Drug & supplement interaction

American Elder + Palifermin

Palifermin brand name: Kepivance.

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 Palifermin 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 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 Palifermin

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 Palifermin 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 Palifermin and American Elder? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Palifermin

Interactions in our licensed database are recorded against drug classes, not just single drug names. Palifermin 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 Palifermin’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 — Palifermin 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. Palifermin)
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 Palifermin 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.

  • Numbness or tingling Additional detail

    American Elder

    “Orally, ingesting several glasses of American elderberry juice has been reported to cause weakness, dizziness, numbness, and stupor (6).”

    American Elder · Natural Medicines adverse-effect record, reported in vertigo.

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

    Palifermin

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

Reported for American Elder but not commonly for Palifermin: dizziness, vomiting and nausea.

Effects for Palifermin come from the ADVERSE REACTIONS section of its FDA label; effects for American Elder come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 388 voluntary FDA FAERS reports for Palifermin that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. 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

Overlapping uses

What Palifermin Is Prescribed For, and What American Elder Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Palifermin is a prescription medicine with approved uses on its FDA label. American Elder is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Palifermin is prescribed for: Kepivance (palifermin) is used to decrease how often and how long severe oral mucositis — painful sores in the mouth and throat — occurs in patients with hematologic malignancies (blood cancers such as lymphoma, leukemia, or multiple myeloma) who are receiving high-dose, cell-damaging (myelotoxic) therapy before an autologous hematopoietic stem cell transplant (a transplant using the patient's own stem cells). Kepivance is specifically indicated when the preparative chemotherapy or radiation regimen is expected to cause severe mucositis in most patients. It is not recommended for use with a high-dose melphalan conditioning regimen, and it was not found to be effective in the setting of allogeneic stem cell transplant (using a donor's cells). Its safety and effectiveness have not been established for patients with non-blood cancers (non-hematologic malignancies).

American Elder has been studied for:

  • Cancer studied, not established American Elder has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    American Elder for cancer

    Although there has been interest in using oral American elder for cancer, there is insufficient reliable information about the clinical effects of American elder for this purpose.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Palifermin on your own; if you are taking American Elder for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

Everything else you take

See Every Supplement That Interacts With Palifermin

This page covers American Elder only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Palifermin 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 Palifermin page

“Palifermin (Kepivance) is given by IV to prevent the severe mouth sores that intensive chemotherapy can cause, most often in patients heading into a stem cell transplant, and I read its interaction list with genuine caution because of how fragile those patients already are. All 17 supplements on file act on absorption through the gut,…”

Reviewed by 2 · Jul 18, 2026

Open the Palifermin 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 Palifermin, 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 Palifermin 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

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

29 days ago today
Medication Palifermin
Steady interest

#2,659 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 Palifermin 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 Palifermin

What Is Palifermin Used For?

Brand name: Kepivance

Kepivance (palifermin) is used to decrease how often and how long severe oral mucositis — painful sores in the mouth and throat — occurs in patients with hematologic malignancies (blood cancers such as lymphoma, leukemia, or multiple myeloma) who are receiving high-dose, cell-damaging (myelotoxic) therapy before an autologous hematopoietic stem cell transplant (a transplant using the patient's own stem cells).

Kepivance is specifically indicated when the preparative chemotherapy or radiation regimen is expected to cause severe mucositis in most patients. It is not recommended for use with a high-dose melphalan conditioning regimen, and it was not found to be effective in the setting of allogeneic stem cell transplant (using a donor's cells). Its safety and effectiveness have not been established for patients with non-blood cancers (non-hematologic malignancies).

Most-Reported Side Effects for Palifermin

From FAERS, the FDA’s public side-effect reporting system (388 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Mucosal inflammation 56 reports
Febrile neutropenia 39 reports
Rash 39 reports
Stomatitis 34 reports
Erythema 28 reports
See full Palifermin 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 Palifermin, 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 Palifermin Together: Common Questions

Is it safe to take American Elder with Palifermin?
We do not list a known interaction between American Elder and Palifermin. 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 Palifermin 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.
Are American Elder and Palifermin used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for American Elder in each. That is a conversation for your prescriber, especially if Palifermin is being adjusted to a target.
How was the American Elder and Palifermin combination checked?
Interactions in our licensed database are recorded against drug classes. Palifermin is filed under 1 classification, and American Elder has documented interactions with 2 drug classes — none of Palifermin'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 — Palifermin 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 Palifermin interact with any supplements?
Yes. Palifermin has documented interactions with 17 supplements in our database — American Elder is not one of them. The Palifermin 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 Palifermin drug information The full plain-English guide to this medication Palifermin supplement interactions Every supplement checked against Palifermin, 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 Palifermin and American Elder?

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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.