Skip to main content
Wiley - PMC COVID-19 Collection logoLink to Wiley - PMC COVID-19 Collection
. 2012 Jan 17;20(6):690–697. doi: 10.1592/phco.20.7.690.35173

Evaluation of Echinacea for Treatment of the Common Cold

Joel T Giles 1, Cuthbert T Palat III 2, Susan H Chien 4, Ziba Gorji Chang 3, Daniel T Kennedy 1,
PMCID: PMC7167769  PMID: 10853625

Abstract

Considered to have immunostimulating activity, echinacea is a widely used phytomedicinal for treatment of the common cold and upper respiratory tract infections (URTIs). We reviewed the literature from the MEDLINE database (January 1966–July 1999), International Pharmaceutical Abstracts (IPA) online database, Cambridge Scientific Abstracts Biological Sciences online database, Alt‐Health Watch online database, EMBase CD‐ROM database, and references from published articles, reviews, and letters to evaluate evidence from clinical trials of echinacea's purported efficacy for treating or preventing URTIs. Twelve clinical studies published from 1961–1997 concluded that echinacea was efficacious for treating the common cold, but the results are unclear due to inherent flaws in study design. Five trials were published since 1997; two showed that echinacea lacked efficacy for treating and preventing URTI symptoms, and three concluded that it was effective in reducing the frequency, duration, and severity of common cold symptoms. Again, these results are unclear because of methodologic uncertainties, such as small populations and use of noncommercially available, nonstandardized dosage forms. Although evidence for echinacea's efficacy is inconclusive, it appears to be safe. Patients without contraindications to it may not be dissuaded from using an appropriate preparation to treat the common cold.

References

  • 1. Kirkpatrick GL. The common cold. Prim Care 1996; 23(4): 657–75. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2. Turner RB. Epidemiology, pathogenesis, and treatment of the common cold. Ann Allergy Asthma Immunol 1997; 78(6): 531–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3. Lorber B. The common cold. J Gen Intern Med 1996; 11(4): 229–36. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4. Hilding DA. Literature review: the common cold. Ear Nose Throat J 1994; 73(9): 639–43, 646–7. [PubMed] [Google Scholar]
  • 5. Gwaltney JM Jr. Rhinovirus infection of the normal human airway. Am J Respir Crit Care Med 1995; 152(4 pt 2): S36–9. [DOI] [PubMed] [Google Scholar]
  • 6. Mossad SB. Treatment of the common cold. BMJ 1998; 317(7150): 33–6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7. Eisenberg DM, Davis RB, Ettner SL, et al Trends in alternative medicine use in the United States, 1990–1997: results of a follow‐up national survey. JAMA 1998; 280(18): 1569–75. [DOI] [PubMed] [Google Scholar]
  • 8. Anonymous. America the beautiful (and herbal). Retail Pharmacy News 1998: 16. [Google Scholar]
  • 9. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med 1993; 328(4): 246–52. [DOI] [PubMed] [Google Scholar]
  • 10. Winslow LC, Kroll DJ. Herbs as medicine. Arch Intern Med 1998; 158: 2192–9. [DOI] [PubMed] [Google Scholar]
  • 11. Murray MT. Echinacea: pharmacology and clinical applications. Am J Nat Med 1995; 2: 18–24. [Google Scholar]
  • 12. Bauer R, Jurcic K, Puhlmann J, Wagner H. Immunological in vivo and in vitro examinations of echinacea extracts. Arzneimittelforschung 1988; 38(2): 276–81. [PubMed] [Google Scholar]
  • 13. Schumacher A, Friedberg KD. Analysis of the effect of Echinacea angustifolia on unspecified immunity of the mouse. Arzneimittelforschung 1991; 41: 141–7. [PubMed] [Google Scholar]
  • 14. Blumenthal M, Riggins C. Popular herbs in the U.S. market: therapeutic monographs. Austin, TX: American Botanical Council; 1997: 1–68. [Google Scholar]
  • 15. Blumenthal M. The complete German Commission E monographs. Therapeutic guide to herbal medicines. Boston: American Botanical Council with Interpretive Medicine Communications, 1998. [Google Scholar]
  • 16. Melchart D, Linde K, Worku F, Bauer R, Wagner H. Immunomodulation with echinacea—a systematic review of controlled clinical trials. Phytomedicine 1994; 1: 245–54. [DOI] [PubMed] [Google Scholar]
  • 17. Braunig B, Dorn M, Knick E. Echinacea purpureae radix for the enhancement of the body's own immune defense mechanisms in influenza‐like infections. Z Phytother 1992; 13: 7–13. [Google Scholar]
  • 18. Braunig B, Knick E. Therapeutical experiences with Echinacea pallida for influenza‐like infections. Naturheilpraxis 1993; 1: 72–5. [Google Scholar]
  • 19. Dorn M. Treatment of influenza‐like syndromes with a phytotherapeutic immunostimulatory preparation. Nat GanzheitsMed 1990; 2: 314–19. [Google Scholar]
  • 20. Reitz HD. Immunomodulation with phytotherapeutic agents: a scientific study on the example of esberitox. Notabene Medici 1990; 20: 362–6. [Google Scholar]
  • 21. Vorberg G. Stimulation of the immune defense in common colds. Arztliche Praxis 1984; 36: 97–8. [Google Scholar]
  • 22. Vorberg G, Schneider B. Phytotherapeutic immunostimulator decreases the duration of influenza‐like syndromes. Double‐blind trial proves the enhancement of unspecific immune defense. Arztliche Forschung 1989; 36: 3–8. [Google Scholar]
  • 23. Forth H, Beuscher N. Influence of esberitox on the frequency of the common cold. Z Allgemeinmed 1981; 57: 2272–5. [PubMed] [Google Scholar]
  • 24. Freyer HU. Frequency of the common cold in children and possibilities for prophylaxis. Fortschr Med 1974; 92: 165–8. [PubMed] [Google Scholar]
  • 25. Helbig G. Unspecific stimulation therapy for the prophylaxis of infections. Med Klin 1961; 56: 1512–14. [PubMed] [Google Scholar]
  • 26. Kleinschmidt H. Trials to decrease the frequency of infections in infants with esberitox. Ther Gegenwart 1965; 104: 1258–62. [PubMed] [Google Scholar]
  • 27. Schmidt U, Albrecht M, Schenk N. Immunostimulator decreases the frequency of influenza‐like syndromes. Double‐blind, placebo‐controlled trial on 646 students of the University of Cologne. Nat GanzheitsMed 1990; 3: 277–81. [Google Scholar]
  • 28. Schoneberger D. Influence of the immunostimulating effects of the pressed juice of herbal Echinacea purpureae on the duration and intensity of the common cold. Results of a double‐blind clinical trial. Forum Immunol 1992; 2: 18–22. [Google Scholar]
  • 29. Barrett B, Vohmann M, Calabrese C. Echinacea for upper respiratory infection. J Fam Pract 1999; 48(8): 628–35. [PubMed] [Google Scholar]
  • 30. Melchart D, Walther E, Linde K, Brandmaier R, Lersch C. Echinacea root extracts for the prevention of upper respiratory tract infections: a double‐blind, placebo‐controlled randomized trial. Arch Fam Med 1998; 7: 541–5. [DOI] [PubMed] [Google Scholar]
  • 31. Gunning K, Steele P. Echinacea for the prevention of upper respiratory tract infections. J Fam Pract 1999; 48(2):93. [PubMed] [Google Scholar]
  • 32. Hoheisel O, Sandberg M, Bertram S, Bulitta M, Schafer M. Echinacea treatment shortens the course of the common cold: a double‐blind, placebo‐controlled clinical trial. Eur J Clin Res 1997; 9: 261–9. [Google Scholar]
  • 33. Brown D. Echinacea shortens the course of the common cold. Q Rev Nat Med 1998: 3–4. [Google Scholar]
  • 34. Dorn M, Knick E, Lewith G. Placebo‐controlled, double‐blind study of Echinacea pallidae radix in upper respiratory tract infections. Complement Ther Med 1997; 5: 40–2. [Google Scholar]
  • 35. Grimm W, Muller HH. A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the frequency and severity of colds and respiratory infections. Am J Med 1999; 106: 138–43. [DOI] [PubMed] [Google Scholar]
  • 36. Brinkeborn RM, Shah DV, Degenring FH. Echinaforce and other echinacea fresh plant preparations in the treatment of the common cold. A randomized, placebo controlled, double‐blind clinical trial. Phytomedicine 1999; 6(1): 1–5. [DOI] [PubMed] [Google Scholar]
  • 37. AltMedDex Database . Echinacea monograph. Englewood, CO: Micromedex, Inc., 1999. [Google Scholar]
  • 38. Hobbs C. Echinacea: a literature review. HerbalGram 1994; 30: 33–48. [Google Scholar]
  • 39. Pepping J. Echinacea. Am J Health-Syst Pharm 1999; 56(2): 121–2. [DOI] [PubMed] [Google Scholar]
  • 40. Bove M. The echinacea species: a research review. Br J Phytother 1990; 1(1): 24–7. [Google Scholar]
  • 41. Jellin JM, Batz F, Hitchens K. Pharmacist's letter/prescriber's letter natural medicines comprehensive database. Stockton, CA: Therapeutic Research Faculty, 1999: 304–6. [Google Scholar]

Articles from Pharmacotherapy are provided here courtesy of Wiley

RESOURCES