Echinacea: benefits, dosage, contraindications

Immune support
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Echinacea exerts an immunostimulant effect. Its effect on the immune system has been demonstrated in vitro and in vivo. In a randomized, double-blind, placebo-controlled trial, the total daily number of common cold symptoms was lower with echinacea than with placebo, and the difference was statistically significant after the third day. An increase in total leukocyte, monocyte, and neutrophil counts—but not lymphocytes—and an increase in neutrophil respiratory burst capacity were also observed, while erythrocyte superoxide dismutase units decreased during echinacea treatment.

Posologie

Oral: root, aerial parts

1500 - 2400 mg

1 - month

Adults

standardized extract, dry extract

Common cold
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The reduction in the rate of ENT infections observed with echinacea as a daily supplement appears to be very effective in some cases, but is subject to a high degree of variability. Meta-analyses show a modest reduction in the risk of developing a common cold when taking various echinacea products. A large clinical study conducted with Echinaforce (A. Vogel) shows that adults who take 0.9 ml three times a day (providing 2,400 mg of echinacea per day) for 4 months, or 0.9 ml five times a day (4 g of echinacea per day) at the first sign of a cold, have fewer episodes and shorter duration of common cold than those who take a placebo. Overall, the data confirm a low-to-moderate efficacy. The EMA lists echinacea as an herbal medicinal product for the prevention and the short-term treatment of the common cold.

Posologie

Oral use: root, aerial parts

900 - 4000 mg

4 - months

standardized extract, dry extract

Respiratory infections, Flu
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Echinacea may have antiviral activity against influenza virus, rhinoviruses, and herpes simplex viruses (HSV-1 and HSV-2). Preliminary research using viruses from nasal secretions suggests that Echinacea purpurea may inhibit enveloped viruses such as coronaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial viruses, and metapneumoviruses. Clinically, a recent Cochrane systematic review indicates that the efficacy of echinacea may be superior to placebo for reducing the incidence of influenza, suggesting its potential usefulness as a preventive intervention. Another large study conducted in adults with respiratory infections shows that taking a daily 5-day combination containing 1100 to 2200 mg of echinacea, zinc, and vitamin C shortens recovery time; however, it had no major effect on symptom severity compared with placebo.

Posologie

Oral: root, aerial parts

900 - 2200 mg

5 days

Adults, Children

standardized extract, dry extract

Synergies

Pharyngitis
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Thanks to its antiviral and antibacterial action, Echinacea may be used in cases of pharyngitis and even bronchitis. An observational study examined the efficacy of an Echinacea and Sage lozenge in the treatment of pharyngitis. The study showed a significant reduction in viral load and symptoms, such as sore throat. However, there was no control group, which limits the validity of these results. The Echinacea/Sage lozenge contained 800 mg of hydroalcoholic extract of Echinacea purpurea (95% aerial parts and 5% root, Echinaforce®) and 378.5 mg of hydroalcoholic extract of Salvia officinalis leaves (drug extraction ratio 1:17).

Posologie

Oral route: root, aerial parts

4000 mg

1 - days

standardized extract, dry extract

Synergies

Urinary tract infections
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Thanks to its immunostimulant and antibacterial properties, Echinacea is indicated for cystitis. ESCOP indicates it as an adjuvant and preventive therapy for recurrent infections of the urogenital tract.

Posologie

Oral route: root, aerial parts

1500 - 2400 mg

standardized extract, dry extract

Gingivitis
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Preliminary clinical research shows that the use of a mouthwash containing echinacea, gotu kola and elderberry — 15 ml three times a day for 14 days — may prevent worsening of gingivitis compared with a placebo mouthwash, but it produces only minimal improvement in symptoms. The application of a periodontal patch containing echinacea, gotu kola and elderberry, either as a single dose or three times a day for 1 day then once a day for 2 days, appears to reduce some measures of inflammation and gingivitis at certain time points, but the effects are inconsistent.

Posologie

By mouth: root, aerial parts

1500 - 2400 mg

14 days

standardized extract, dry extract

Synergies

Vaginal infections
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Clinical results on the prevention of female urogenital infections (fungal infections, candidiasis, herpes) appear mixed, despite promising laboratory results.nnA one-year double-blind, placebo-controlled trial studied the effects of an extract of the plant and root of E. purpurea (Echinaforce 800 mg twice daily) on the incidence and severity of genital herpes outbreaks in 50 patients. The study did not show a statistically significant advantage over placebo after 6 months of treatment.nn

Posologie

Oral route: root, aerial parts

1600 - 2400 mg

standardized extract, dry extract

Skin healing
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On wounds, Echinacea extracts appear to act by inhibiting bacterial proliferation and promoting healing by stimulating collagen synthesis.nnThe EMA recognizes echinacea as a traditional herbal medicinal product for the treatment of minor superficial wounds but also to relieve spots and pimples caused by mild acne.nnThe Commission E approves the external use of the herb E. purpurea for poorly healing wounds and chronic ulcerations.nn

Posologie

Topical route: root, aerial parts

1500 - 2400 mg

standardized extract, dry extract