Echinacea Side Effects & Warnings

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If used beyond 8 weeks, Echinacea could cause hepatotoxicity and therefore should not be used with other known hepatoxic drugs, such as anabolic steroids, amiodarone, methotrexate, and ketoconazole.
- Arch Intern Med 1998 Nov 9;158(20):2200-11 -- Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. -- Miller LG.

Use of Echinacea is discouraged during pregnancy and for people with tuberculosis or autoimmune problems

Do not use Echinacea continuously for more than a few weeks.

Do not give Echinacea to children younger than two years old; start with minimal doses for older children and older adults.

Should not be used by those who are allergic to plants in the sunflower family.

Incidences of hepatotoxicity and nephrotoxicity may be augmented by acetaminophen when concomitantly used with the potentially hepatotoxic herbs Echinacea and kava, and with herbs containing salicylate (willow, meadowsweet), respectively.
- J Clin Pharm Ther 2002 Dec;27(6):391-401 -- Herbal medication: potential for adverse interactions with analgesic drugs. -- Abebe W. 

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