⚠️ Mechanism
Echinacea may inhibit intestinal CYP3A4 but induce hepatic CYP3A4, with net effect on midazolam being variable.
📋 Effect
Variable effect on midazolam levels depending on route of administration
💊 Management
Monitor for altered sedative effect. Minor clinical concern for most patients.
Plain Language Summary
This combination is generally considered a minor concern for most people. Echinacea may cause unpredictable changes in the levels of midazolam in your body, which could affect how much the medication makes you sleepy.
Source
Gurley BJ et al. Clin Pharmacol Ther 2004
Supporting Research
Echinacea Supplementation Does Not Impact Aerobic Capacity and Erythropoiesis in Athletes: A Meta-Analysis
Herbal Medicine in Children With Respiratory Tract Infection: Systematic Review and Meta-Analysis
Herbal Medicine for Cough: a Systematic Review and Meta-Analysis
Rabbit dietary supplementation with pale purple coneflower. 1. Effects on the reproductive performance and immune parameters of does
Efficacy of Functional Foods, Beverages, and Supplements Claiming to Alleviate Air Travel Symptoms: Systematic Review and Meta-Analysis
Interaction of herbal products with prescribed medications: A systematic review and meta-analysis
Echinacea for treating the common cold: a randomized trial
Efficacy of vitamin C for the prevention and treatment of upper respiratory tract infection. A meta-analysis in children
Medical Disclaimer: This interaction record is for informational and educational purposes only and does not constitute medical advice. Drug-supplement interactions can be dangerous. Always consult your healthcare provider or pharmacist before combining any supplement with prescription medications. Do not stop or change any medication without professional guidance.