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Biological Based Systems
Echinacea purpurea
(purple coneflower)
Main Constituents
Caffeic acid derivatives, polysaccharides and lipophilic compounds, polyacetylenes and alkamides.
Possible Applications
Echinacea purpurea may be effective in the treatment of colds, influenza-like symptoms and respiratory and lower urinary tract infections. The current available scientific literature, however, does not suggest benefit/rationale for long-term prophylactic use for the prevention of colds or influenzas, or during and after immuno-compromising therapies such as chemotherapy for the treatment of cancer. Applications that have been less scientifically evaluated include external Echinacea poultice for wound healing, burns, abscesses, leg ulcers, insect bites, rattlesnake bites. It has also been used as a treatment for the pain associated with headaches, stomach aches, measles, coughs and gonorrhea.
There are three different types of Echinacea. E. angustifolia, E. pallida and E. purpurea. Of the three types, E. purpurea is the most commonly used.
Adverse Reactions and Drug Interactions
While it is infrequently done, when used parenterally, Echinacea can cause nausea, vomiting and fever reactions. This is usually dose-dependent. In persons with diabetes, hypersensitivity reactions have occurred; these include rash, itching, occasional swelling of the face, breathing difficulty, dizziness and a drop in blood pressure.
The immune stimulating properties of Echinacea may interact with immunosuppression drugs like cyclosporin or other anti-rejection drugs. The Herbal Physician's Desk Reference (PDR) also lists possible interaction with cancer chemotherapeutic effect of corticosteriods.
Contraindications
Because Echinacea stimulates the immune system, use of this herb may be contraindicated in persons suffering from autoimmune diseases and diseases of a dysfunctional immune system such as multiple sclerosis, AIDS, collagen disease, leukosis and tuberculosis. This claim is currently under review; however, it would be a prudent precaution until further information is available. Supplemental Echinacea is not advisable for individuals who are allergic to the Daisy flower family (Asteraceae).
Echinacea use is also not advisable during pregnancy.
Proposed Doses
Doses suggested in the Commission E Monographs and the Herbal PDR:
Internal
Herb (the above ground portion of the plant): 6-9mls of the expressed juice or an equivalent preparation* *300mg TID of powder form
Radix (the below ground portion of the plant): 30-60drops of hydroalcoholic tincture taken TID
External
Semi-solid preparation containing 15% pressed juice
Parenteral Doses are individualized based on the condition being treated and the preparation in use. The drug manufacturer makes dosing recommendations.
Echinacea is available over the counter (OTC) in capsules, tinctures and as pressed juice.
Scientific Rationale
In vitro and in vivo studies show that E. purpurea stimulates the immune system in a non-specific way by activating macrophages, enhancing phagocytes and stimulating the secretion of TNF and interleukins 1 and 6.
Very limited research is available using parenteral administration of E. purpurea and thymostimulin in addition to cyclophosphamide in cancer treatment. The results were encouraging but by no means conclusive. Parenteral administration E. purpurea is not available in the United States.
References
1. Physician's Desk Reference on Herbal Medicine. Montvale, NJ: Medical Economics Company; 2000.
2. Alternative Medicine, Expanding Medical Horizons: A Report to the NIH on Alternative Medical Systems and Practices in the United States. Washington DC: National Institutes of Health; 1994.
3. Boik J. Cancer and Natural Medicine. Princeton, MN: Oregon Medical Press; 1996.
4. Miller LG. Herbal Medicinals, Selected clinical considerations focusing on known or potential drug herb interactions. Archives of Internal Medicine.1998: 158:2200-2211.
5. Herb Chart drafted by June H. McDermott, MS Pharm MBA.
6. Blumenthal M et al. Commission E Monographs. Austin, TX: American Botanical Council;1998.
7. Tyler VE, Foster S. The Honest Herbal. Binghamton, NY: Pharmaceutical Products Press/ Haworth Press; 1998.
8. American Botanical Council website: http://www.herbalgram.org
9. Lersch C et al. Nonspecific immunostimulation with low doses of cyclophosphamide, thymostimulin, and Echinacea purpurea extracts in patients with far advances colorectal cancer: preliminary results. Cancer Invest. 1992;10(5): 343-348.
10. McCaleb RS, Leigh E, Morien K. The Encyclopedia of Popular Herbs. Roseville, CA: Prima Health; 2000.
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