# Echinacea (Echinacea purpurea) *Purple coneflower, American coneflower, Black Sampson, *Rudbeckia*; *Echinacea purpurea* (L.) Moench, with the narrow-leaved *E. angustifolia* DC. and the pale *E. pallida* (Nutt.) Nutt.; in pharmacy *Echinaceae purpureae herba* and *radix*, *Echinaceae angustifoliae radix*, *Echinaceae pallidae radix** **Known today as.** The coneflowers of North America, of the family Asteraceae, whose rich purple florets are “seated round a high cone.” LiverTox counts at least nine species, of which *Echinacea purpurea*, *pallida*, and *angustifolia* are the most used, and gives *E. purpurea* as native to the United States east of the Rocky Mountains. Grieve, describing *E. angustifolia* from America west of Ohio, notes that its root has a faint aromatic smell and a sweetish taste, “leaving a tingling sensation in the mouth not unlike *Aconitum napellus*, but without its lasting numbing effect.” Kind: Plant > **Caution.** Not for those allergic to plants of the Asteraceae (Compositae) family, and not recommended under twelve. The European agency advises against it in progressive systemic diseases such as tuberculosis, in diseases of the white blood cells, collagenoses, multiple sclerosis, HIV infection, and other immune diseases, and warns of a possible risk of severe allergic reactions in atopic patients. Rash, urticaria, and swelling of the face have been reported, and rarely severe reactions including Stevens-Johnson syndrome, bronchospasm, and anaphylactic shock; an association with autoimmune diseases cannot be excluded. Applied to the skin it can cause contact dermatitis, and it should not be applied to the breast of a breastfeeding woman. LiverTox finds it generally well tolerated, but records isolated reports of liver injury with jaundice, which recovered on stopping; it is unclear whether a particular species, preparation, or contaminant was to blame. ## What was it used for? A remedy, in Grieve’s words, that “increases bodily resistance to infection,” used for boils, erysipelas, septicaemia, and impurities of the blood, its action being antiseptic; a tincture of the fresh root was found beneficial in diphtheria and putrid fevers. Its modern use is chiefly against the common cold. ## What does modern science say? The European Medicines Agency’s herbal committee treats each species and part separately. It accepts the expressed juice of the herb of *E. purpurea* on clinical evidence, as ‘well-established use,’ for the short-term prevention and treatment of the common cold, and, as a traditional herbal medicine, for small superficial wounds (monograph of 2015). As traditional herbal medicines, “exclusively based upon long-standing use,” it accepts the root of *E. purpurea* for the symptoms of the common cold and for the spots and pimples of mild acne (2017), the root of *E. angustifolia* for supportive treatment of the common cold (2012), and the root of *E. pallida* for the symptoms of the common cold (2018). Its assessment reports name caffeic acid derivatives, cichoric acid chief in *E. purpurea* and echinacoside in the other two roots, with alkamides, polysaccharides, and a little volatile oil; the root of *E. pallida* is almost without alkamides. The trials are less clear than the regulator. A Cochrane review of 2014, of twenty-four trials in 4,631 participants, found that echinacea products “have not here been shown to provide benefits for treating colds,” though a weak benefit from some products is possible, and that no single prevention comparison was significant, a post hoc pooling suggesting a relative risk reduction of 10 to 20 per cent. A 2025 meta-analysis of nine trials in children found that *E. purpurea* shortened upper respiratory infections and reduced their incidence and the use of antibiotics, while judging its safety profile unclear. ## Pharmacognosy and toxicology - **cichoric acid**: the chief caffeic acid derivative in *E. purpurea* - **echinacoside**: the chief in the roots of *E. angustifolia* and *E. pallida* - **alkamides**: almost absent from the root of *E. pallida* - **polysaccharides**: **Mechanism.** Not established in the sources read for this entry. **Standing.** European Union herbal monographs (2012 to 2018): well-established use of the expressed juice of *E. purpurea* herb for the common cold, and traditional use, “exclusively based upon long-standing use,” of the roots of three species. A Cochrane review (2014) found no clear benefit for treating colds. ## What lore surrounds it? Grieve lists among its uses cancer and syphilis, and gives it “useful properties as a strong alterative and aphrodisiac”; she records too that an injection of the extract had been used for haemorrhoids. ## What did the older authorities say? **Grieve, *A Modern Herbal* (1931).** The plant was named *Echinacea* by Linnaeus, and *Rudbeckia* after Rudbeck, father and son, his predecessors at Uppsala. Grieve’s chapter is on *E. angustifolia*, the dried root and rhizome; of *E. purpurea* she adds only that it “has similar properties,” the fresh root being the part used. ## Sources - Grieve, M. *A Modern Herbal*, “Echinacea.” As published on botanical.com. - European Medicines Agency, Committee on Herbal Medicinal Products. *European Union herbal monograph on Echinaceae purpureae herba (Purple Coneflower Herb)*. EMA/HMPC/48704/2014 Corr 1, 24 November 2015. - European Medicines Agency, Committee on Herbal Medicinal Products. *European Union herbal monograph on Echinaceae purpureae radix (Purple Coneflower Root)*. EMA/HMPC/424583/2016, 30 May 2017. - European Medicines Agency, Committee on Herbal Medicinal Products. *European Union herbal monograph on Echinaceae angustifoliae radix (Narrow-leaved coneflower root)*. EMA/HMPC/688216/2008, 27 March 2012. - European Medicines Agency, Committee on Herbal Medicinal Products. *European Union herbal monograph on Echinaceae pallidae radix (Pale Coneflower Root)*. EMA/HMPC/737380/2018, 05 June 2018. - European Medicines Agency, Committee on Herbal Medicinal Products. *Assessment report on Echinaceae purpureae herba*. EMA/HMPC/557979/2013, 24 November 2014. - European Medicines Agency, Committee on Herbal Medicinal Products. *Assessment report on Echinaceae purpureae radix*. EMA/HMPC/424584/2016, 30 May 2017. - European Medicines Agency, Committee on Herbal Medicinal Products. *Assessment report on Echinaceae angustifoliae radix*. EMA/HMPC/688212/2008, 27 March 2012. - European Medicines Agency, Committee on Herbal Medicinal Products. *Assessment report on Echinaceae pallidae radix*. EMA/HMPC/737379/2017, 05 June 2018. - Karsch-Völk M, et al. (2014). Echinacea for preventing and treating the common cold. *The Cochrane database of systematic reviews*. PMID 24554461. - Pham TP, et al. (2025). Efficacy and safety of Echinacea purpurea in treating upper respiratory infections and complications of otitis media in children: Systematic review and meta-analysis. *Clinical nutrition ESPEN*. PMID 40311928. - LiverTox: Clinical and Research Information on Drug-Induced Liver Injury, “Echinacea.” National Institute of Diabetes and Digestive and Kidney Diseases, updated 2019. NCBI Bookshelf. - European Medicines Agency, Committee on Herbal Medicinal Products. *European Union herbal monograph on Echinaceae purpureae herba (Purple Coneflower Herb)*. EMA/HMPC/48704/2014 Corr 1, 24 November 2015. - European Medicines Agency, Committee on Herbal Medicinal Products. *Assessment report on Echinaceae purpureae herba*. EMA/HMPC/557979/2013, 24 November 2014. - European Medicines Agency, Committee on Herbal Medicinal Products. *Assessment report on Echinaceae angustifoliae radix*. EMA/HMPC/688212/2008, 27 March 2012. - Karsch-Völk M, et al. (2014). Echinacea for preventing and treating the common cold. *The Cochrane database of systematic reviews*. PMID 24554461. - LiverTox: Clinical and Research Information on Drug-Induced Liver Injury, “Echinacea.” National Institute of Diabetes and Digestive and Kidney Diseases, updated 2019. NCBI Bookshelf. --- *Echinacea.* In *Materia Medica*, edited by B. C. P. Statema. Version 1, revised 2026-10-16. The Thinking Press. https://thethinkingpress.org/materia-medica/echinacea Historical description, not medical advice.