Elderberry - Prograf (capsule) (Tacrolimus) Interaction
Herbal: Elderberry
Also Known As: Sambucus nigra, Arbre de Judas, Baccae, Baises de Sureau, Black-Berried Alder, Black Elder, Black Elderberry, Boor Tree, Bountry, Common Elder, Elder, Elder Berry, Elderberries, Elderberry Fruit, Ellanwood, Ellhorn, European Alder, European Black Elder
Drug: Tacrolimus
Brand names:
Prograf (capsule), Prograf (injectable), Protopic, Prograf XL, Astagraf XL, Envarsus XR
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Apr 20, 2025
Interaction Details
Tacrolimus is classified as belonging to the following category: Immunosuppressants
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Elderberry has immunostimulant activity, increasing the production of cytokines, including interleukin and tumor necrosis factor.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Barak V, Halperin T, Kalickman I. The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw 2001;12:290-6..
Elderberry Overview
Elderberry (Sambucus) is a plant that belongs to the Adoxaceae family. It is native to Europe, Asia, and North America, and has been used for centuries in traditional medicine. The Elderberry plant has distinctive dark purple or black berries, which are often used in different types of food, including jams, jellies, and syrups. In traditional medicine, elderberry is one of the most popular over-the-counter supplements due to its purported immune-stimulating effects and is used to treat colds, flu, and other respiratory infections. Some studies have suggested that elderberry may have antiviral and immune-boosting properties, but more research is needed to confirm these effects. It is important to note that there are several different species of elderberry, including American elder (Sambucus canadensis) and black elder (Sambucus nigra). Black elder is more commonly used in dietary supplements.
Tacrolimus Overview
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Tacrolimus (Astagraf XL, Envarsus XR, Prograf) is used along with other medications to prevent rejection (attack of a transplanted organ by the immune system of a person receiving the organ) in people who have received a kidney transplant. Tacrolimus (Prograf) is also used along with other medications to prevent rejection in people who have received a liver, lung, or heart transplant. Tacrolimus is in a class of medications called immunosupressants. It works by decreasing the activity of the immune system to prevent it from attacking the transplanted organ.
Elderberry - More Interactions
Elderberry interacts with 112 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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