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Equinacea Arkopharma is a pharmaceutical-grade herbal medicinal product containing 250 mg of cryo-milled (cryogenized) root of *Echinacea purpurea* (L.) Moench per hard caplet. It is classified as a traditional herbal medicinal product by the European Medicines Agency (EMA) for the supportive treatment of the common cold. The product was evaluated in the Phase 4 ECCO-2 (Echinacea and Coronavirus-II) clinical trial, led by Jesús R. Requena, as an adjunct therapy for ambulatory patients with mild COVID-19. Its mechanism of action involves the stimulation of the innate immune system and direct antiviral effects against SARS-CoV-2, mediated by active principles such as alkylamides, cichoric acid, and glycoproteins. Although the ECCO-2 trial confirmed the safety and tolerability of the product, it did not demonstrate significant clinical efficacy in the COVID-19 population, a result attributed in part to low patient recruitment.
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