Echinacea × Midazolam Interaction

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

✨ AI-generated · Qwen 3.6 · grounded in 2 sources · methodology

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

Research

Supporting Research

Echinacea Supplementation Does Not Impact Aerobic Capacity and Erythropoiesis in Athletes: A Meta-Analysis

PMID:38999738 DOI 2024

Herbal Medicine in Children With Respiratory Tract Infection: Systematic Review and Meta-Analysis

PMID:28610802 DOI 2018

Herbal Medicine for Cough: a Systematic Review and Meta-Analysis

PMID:26840418 DOI 2015

Rabbit dietary supplementation with pale purple coneflower. 1. Effects on the reproductive performance and immune parameters of does

PMID:26763800 DOI 2016

Efficacy of Functional Foods, Beverages, and Supplements Claiming to Alleviate Air Travel Symptoms: Systematic Review and Meta-Analysis

PMID:33809656 DOI 2021

Interaction of herbal products with prescribed medications: A systematic review and meta-analysis

PMID:30660822 DOI 2019

Echinacea for treating the common cold: a randomized trial

PMID:21173411 DOI 2010

Efficacy of vitamin C for the prevention and treatment of upper respiratory tract infection. A meta-analysis in children

PMID:30465062 DOI 2019

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Medical Disclaimer: This interaction record is for informational and educational purposes only and does not constitute medical advice. Always consult your healthcare provider or pharmacist before combining any supplement with prescription medications.