preventing rhinovirus colds and mixed for shortening them, with some positive findings at higher doses. There are no trials of echinacea as a treatment or supportive therapy in cancer. MSK lists chemotherapy as a reason for caution: echinacea inhibits the drug-metabolising enzymes CYP3A4 and CYP2C8 in laboratory studies; in vitro work suggests it could lower exposure to prodrugs such as tamoxifen; and a man with non-small-cell lung cancer receiving cisplatin and etoposide with radiotherapy developed profound thrombocytopenia while taking it. In a study of people receiving docetaxel, echinacea at the recommended dose did not change docetaxel levels, so the interaction is drug-specific and uncertain rather than general. Allergic reactions, including anaphylaxis in people with allergies or asthma, and rare cases of hepatitis have been reported. MSK also notes that echinacea may oppose the effect of immunosuppressant drugs.

## Fields

- Kind: Technology
- Status: phase-2
- Last checked: 2026-11-04
- Also known as: Echinacea purpurea; Echinacea angustifolia; Purple coneflower; Coneflower
- Tags: complementary; supportive-care; evidence:insufficient
- Principle: Alkamides, polysaccharides and caffeic acid derivatives stimulate innate immune cells in laboratory studies; effects in people are inconsistent.
- Strengths: Generally mild side effects; Some evidence for shortening colds at higher doses
- Limitations: No studies in people with cancer; Possible interactions with etoposide and tamoxifen; Allergy and rare liver injury

## Sources

- MSK About Herbs: Echinacea (page last updated 7 August 2023): https://www.mskcc.org/cancer-care/integrative-medicine/herbs/echinacea

## Connected records

- technologies: [Dietary supplements during cancer treatment: interactions and harms](https://onco.cc/technologies/dietary-supplements-treatment-interactions/), [Evidence-based integrative oncology](https://onco.cc/technologies/integrative-oncology/), [Garlic supplements](https://onco.cc/technologies/garlic-supplements/), [Ginkgo biloba](https://onco.cc/technologies/ginkgo/)
- fronts: [Chemotherapy](https://onco.cc/fronts/chemotherapy/), [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- drugs: [Docetaxel](https://onco.cc/drugs/docetaxel/), [Etoposide](https://onco.cc/drugs/etoposide/), [Tamoxifen](https://onco.cc/drugs/tamoxifen/)
- bottlenecks: [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)

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