title: Safety and efficacy of echinacea (Echinacea angustafolia, e. purpurea and e. pallida) during pregnancy and lactation.
abstract: BACKGROUND
  There is a lack of basic knowledge on the part of both clinicians and patients as to the indications for use and safety of herbal medicines used in pregnancy and lactation. This is one article in a series that systematically reviews the evidence for commonly used herbs during pregnancy and lactation.
  
  
  OBJECTIVE
  To systematically review the literature for evidence on the use, safety, and pharmacology of echinacea focusing on issues pertaining to pregnancy and lactation.
  
  
  METHODS
  We searched 7 electronic databases and compiled data according to the grade of evidence found.
  
  
  RESULTS
  There is good scientific evidence from a prospective cohort study that oral consumption of echinacea during the first trimester does not increase the risk for major malformations. Low-level evidence based on expert opinion shows that oral consumption of echinacea in recommended doses is safe for use during pregnancy and lactation.
  
  
  CONCLUSIONS
  Echinacea is non-teratogenic when used during pregnancy. Caution with using Echinacea during lactation until further high quality human studies can determine its safety.
authors.affiliation: Department of Clinical Pharmacology and Toxicology, University of Toronto, Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Perri
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Dugoua
authors.forename: Edward
authors.initials: E
authors.lastname: Mills
authors.forename: Gideon
authors.initials: G
authors.lastname: Koren
mesh_terms: D000284:Administration, Oral; D000818:Animals; D020900:Echinacea / Q000009:adverse effects; D005260:Female; D041743:Herb-Drug Interactions; D006801:Humans; D007774:Lactation; D007928:Lethal Dose 50; D018515:Plant Leaves; D028321:Plant Preparations / Q000008:administration & dosage / Q000009:adverse effects / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use / Q000633:toxicity; D018517:Plant Roots; D018547:Plant Stems; D011247:Pregnancy; D018570:Risk Assessment
chemical_list: D028321:Plant Preparations