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Is echinacea safe during pregnancy?

Written by the Full Measure editorial team, which sells supplements. Approved for publication by the Full Measure owners. Updated .

Drafted with AI assistance from the sources listed below. How we write these

Quick answer

Official sources differ. NCCIH says some studies suggest short use of echinacea extracts is possibly safe for up to 7 days in the first trimester, while NIH says safety in pregnancy is not known and experts recommend against supplements. Two observational studies covering 569 exposed pregnancies found no excess of malformations. Ask your doctor first.1,2,3,4

Key facts

  • NCCIH says some studies of solid or liquid extracts of E. purpurea and E. angustifolia suggest it is possibly safe for up to 7 days during the first trimester, and advises talking to a health care provider.1
  • NIH's health professional fact sheet says the safety of echinacea during pregnancy is not known, so experts recommend against echinacea supplements for women who are pregnant.2
  • In a Norwegian study of 68,522 pregnancies, the 363 women who used echinacea had no higher rate of birth defects or other adverse outcomes.3
  • In a Toronto study, 206 women who used echinacea, 112 of them in the first trimester, had rates of malformations similar to 206 matched women who did not.4
  • The European Medicines Agency's monograph says limited data on several hundred exposed pregnancies show no adverse effects, but that use is not recommended unless a doctor advises it, for lack of sufficient data.5

What do NCCIH, NIH and European regulators say?

They do not say the same thing, and the difference is worth seeing. NCCIH's page on echinacea says some studies of solid or liquid extracts of E. purpurea and E. angustifolia suggest it is possibly safe for up to 7 days in the first trimester, and tells anyone considering it while pregnant to consult a health care provider.1

NIH's Office of Dietary Supplements is more cautious. Its fact sheet for health professionals says the safety of echinacea during pregnancy is not known, so experts recommend against supplements for pregnant women, and its consumer sheet says scientists do not know whether echinacea is safe during pregnancy.2,6

The European Medicines Agency's monograph, written for pressed juice from the fresh flowering herb, lands in between. It notes that limited data on several hundred exposed pregnancies show no adverse effects on pregnancy or on the fetus or newborn, then says that without enough data the use in pregnancy and lactation is not recommended unless a doctor advises it.5

What do studies of women who used echinacea show?

In a Norwegian study of 68,522 pregnancies, the 363 women who used echinacea had no higher rate of birth defects or other adverse pregnancy outcomes than those who did not.3

In a Toronto study, 206 women who took echinacea in pregnancy, 112 of them in the first trimester, had rates of major and minor malformations similar to a matched group of 206 women.4

Both studies are observational. The women who used echinacea were not assigned to it at random, the Toronto women used it for upper respiratory ailments, and that group had only 112 first-trimester users. Neither study can show that a rare problem never happens, and neither says which product, species or plant part was used.3,4

A 2005 systematic review of echinacea safety looked across trials, reports to drug safety bodies and manufacturers' files. It judged that use during pregnancy and lactation would appear ill-advised given how little data exist. That review was published in 2005, before the Norwegian cohort was done.7

Does it matter whether it is tea, root or extract?

It may. Products differ in species, plant part and preparation, and NCCIH's first-trimester statement names solid or liquid extracts of two species. None of the sources we read tested tea, root powder or a blend of species in pregnancy.1

Supplements mostly use extracts of E. purpurea, E. angustifolia or E. pallida, made from the root, the parts above ground or the whole plant, and US products often mix species and plant parts.2,5,8

Echinacea studies have used different species, plant parts and preparations, so a result with one product may not apply to another.2,9

Who should ask their doctor before using echinacea while pregnant?

  • Anyone who is pregnant or trying to conceive should ask their doctor before using echinacea, because the official sources disagree.1,2
  • Anyone with an allergy to plants in the daisy family, such as ragweed, daisies or sunflowers, should ask their doctor, because echinacea belongs to that family and allergic reactions can be severe.1
  • Anyone with asthma, eczema or hay fever should ask their doctor, because European regulators warn of a possible risk of severe allergic reactions in people prone to allergy.5
  • Anyone who takes warfarin or another prescription medicine should ask their pharmacist, because NCCIH describes conflicting evidence that echinacea affects medicines broken down by the liver.1

Questions people ask

Is echinacea safe during pregnancy?

Official sources differ. NCCIH says some studies suggest short first-trimester use is possibly safe, and NIH says its safety in pregnancy is not known. Ask your doctor.1,2

Is echinacea tea safe during pregnancy?

No source we read tested tea in pregnancy. NCCIH's statement concerns solid or liquid extracts of two species taken for up to 7 days in the first trimester. Ask your doctor.1

Is echinacea purpurea safe during pregnancy?

NCCIH's first-trimester statement covers E. purpurea and E. angustifolia extracts, while NIH says experts recommend against supplements because the safety is not known. Ask your doctor.1,2

Is echinacea root safe during pregnancy?

We found no source on root in pregnancy. Products differ in plant part and preparation, so a result with one product may not apply to another. Ask your doctor.2

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Sources

  1. National Center for Complementary and Integrative Health. Echinacea. Bethesda (MD): National Institutes of Health. Last updated November 2024. Opened 2026-10-07.
  2. National Institutes of Health, Office of Dietary Supplements. Dietary Supplements for Immune Function and Infectious Diseases: Fact Sheet for Health Professionals. Updated March 10, 2025. Opened 2026-10-07.
  3. Heitmann K, Havnen GC, Holst L, Nordeng H. Pregnancy outcomes after prenatal exposure to echinacea: the Norwegian Mother and Child Cohort Study. Eur J Clin Pharmacol. 2016;72(5):623-630. Opened 2026-10-07.
  4. Gallo M, Sarkar M, Au W, et al. Pregnancy outcome following gestational exposure to echinacea: a prospective controlled study. Arch Intern Med. 2000;160(20):3141-3143. Opened 2026-10-07.
  5. European Medicines Agency, Committee on Herbal Medicinal Products. European Union herbal monograph on Echinacea purpurea (L.) Moench, herba recens. EMA/HMPC/48704/2014 Corr. 1. 24 November 2015. Opened 2026-10-07.
  6. National Institutes of Health, Office of Dietary Supplements. Dietary Supplements for Immune Function and Infectious Diseases: Fact Sheet for Consumers. Updated March 10, 2025. Opened 2026-10-07.
  7. Huntley AL, Thompson Coon J, Ernst E. The safety of herbal medicinal products derived from Echinacea species: a systematic review. Drug Saf. 2005;28(5):387-400. Opened 2026-10-11.
  8. Gorski JC, Huang SM, Pinto A, et al. The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo. Clin Pharmacol Ther. 2004;75(1):89-100. Opened 2026-10-07.
  9. Echinacea. In: Drugs and Lactation Database (LactMed). Bethesda (MD): National Institute of Child Health and Human Development; 2006 onward. Updated October 15, 2024. Summary read through PubMed. Opened 2026-10-07.

This page is information, not medical advice. Talk to your doctor or pharmacist about your own situation.