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Echinacea Efficacy In Influenza

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  • Blooming medicinal herb Echinacea purpurea or coneflower

Amy Jordan ● 2 min read

Echinacea has a long history of traditional use in North America for upper respiratory tract infections (URTIs).[1]

A recent study has shown that formulae containing Echinacea purpurea may be as effective as Oseltamivir, an antiviral medication used to treat and prevent influenza A and influenza B, in the early treatment of clinically diagnosed influenza virus.

The randomised, double-blind, parallel, double dummy controlled multicenter clinical trial included 464 adults aged 18-70 years and nine children and adolescents aged 12-17 years with early acute influenza symptoms. Diagnosis was confirmed on the basis of: at least one respiratory symptom (sore throat, cough, nasal symptoms); at least one systemic symptom (headache, sweats and/or chills, fatigue, malaise, myalgia); and nasal swab testing for viral identification.[2] Exclusion criteria included influenza vaccination within the previous 12 months, suspected bacterial infection, bronchitis, use of steroid or immune-suppressive medication and intake of antimicrobial agents within the previous month.

Participants were randomised to receive either 5mL of a syrup containing 1200mg echinacea (both herb extract and root extract) and 1382.5mg Sambuccus nigra and Oseltamivir placebo (n = 237) for 10 days (5mL five times a day for three days, followed by 5mL three times a day for seven days) or syrup placebo and two capsules of Oseltamivir (n = 236) for 5 days, followed by syrup placebo and Oseltamivir placebo for 5 days. Participants recorded influenza symptoms in the morning and evening for the duration of the study or until recovery.[2]

Recovery rates were similar across both groups at 1.5% and 4.1% after one day, 50.2% and 48.8% after five days and 90.1% and 84.4% after 10 days of treatment with the syrup and Oseltamivir, respectively. In addition, the echinacea syrup treatment group saw a significantly lower incidence of complications (2.46% vs 6.45%; p = 0.076) and fewer adverse events.[2] This research builds on current knowledge of the immunomodulatory effects of echinacea,[3] as well as confirming similar effects seen in vitro[4] and in animal models.[5,6]

Considering the risk of drug resistance, safety issues and limited availability associated with neuraminidase inhibitors like Oseltamivir,[2] echinacea may be a more convenient option for early influenza therapy.


  1. Morazzoni P, Cristoni A, Di Pierro F, et al. In vitro and in vivo immune stimulating effects of a new standardized Echinacea angustifolia root extract (PolinaceaTM). Fitoterapia 2005;76:401-411. [Abstract]
  2. Rauš K, Pleschka S, Klein P, et al. Effect of an echinacea-based hot drink versus Oseltamivir in influenza treatment: a randomized, double-blind, double-dummy, multicenter, noninferiority clinical trial. Curr Ther Res Clin Exp 2015;77:66-72. [Full text]
  3. Dall’Acqua S, Perissutti B, Grabnar I, et al. Pharmacokinetics and immunomodulatory effect of lipophilic echinacea extract formulated in softgel capsules. Eur J Pharm Biopharm 2015;97(Pt A):8-14. [Abstract]
  4. Pleschka S, Stein M, Schoop R, et al. Anti-viral properties and mode of action of standardized Echinacea purpurea extract against highly pathogenic avian influenza virus (H5N1, H7N7) and swine-origin H1N1 (S-OIV). Virol J 2009;6:197. [Full text]
  5. Bałan BJ, Sokolnicka I, Skopińska-Różewska E, et al. The modulatory influence of some echinacea-based remedies on antibody production and cellular immunity in mice. Cent Eur J Immunol 2016;41(1):12-18. [Full text]
  6. Fusco D, Liu X, Savage C, et al. Echinacea purpurea aerial extract alters course of influenza infection in mice. Vaccine 2010;28(23):3956-3962. [Full text]


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Amy Jordan
Amy completed a bachelor’s degree in nutrition in London, before moving to Australia. She worked at the University of Technology Sydney assisting in research in health, resulting in a number of published scientific journal papers. From here, she began working for IsoWhey as a nutritionist, providing advice to and writing articles for the general public to provide the tools for people to take charge of their health. Amy believes passionately in prevention over cure of disease, and works hard to provide people the tools to manifest this.