Drug interactions
Echinacea + Methotrexate
Severity: Minor
Echinacea and Methotrexate: minor interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Echinacea is an immune stimulant and could theoretically oppose methotrexate's immunosuppressive action. Echinacea has also been linked to hepatotoxicity, which may add to methotrexate liver risk. Clinical evidence is minimal.
What this interaction means in plain words
Echinacea and Methotrexate have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Echinacea belongs to Gastrointestinal Tract; Methotrexate belongs to Oncology.
Why it happens
Theoretical pharmacodynamic opposition through immune stimulation, plus possible additive hepatotoxicity; not well established.
What to do
Advise avoiding echinacea during methotrexate therapy for immune conditions. Monitor liver enzymes as per routine methotrexate monitoring.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Methotrexate
- Acitretin + Methotrexate Contraindicated
- Adenovirus types 4 and 7 live + Methotrexate Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Methotrexate Contraindicated
- Ketorolac + Methotrexate Contraindicated
- Measles mumps and rubella vaccine live + Methotrexate Contraindicated
- Measles mumps and rubella vaccine + Methotrexate Contraindicated
Other interactions of Echinacea
- Alefacept + Echinacea Moderate
- Antithymocyte globulin equine + Echinacea Moderate
- Antithymocyte globulin rabbit + Echinacea Moderate
- Azathioprine + Echinacea Moderate
- Basiliximab + Echinacea Moderate
- Cyclosporine + Echinacea Moderate
Frequently asked questions
Can I take Echinacea with Methotrexate?
MediHelp rates the interaction as minor. Echinacea and Methotrexate have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Echinacea is an immune stimulant and could theoretically oppose methotrexate's immunosuppressive action. Echinacea has also been linked to hepatotoxicity, which may add to methotrexate liver risk. Clinical evidence is minimal.
How serious is the interaction between Echinacea and Methotrexate?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise avoiding echinacea during methotrexate therapy for immune conditions. Monitor liver enzymes as per routine methotrexate monitoring.
What other medicines interact with Methotrexate?
MediHelp also lists interactions of Methotrexate with, for example, Acitretin, Adenovirus types 4 and 7 live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Methotrexate page.
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