American Elder - Sirturo (Bedaquiline) Interaction
Herbal: American Elder
Also Known As: Sambucus canadensis, American Elderberry, Common Elderberry, Elder Flower, Elderberry, Sabugueiro, Saúco, Saúco de Canada, Sureau, Sureau Blanc, Sureau du Canada, Sweet Elder
Drug: Bedaquiline
Brand names:
Sirturo
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 18, 2025
Interaction Details
Bedaquiline is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, taking American elder might increase levels of CYP3A4 substrates.
In vitro research shows that American elder inhibits CYP3A4 enzymes.
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
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82.
American Elder Overview
The American elder (Sambucus canadensis) is a plant native to North America. It is a member of the Caprifoliaceae family and is commonly known as elderberry or simply 'elder'. It has large leaves and produces clusters of small, white, or cream-colored flowers. The plant's fruit is a dark blue/purple berry.
American elder (Sambucus canadensis) and black elder (Sambucus nigra) are two different species of plants in the Sambucus genus. Both are used in traditional medicine and as food. They are claimed to have a variety of health benefits and are commonly used for their purported immune system-stimulating effects. However, black elder (Sambucus nigra) is far more commonly utilized in dietary supplements.
Bedaquiline Overview
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Bedaquiline is used along with at least three other medications to treat multi-drug resistant tuberculosis (MDR-TB; a serious infection that affects the lungs and other parts of the body and that cannot be treated with other medications that are usually used to treat the condition) in adults and children 5 years and older who weigh at least 33 lbs (15 kg) that has affected the lungs. Bedaquiline should not be used to treat TB that mainly affects other parts of the body. Bedaquiline is in a class of medications called anti-mycobacterials. It works by killing the bacteria that cause MDR-TB.
American Elder - More Interactions
American Elder interacts with 623 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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