Drug & supplement interaction

American Elder + Mesalamine

Mesalamine brand names: Pentasa, Asacol, Canasa, Rowasa, Lialda, and others.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between American Elder and Mesalamine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Mesalamine states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

American Elder and Mesalamine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Mesalamine and American Elder in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

American Elder safety at a glance

American Elder overall Use caution Cooked ripe berries and flowers are generally well tolerated, but raw or unripe berries and other plant parts can be toxic.
Pregnancy Likely Unsafe When the leaves, stems, or unripe fruit are used orally. There is insufficient reliable information available about the safety of the flower or cooked fruit dur... Read the full pregnancy detail
Breastfeeding Likely Unsafe When the leaves, stems, or unripe fruit are used orally. There is insufficient reliable information available about the safety of the flower or cooked fruit dur... Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Mesalamine and American Elder? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Mesalamine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Mesalamine is filed under a single classification — oral drugs. American Elder has documented interactions with 2 drug classes — the most serious being cytochrome p450 3a4 (cyp3a4) substrates (moderate) and lithium (moderate) — and none of Mesalamine’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

American Elder Does Interact With Other Medications

American Elder has 644 moderate known drug interactions in our database — Mesalamine isn’t one of them. If you take anything else, check it against the full list below.

Moderate 644 No known interaction 2,186 (incl. Mesalamine)
Taking anything else?

Check Another of Your Medications Against American Elder

Covers the 2,830 medications we’ve checked against American Elder. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests American Elder and Mesalamine May Share a Side Effect

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Vomiting Additional detail

    American Elder

    “Orally, ingesting several glasses of American elderberry juice has been reported to cause nausea and vomiting (6).”

    American Elder · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    1 source cited
    1. 6. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.

    Mesalamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Mesalamine. Read the label on DailyMed ›

Reported for American Elder but not commonly for Mesalamine: dizziness, numbness or tingling and nausea.

Effects for Mesalamine come from the ADVERSE REACTIONS section of its FDA label; effects for American Elder come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

American Elder in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Unsafe

When the leaves, stems, or unripe fruit are used orally. There is insufficient reliable information available about the safety of the flower or cooked fruit during pregnancy or lactation; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Mesalamine Products Have a Food Rule — American Elder Should Not Break It

At least one FDA label for a product containing Mesalamine says to take it with food. If you take American Elder on an empty stomach out of habit, keep them separate — and take Mesalamine with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Mesalamine products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

( 2 ) Administer mesalamine delayed-release tablets with food.

From the Dosage and Administration section of the FDA label we read for Mesalamine — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

From our Q&A

Questions About American Elder or Mesalamine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers American Elder or Mesalamine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Mesalamine

This page covers American Elder only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Mesalamine page lists 17 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 7 moderate · 9 minor.

From our pharmacist’s overview on the Mesalamine page

“Activated charcoal is the one entry here I would treat as a genuine problem for anyone taking mesalamine (Asacol, Lialda, Pentasa, and others). It is the lone major-rated interaction among the 17 on file, because charcoal soaks up drugs in the gut and can pull mesalamine out of the picture before it does its job.”

Reviewed by 2 · Jul 18, 2026

Open the Mesalamine interaction page

One more smart check

Taking American Elder as Part of a Dietary Supplement Product? Check It for Interactions

We hold 61 real supplement products containing American Elder, each one broken down to its full ingredient list — and combination products often carry several ingredients besides American Elder. Even though American Elder itself has no known interaction with Mesalamine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where American Elder and Mesalamine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement American Elder
Top half

#534 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Mesalamine
Top 25%

#687 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every American Elder reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The American Elder and Mesalamine records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About American Elder

What is American Elder?

American Elder
  • Cold and flu symptoms
  • Immune support
  • Fever and congestion (traditional)
  • Constipation (traditional)
  • Antioxidant support

American elder is a North American plant whose cooked, ripe berries and flowers are used mainly for colds, flu, and general immune support. The science behind these uses is limited and most studies focus on the closely related European black elder (Sambucus nigra), so benefits are uncertain. Only properly prepared berries and flowers should be used, since raw berries, leaves, bark, and seeds can cause poisoning.

Sambucus canadensis · Adoxaceae · Ripe berries (fruit) and flowers; other parts are considered unsafe · Syrups, capsules, gummies, lozenges, teas, tinctures, juices, and jams

An interaction check asks whether these two react with each other — it does not ask whether American Elder is a good idea for someone in your situation. Here is what our American Elder record says about it on its own.

American Elder: dosing

There is no official standardized dose for American elder, and products vary widely in strength and form. Syrups, gummies, capsules, and teas all contain different amounts of elderberry.The safest approach is to follow the directions on the product label and not exceed the recommended amount.

From our American Elder monograph — the full record covers uses, side effects and every documented interaction.

Read the full American Elder monograph & all interactions
Medication

About Mesalamine

What Is Mesalamine Used For?

Brand names: Pentasa, Asacol, Canasa, Rowasa, Lialda, Delzicol

Mesalamine is used to treat mildly to moderately active ulcerative colitis — a condition where the lining of the large intestine becomes inflamed and ulcerated. Depending on the product and formulation, it can be used to bring the disease under control (induction of remission) and/or to keep it from coming back (maintenance of remission).

Different products target different parts of the lower digestive tract. Oral forms (tablets and capsules) treat the colon more broadly. Rectal forms — including enemas (ROWASA, sfROWASA, mesalamine rectal suspension) — are used for distal ulcerative colitis, proctosigmoiditis, or proctitis (inflammation limited to the lower end of the colon or rectum). Rectal suppositories (CANASA, mesalamine rectal suppositories) are specifically for ulcerative proctitis (inflammation of the rectum only).

See full Mesalamine drug information
Keep checking

Other Drugs & American Elder

Browse every other medication we’ve checked against American Elder — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
644Moderate
0Minor
2,185No known interaction
644 Moderate 2,185 No interaction
Moderate

644 interactions

Showing 60 of 644 moderate interactions — see all 644 on the American Elder page.

No interaction 2,185 drugs checked — show the list

We also checked American Elder against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,185 medications checked with no known interaction — see the full American Elder list.

See the full American Elder interactions page
See every supplement checked against Mesalamine, ranked by severity
Evidence & sources

American Elder References

The 2 references that drive our American Elder monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. 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. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking American Elder and Mesalamine Together: Common Questions

Is it safe to take American Elder with Mesalamine?
We do not list a known interaction between American Elder and Mesalamine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do American Elder and Mesalamine have any of the same side effects?
Yes — our sources link each of them separately to one of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take American Elder and Mesalamine at the same time of day?
At least one FDA label for a product containing Mesalamine says to take it with food. If you take American Elder on an empty stomach out of habit, keep them separate and take Mesalamine with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Mesalamine products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the American Elder and Mesalamine combination checked?
Interactions in our licensed database are recorded against drug classes. Mesalamine is filed under 1 classification, and American Elder has documented interactions with 2 drug classes — none of Mesalamine's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does American Elder interact with any other medications?
Yes. American Elder has 644 documented drug interactions in our database — Mesalamine is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Mesalamine interact with any supplements?
Yes. Mesalamine has documented interactions with 17 supplements in our database — American Elder is not one of them. The Mesalamine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

American Elder monograph Uses, safety profile, and every drug interaction in one place Mesalamine drug information The full plain-English guide to this medication Mesalamine supplement interactions Every supplement checked against Mesalamine, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 2 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Mesalamine and American Elder?

Our pharmacists answer your medication & supplement questions — free.

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.