Minor
Echinacea purpurea (juice/extract) × Paracetamol
Herbal immunomodulators (local classification)×Anilides. Analgesics and antipyretics
Mechanism
Echinacea purpurea modulates CYP1A2 and CYP3A4 in vitro, but the in vivo effect is minimal. No direct pharmacokinetic interaction with paracetamol has been described.
Symptoms
The combination usually causes no specific symptoms. Each drug's individual side effects remain.
Management
No dose adjustment needed. The combination is standard in over-the-counter use for acute respiratory infections. Echinacea's efficacy as an immunostimulant is not confirmed by large randomised trials (Cochrane Review 2014).