General

Pronunciation
ek-i-NAY-sha

Trade Name(s)

• American coneflower

• black sampson

• black susans

• brauneria angustifolia

• kansas snakeroot

• purple coneflower

• red sunflower

• rudbeckia

• sampson root

• scurvy root

Action

• Medicinal parts derived from the roots, leaves, or whole plant of perennial herb (Echinacea)

• Echinacea purpurea herba has been reported to promote wound healing, which may be due to an increase in white blood cells, spleen cells, and increased activity of granulocytes, as well as an increase in helper T cells and cytokines

• E. purpurea radix has been shown to have antibacterial, antiviral, anti-inflammatory, and immune-modulating effects

• Resolution respiratory and urinary tract infections

• Decreased duration and intensity of common cold

• Improved wound healing

• Stimulates phagocytosis; inhibits action of hyaluronidase (secreted by bacteria), which helps bacteria gain access to healthy cells

• Externally, has antifungal and bacteriostatic properties

Pharmacokinetics

Absorption: Unknown

Distribution: Unknown

Metabolism and Excretion: Unknown

Half-life: Unknown

TIME/ACTION PROFILE

Contraindication/Precautions

Contraindicated in:

• Multiple sclerosis, leukosis, collagenoses, AIDS, tuberculosis, auto-immune diseases

• Hypersensitivity and cross-sensitivity in patients allergic to plants in Asteraceae/Compositae plant family (daisies, chrysanthemums, marigolds, etc.)

• Pregnancy and lactation

• Diabetes

• Tinctures should be used cautiously in alcoholics or patients with liver disease

• Do not take longer than 8 wk—may suppress immune function

Adverse Reactions/Side Effects

CNS: dizziness, fatigue, headache, somnolence.

EENT: tingling sensation on tongue, sore throat.

GI: nausea, vomiting, heartburn, constipation, abdominal pain, diarrhea.

Derm: allergic reaction, rash (more common in children).

Misc: fever.

*CAPITALS indicates life-threatening.
*italic indicates most frequent.

Interactions

Natural Products-Drug

• May possibly interfere with immunosuppressants because of its immunostimulant activity

• Anabolic steroids, methotrexate, or ketoconazole may interact with echinacea

• May increase midazolam availability

Route/Dosage

• PO (Adults):
Tablets-6.78 mg tablets, take 2 tabs 3 times daily.
Fluid extract—1–2 ml tid; solid form (6.5:1)—150–300 mg tid. Should not be used for more than 8 wk at a time.
Tea—1/2 tsp comminuted drug, steeped and strained after 10 min, 1 cup 5–6 times daily on the first day, titrating down to 1 cup daily over the next 5 days.
Echinacea purpuren herb juice—6-9 ml/day.
Liquid— 20 drops every 2 hr for the first day of symptoms, then 3 times daily for up to 10 days.

• Topical (Adults):
Ointment, lotion, tincture used externally—1.5–7.5 ml tincture, 2–5 g dried root.

Availability

• Capsules^OTC: 300 mg

• Tablets OTC: 6.78 mg of crude extract

• Dried Root^OTC: The dried root can be steeped and strained in boiling water and taken as a tea

• Liquid extract^OTC: 1:1 in 45% alcohol

• Tincture^OTC: 1:5 in 45% alcohol

• Blended teas^OTC

• Echinacea purpuren herb juice^OTC

Assessment

• Assess wound for size, appearance, and drainage prior to the start of and periodically during therapy

• Assess frequency of common mild illnesses (such as a cold) in response to use of this herb

Potential Nursing Diagnoses

• Impairedskin integrity

Implementation

• Tinctures may contain significant concentrations of alcohol and may not be suitable for children, alcoholics, patients with liver disease, or those taking disulfiram, metronidazole, some cephalosporins, or sulfonylurea oral antidiabetic agents

• Prolonged use of this agent may cause overstimulation of the immune system, and use beyond 8 wk is not recommended. Therapy of 10–14 days is usually considered sufficient

• May be taken without regard to food

Patient/Family Teaching

• Herb is more effective for treatment than prevention of colds. Take at first sign of symptoms

• Advise patient to seek immediate treatment for an illness that does not improve after taking this herb

• Instruct patient that the usual course of therapy is 10–14 days and 8 wk is the maximum

• Inform patient that use of this herb is not recommended in severe illnesses (e.g, AIDS, tuberculosis) or autoimmune diseases (e.g, multiple sclerosis, collagen diseases, etc.)

• Caution patient that prolonged use of this herb may result in overstimulation of the immune system, possibly with subsequent immunosuppression

• Warn pregnant or breastfeeding women not to use this herb

• Instruct patient to consult health care professional before taking any prescription or OTC medications concurrently with echinacea

• Keep tincture in a dark bottle away from sunlight. Should be taken several times a day

• Store herb in airtight container away from sunlight

Evaluation/Desired Outcomes

• Improved wound healing

• Infrequent common illnesses

• Illnesses of shorter duration and less severity

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