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This monograph is intended to serve as a guide to industry for the preparation of Product Licence Applications (PLAs) and labels for natural health product market authorization. It is not intended to be a comprehensive review of the medicinal ingredient.



December 18, 2018

Proper name(s), Common name(s), Source material(s)

Table 1. Proper name(s), Common name(s), Source material(s)
Proper name(s) Common name(s) Source material(s)
Proper name(s) Part(s) Preparation(s)

Echinacea angustifolia

  • Black sampson
  • Black- sampson echinacea
  • Echinacea
  • Kansas snakeroot
  • Narrow-leaf coneflower
  • Narrow-leaf echinacea
  • Narrow-leaf purple-coneflower

Echinacea angustifolia

  • Root
  • Rhizome


References: Proper name: USDA 2018; Common names: USDA 2018, McGuffin et al. 2000, McGuffin et al. 1997, Bradley 1992; Source materials: Barnes et al. 2007, Grieve 1971.

Route of Administration


Dosage Form(s)

This monograph excludes foods or food-like dosage forms as indicated in the Compendium of Monographs Guidance Document.

Acceptable dosage forms by age group:

Children 2 years: The acceptable dosage forms are limited to emulsion/suspension and solution/ liquid preparations (Giacoia et al. 2008; EMEA/CHMP 2006).

Children 3-5 years: The acceptable dosage forms are limited to chewables, emulsion/ suspension, powders and solution/ liquid preparations (Giacoia et al. 2008; EMEA/CHMP 2006).

Children 6-11 years, Adolescents 12-17 years, and Adults 18 years and older: The acceptable dosage forms for this age category and specified route of administration are indicated in the Compendium of Monographs Guidance Document.

Use(s) or Purpose(s)

The following combined use(s) or purpose(s) is/are also acceptable:

Traditionally used in Herbal Medicine to help relieve sore throats and symptoms of upper respiratory tract infections (Barnes et al. 2007; Blumenthal et al. 2000; Moerman 1998; Ellingwood 1983; Felter and Lloyd 1983; Grieve 1971).


Claims for traditional use must include the term "Herbal Medicine", "Traditional Chinese Medicine", or "Ayurveda".



As specified below.


Methods of preparation: Dry, Powder, Non-Standardised Extracts (Dry extract, Tincture, Fluid extract, Decoction, Infusion)

Table 2. Dose information for Echinacea angustifolia root and/or rhizome per day
Subpopulation(s) Dried root/rhizome (gram/day)
Minimum Maximum


2-4 years



5-9 years



10-11 years




12-14 years



15-17 years




18 years and older



1Children and adolescent doses were calculated as a proportion of the adult dose (JC 2018). The use of Echinacea angustifolia in children is supported by the following references: McIntyre 2005; Bove 2001; Schilcher 1997.

2Adult dose supported by the following references: Barnes et al. 2007; Blumenthal et al. 2000; Bradley 1992

3Includes pregnant and breastfeeding women

Direction(s) for use

No statement required.

Duration(s) of Use

Consult a health care practitioner/health care provider/health care professional/doctor/physician for use beyond 8 weeks (Brinker 2010).

Risk Information

Caution(s) and warning(s)


No statement required.

Known adverse reaction(s)

No statement required.

Non-medicinal ingredients

Must be chosen from the current Natural Health Products Ingredients Database (NHPID) and must meet the limitations outlined in the database.

Storage conditions

No statement required.


References Cited

Barnes J, Anderson LA, Philipson JD. 2007. Herbal Medicines, 3rd edition. London (GB): The Pharmaceutical Press.

Blumenthal M, Goldberg A, Brinkmann J, editors. 2000. Herbal Medicine: Expanded Commission E Monographs. Boston (MA): Integrative Medicine Communications.

Bove M. 2001. An Encyclopedia of Natural Healing for Children and Infants. New Canaan (CT): Keats Publishing, Incorporated.

Bradley PR, editor. 1992. British Herbal Compendium: A Handbook of Scientific Information on Widely Used Plant Drugs, Volume 1. Bournemouth (GB): British Herbal Medicine Association.

Brinker F. Herb Contraindications and Drug Interactions, 4th edition. Sandy (OR): Eclectic Medical Publications; 2010.

Ellingwood F. 1983. American Materia Medica, Therapeutics and Pharmacognosy. Sandy (OR): Eclectic Medical Publications [Reprint of 1919 original].

EMEA/CHMP 2006: European Medicines Agency: Pre-authorization Evaluation of Medicines for Human Use. Committee for Medicinal Products for Human Use. Reflection Paper: Formulation of choice for the paediatric population. Adopted September 2006.

EMEA/CHMP/PEG/194810/2005. [Accessed 2018 September 27]. Available from:

Felter HW, Lloyd JU. 1983. King's American Dispensatory, Volume 1, 18th edition. Sandy (OR): Eclectic Medical Publications [Reprint of 1898 original].

Giacoia GP, Taylor-Zapata P, Mattison D. Eunice Kennedy Shriver National Institute of Child Health and Human Development Pediatric Formulation Initiative: selected reports from working groups. Clinical Therapeutics 2008; 30(11):2097-2101.

Grieve M. 1971. A Modern Herbal, Volume 1. New York (NY): Dover Publications [Reprint of 1931 Harcourt, Brace & Company publication].

JC 2018: Justice Canada. Natural Health Products Regulations [Internet]. Ottawa (ON): Justice Canada. [Accessed 2018 September 27]. Available from:

McGuffin M, Kartesz JT, Leung AY, Tucker AO, editors. 2000. Herbs of Commerce, 2nd edition. Silver Spring (MD): American Herbal Products Association.

McGuffin M, Hobbs C, Upton R, Goldberg A, editors. 1997. American Herbal Products Association's Botanical Safety Handbook. Boca Raton (FL): CRC Press.

McIntyre A. 2005. Herbal Treatment of Children - Western and Ayurvedic Perspectives. Toronto (ON): Elsevier Limited.

Mills S, Bone K. 2005. The Essential Guide to Herbal Safety. St. Louis (MO): Elsevier Churchill Livingstone.

Moerman DE. 1998. Native American Ethnobotany. Portland (OR): Timber Press.

Schilcher H. 1997. Phytotherapy in Paediatrics: Handbook for Physicians and Pharmacists. Stuttgart (D): Medpharm Scientific Publishers.

USDA 2018: United States Department of Agriculture, Agricultural Research Service, National Genetic Resources Program. Germplasm Resources Information Network (GRIN) [Internet].Echinacea angustifolia DC. Beltsville (MD): National Germplasm Resources Laboratory. [Accessed 2018 September 27]. Available from:

References Reviewed

Altamirano-Dimas M, Hudson JB, Cochrane D, Nelson C, Arnason JT. 2007. Modulation of immune response gene expression by echinacea extracts: results of a gene array analysis. Canadian Journal of Physiology and Pharmacology 85(11):1091-1098.

Barnes J, Anderson LA, Gibbons S, Phillipson JD. 2005. Echinacea species (Echinacea angustifolia (DC.) Hell., Echinacea pallida (Nutt.) Nutt., Echinacea purpurea (L.) Moench): a review of their chemistry, pharmacology and clinical properties. The Journal of Pharmacy and Pharmacology 57(8):929-954.

Barnes J, Anderson LA, Philipson JD. 2002. Herbal Medicines: A Guide for Healthcare Professionals, 2nd edition. London (GB): The Pharmaceutical Press.

Barrett B. 2003. Medicinal properties of echinacea: a critical review. Phytomedicine 10(1):6686.

Barrett BP, Brown RL, Locken K, Maberry R, Bobula JA, D'Alessio D. 2002. Treatment of the common cold with unrefined echinacea: a randomized, double-blind, placebo-controlled trial. Annals of Internal Medicine 137(12):939-946.

Barrett B, Brown R, Voland R, Maberry R, Turner R. 2006. Relations among questionnaire and laboratory measures of rhinovirus infection. The European Respiratory Journal 28(2):358-363.

Barrett B, Harahan B, Brown D, Zhang Z, Brown R. 2007. Sufficiently important difference for common cold: severity reduction. Annals of Family Medicine 5(3):216-223.

Barrett B, Vohmann M, Calabrese C. 1999. Echinacea for upper respiratory infection. The Journal of Family Practice 48(8):628-635.

Bauer R, Khan IA, Wagner H. 1988. TLC and HPLC analysis of Echinacea pallida and E. angustifolia roots. Planta Medica 54(5):426-430.

Bauer R, Remiger P, Wagner H. 1989. Alkamides from the roots of Echinacea angustifolia. Phytochemistry 28(2):505-508.

Bauer R, Wagner H. 1991. Echinacea species as potential immunostimulatory drugs. In: Wagner H, Farnsworth NR, editors. Economics and Medicinal Plants Research, volume 5. London (GB), Academic Press.

BHP 1996: British Herbal Pharmacopoeia. Bournemouth (GB): British Herbal Medicine Association; 1996.

BHP 1983: British Herbal Pharmacopoeia. Cowling (GB): British Herbal Medical Association; 1983.

Binns SE, Arnason JT, Baum BR. 2002. Phytochemical variation within populations of Echinacea angustifolia (Asteraceae). Biochemical Systematics and Ecology 30:837-854.

Block KI, Mead MN. 2003. Immune system effects of echinacea, ginseng, and astragalus: a review. Integrative Cancer Therapies 2(3):247-267.

Blumenthal M. 2003. The ABC Clinical Guide to Herbs. New York (NY): Theime.

Blumenthal M, Busse W, Goldberg A, Gruenwald J, Hall T, Riggins C, Rister R, editors. 1998.The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin (TX): American Botanical Council.

Blumenthal M, Farnsworth NR, Leach M. 2005. Echinacea angustifolia in rhinovirus infections. New England Journal of Medicine 353(18):1971-1972.

Bone K. 1997. Echinacea: what makes it work? Alternative Medicine Review 2(2):87-93.

Bone K. 1997. Echinacea: When should it be used? Alternative Medicine Review 2(6):451-458.

Boon H, Smith MJ. 1999. The Complete Natural Medicine Guide to the 50 Most Common Medicinal Herbs, 2nd edition. Toronto (ON): Robert Rose Inc.

Bisset NG, Wichtl M, editors. 2001. Herbal Drugs and Phytopharmaceuticals. 2nd edition. Stuttgart (Germany): medpharm GmbH Scientific Publishers.

Bradley PR, editor. 1992. British Herbal Compendium: A Handbook of Scientific Information on Widely Used Plant Drugs, Volume 1. Bournemouth (GB): British Herbal Medicine Association.

Carr RR, Nahata MC. 2006. Complementary and alternative medicine for upper-respiratory-tract infection in children. American Journal of Health-System Pharmacists 63:33-39.

Caruso TJ, Gwaltney JM Jr. 2005. Reply to Barton and Hemilä. Clinical Infectious Diseases 41:763-764.

Caruso TJ, Gwaltney JM Jr. 2005. Treatment of the common cold with Echinacea: a structured review. Clinical Infectious Diseases 40(6):807-810.

Chevallier A. 1996. The Encyclopedia of Medicinal Plants. New York (NY): DK Publishing Inc.

Classen B, Csavas M, Borbas A, Dingermann T, Zundorf I. 2004. Monoclonal antibodies against an arabinogalactan-protein from pressed juice of Echinacea purpurea. Planta Medica 70(9):861865.

Cohen HA, Varsano I, Kahan E, Sarrell EM, Uziel Y. 2004. Effectiveness of an herbal preparation containing echinacea, propolis, and vitamin C in preventing respiratory tract infections in children: a randomized, double-blind, placebo-controlled, multicenter study. Archives of Pediatrics & Adolescent Medicine 158(3):217-221.

Ernst E. 2002. The risk-benefit profile of commonly used herbal therapies: Gingko, St John's Wort, Ginseng, Echinacea, Saw Palmetto and Kava. Annals of Internal Medicine 136(1):42-53.

Felter HW. 1983. The Eclectic Materia Medica, Pharmacology and Therapeutics. Sandy (OR): Eclectic Medical Publications; [Reprint of 1922 original].

Felter HW, Lloyd JU. 1983. King's American Dispensatory, Volume 1, 18th edition. Sandy (OR): Eclectic Medical Publications; [Reprint of 1898 original].

Foster S. 1996. Echinacea. The Purple Coneflowers. Austin (TX): Steven Foster.

Gallo M, Sarkar M, Au W, Pietrzak K, Comas B, Smith M, Jaeger TV, Einarson A, Koren G. 2000. Pregnancy outcome following gestational exposure to echinacea: a prospective controlled study. Archives of Internal Medicine 160(20):3141-3143.

Gertsch J, Schoop R, Kuenzle U, Suter A. 2004. Echinacea alkylamides modulate TNF-? gene expression via cannabinoid receptor CB2 and multiple signal transduction pathways. FEBS Letters 577(3):563-569.

Giles JT, Palat CT, Chien SH, Chien SH, Chang ZG, Kennedy DT. 2000. Evaluation of Echinacea for treatment of the common cold. Pharmacotherapy 20(6):690-697.

Grieve M. 1971. A Modern Herbal, Volume 1. New York (NY): Dover Publications; [Reprint of 1931 Harcourt, Brace & Company publication].

Gunning K. 1999. Echinacea in the treatment and prevention of upper respiratory tract infections. The Western Journal of Medicine 171(3):198-200.

Haddad PS, Azar GA, Groom S, Boivin M. 2005. Natural health products, modulation of immune function and prevention of chronic diseases. Evidence-Based Complementary and Alternative Medicine 2(4):513-520.

Hemilä H. 2005. Echinacea, vitamin C, the common cold and blinding. Clinical Infectious Diseases 41(5):762-763.

Islam J, Carter R. 2005. Use of Echinacea in upper respiratory tract infection. Southern Medical Journal 98(3):311-318.

Kemp DE, Franco KN. 2002. Possible leucopenia associated with long-term use of echinacea. The Journal of the American Board of Family Practice 15(5):417-419.

Knight V. 2005. Echinacea treatment for the common cold. Clinical Infectious Diseases 40(6):811-812.

Lee AN, Werth VP. 2004. Activation of autoimmunity following use of immunostimulatory herbal supplements. Archives of Dermatology 140:723-727.

Li T. 1998. Echinacea: cultivation and medicinal value. HortTechnology 8(2):122-129.

Linde K, Barrett B, Wölkart K, Bauer B, Melchart D. 2006. Echinacea for preventing and treating the common cold. Cochrane Database of Systematic Reviews. Issue 1. Art. No.: CD000530. DOI: 10.1002/14651858.CD000530.pub2

Lindenmuth GF, Lindenmuth EB. 2000. The efficacy of echinacea compound herbal tea preparation on the severity and duration of upper respiratory and flu symptoms: a randomized, double-blind, placebo-controlled study. Journal of Alternative and Complementary Medicine 6(4):327-334.

Matthias A, Addison RS, Penman KG, Dickinson RG, Bone KM, Lehmann RP. 2005. Echinacea alkamide disposition and pharmacokinetics in humans after tablet ingestion. Life Sciences 77(16):2019-2029.

Matthias A, Banbury L, Bone KM, Leach DN, Lehmann RP. 2008. Echinacea alkylamides modulate induced immune responses in T-cells. Fitoterapia 79(1):53-58.

Matthias A, Blanchfield JT, Penman KG, Toth I, Lang CS, De Voss JJ, Lehmann RP. 2004. Permeability studies of alkylamides and caffeic acid conjugates from echinacea using a Caco-2 cell monolayer model. Journal of Clinical Pharmacy and Therapeutics 29(1):7-13.

McGregor RL. 1968. The taxonomy of the genus echinacea (compositae). University of Kansas Science Bulletin 48(4):113-142.

Melchart D, Linde K, Fischer P, Kaesmayr J. Echinacea for preventing and treating the common cold. Cochrane Database of Systematic Reviews 1999; Issue 1. Art. No.: CD000530. DOI:10.1002/14651858.CD000530.

Melchart D, Linde K, Worku F, Bauer R, Wagner H. 1994. Immunomodulation with echinacea- a systematic review of controlled clinical trials. Phytomedicine 1:245-254.

Melchart D, Linde K, Worku F, Sarkady L, Holzmann M, Jurcic K, Wagner H. 1995. Results of five randomized studies on the immunomodulatory activity of preparations of Echinacea. Journal of Alternative and Complementary Medicine 1(2):145-160.

Melchart D, Walther E, Linde K, Brandmaier R, Lersch C. 1998. Echinacea root extracts for the prevention of upper respiratory tract infections. Archives of Family Medicine 7(6):541-545.

Merali S, Binns S, Paulin-Levasseur M, Ficker C, Smith M, Baum B, Brovelli E, Arnason JT. 2003. Antifungal and anti-inflammatory activity of the Genus Echinacea. Pharmaceutical Biology 41(6):412-420.

Meyer JE. 1993. The Herbalist. Glenwood (IL): Meyerbooks.

Miller LG. 1998. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Archives of Internal Medicine 158(20):2200-2211.

Mills S, Bone K. 2000. Principles and Practice of Phytotherapy. Toronto (ON): Churchill Livingstone.

Mossad SB. 1998. Treatment of the common cold. British Medical Journal 317(7150):33-36.

Mullins RJ, Heddle R. 2002. Adverse reactions associated with echinacea: the Australian experience. Annals of Allergy, Asthma & Immunology 88(1):42-51.

Myers SP, Wohlmuth H. 1998. Echinacea-associated anaphylaxis. Medicinal Journal of Australia 168(11):583-584.

Pepping J. 1999. Echinacea. American Journal of Health System Pharmacy 56(2):121-122.

Percival SS. 2000. Use of echinacea in Medicine. Biochemical Pharmacology 60(2):155-158.

Perri D, Dugoua JJ, Mills E, Koren G. 2006. Safety and efficacy of echinacea (Echinacea angustifolia, E. purpurea and E. Pallida) during pregnancy and lactation. Canadian Journal of Clinical Pharmacology 13(3):e262-e267.

Randolph RK, Gellenbeck K, Stonebrook K, Brovelli E, Qian Y, Bankaitis-Davis D, Cheronis J. 2003. Regulation of human immune gene expression as influenced by a commercial blended echinacea product: preliminary studies. Experimental Biology and Medicine 228(9):1051-1056.

Sampson W. 2005. Studying herbal remedies. New England Journal of Medicine 353(4):337339.

Schoop R, Klein P, Suter A, Johnston SL. 2006. Echinacea in the prevention of induced rhinovirus colds: a meta-analysis. Clinical Therapeutics 28(2):174-183.

Senchina DS, Flagel LE, Wendel JF, Kohut ML. 2006. Phenetic comparison of seven Echinacea species based on immunomodulatory characteristics. Economic Botany 60(3):205-211.

Shah SA, Sander S, White CM, Rinaldi M, Coleman CI. 2007. Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis. The Lancet Infectious Diseases 7(7):473-480.

Taylor JA, Weber W, Standish L, Quinn H, Goesling J, McGann M, Calabrese C. 2003. Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial. JAMA 290(21):2824-2830.

Thomas PR. 2001. Echinacea: a natural remedy for the common cold and flu? Nutrition Today 36(5):249-253.

Tragni E, Galli CL, Tubaro A, Del Negro P, Della Loggia R. 1988. Anti-inflammatory activity of Echinacea angustifolia fractions separated on the basis of molecular weight. Pharmaceutical Research Communications 20 Suppl 5:87-90.

Tubaro A, Tragni E, Del Negro P, Galli CL, Della Loggia R. 1987. Anti-inflammatory activity of a polysaccharidic fraction of Echinacea angustifolia. Journal of Pharmacy and Pharmacology 39(7):567-569.

Turner RB. 2001. The treatment of rhinovirus infections: progress and potential. Antiviral Research 49(1):1-14.

Turner RB, Bauer R, Woelkart K, Hulsey TC, Gangemi JD. 2005. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. The New England Journal of Medicine 353(4):341-348.

Turner RB, Riker DK, Gangemi JD. 2000. Ineffectiveness of echinacea for prevention of experimental rhinovirus colds. Antimicrobial Agent and Chemotherapy 44(6):1708-1709.

WHO 1999: WHO monographs on selected medicinal plants. Volume 1. Geneva (CHE): World Health Organization.

Wichtl M, editor. 2004. Herbal Drugs and Phytopharmaceuticals: A Handbook for Practice on a Scientific Basis, 3rd edition. Stuttgart (D): Medpharm GmbH Scientific Publishers.

Woelkart K, Bauer R. The role of alkamides as an active principle of echinacea. 2007. Planta Medica 73(7):615-623.

Wölkart K, Gangemi JD, Turner RB, Bauer R. 2004. Enzymatic degradation of echinacoside and cynarine in Echinacea angustifolia root preparations. Pharmaceutical Biology 42(6):443-448.

Woelkart K, Koidl C, Grisold A, Gangemi JD, Turner RB, Marth E, Bauer R. 2005.Bioavailability and pharmacokinetics of alkamides from the roots of Echinacea angustifolia in humans. Journal of Clinical Pharmacology 45(6):683-689.

Wren RC. 1907. Potter's Cyclopedia of Botanical Drugs and Preparations. London (GB): Potter and Clark.