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Avoid if you have an allergy against plants of the Asteraceae family. Root preparations have minimal risk. Pollen proteins that may cause an allergic reaction are denatured by alcohol, the risk of allergic reactions are minimal when using alcoholic extracts or tablets based on dried alcoholic extracts. It increases cytokines, which provoke the inflammatory response in asthmatics. However, this reaction was found in a study based on constituents in vitro. A clinical study based on oral echinacea showed no detectable effect on cytokine production by lymphocytes. As the use of echinacea acts to reduce the frequency of respiratory viral infections, which are known to aggravate asthma, many herbalists conducer echinacea to be beneficial for asthma. Commission E monograph stated, “In principle, echinacea is not to be used in progressive conditions such as tuberculous, leukosis, collagenosis, MS, AIDS, HIV infection & other autoimmune disorders.” However, this claim is not supported by any solid evidence (such as clinical trials etc.) Many herbalists consider echinacea to be of value in such disorders due to the beneficial effect is has on the immune system. There is no evidence that echinacea should not be taken long-term if it is indicated.
Avoid with immunosuppressive drugs (Neoral, Cicloral, Cyosporin).