Drug & supplement interaction

Elderberry + Brexpiprazole

Brexpiprazole brand name: Rexulti.

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 Elderberry and Brexpiprazole 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

Elderberry and Brexpiprazole

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 Brexpiprazole and Elderberry 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.

Elderberry safety at a glance

Elderberry overall Use caution Properly prepared (cooked) elderberry products are generally well tolerated, but raw or unripe berries, leaves, bark, and seeds can be toxic.
Pregnancy Likely Safe When consumed in the amounts typically found in foods. There is insufficient reliable information available about the safety of elderberry when used for medicin... Read the full pregnancy detail
Breastfeeding Likely Safe When consumed in the amounts typically found in foods. There is insufficient reliable information available about the safety of elderberry when used for medicin... 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 Brexpiprazole and Elderberry? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Brexpiprazole

Interactions in our licensed database are recorded against drug classes, not just single drug names. Brexpiprazole is filed under 8 classifications — including dopamine agonists, antipsychotic drugs, serotonergic drugs. Elderberry has documented interactions with 2 drug classes — the most serious being immunosuppressants (moderate) and pazopanib (votrient) (moderate) — and none of Brexpiprazole’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

Elderberry Does Interact With Other Medications

Elderberry has 121 moderate known drug interactions in our database — Brexpiprazole isn’t one of them. If you take anything else, check it against the full list below.

Moderate 121 No known interaction 2,709 (incl. Brexpiprazole)
Taking anything else?

Check Another of Your Medications Against Elderberry

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

What to actually watch for

No Interaction Found — But Data Suggests Elderberry and Brexpiprazole May Share Several of the Same Side Effects

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.

  • Stomach pain Additional detail

    Elderberry

    “In one case report, a 60-year-old female with underlying autoimmune disease presented with autoimmune hepatitis after taking elderberry at an unknown dose for several years. The patient presented with nausea, jaundice, abdominal pain, and abdominal distention. Liver function tests returned to baseline 4 weeks after initiating treatment with prednisone 40 mg daily and discontinuing elderberry.”

    Elderberry · Natural Medicines adverse-effect record, reported in hepatitis.

    1 source cited
    1. 110123. Ramachandran A, Antala D, Pudasainee P, Panginikkod S, Gupta H. A Plausible Association Between the Use of Elderberry and Autoimmune Hepatitis. Cureus 2022;14(4):e24250. PubMed

    Brexpiprazole

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

  • Dizziness Additional detail

    Elderberry

    “Raw and unripe elderberries might cause weakness, dizziness, numbness, and stupor due to cyanogenic glycosides. Cooking eliminates the toxin.”

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

    2 sources cited
    1. 17020. Elderberry (Sambucus species). The Poison Plant Patch, Novia Scotia Museum, 2007. Available at: http://museum.gov.ns.ca/poison/?section=species&id=117 (Accessed 16 October 2009).
    2. 17021. European elder. Canadian Poisonous Plants Information System. Available at: http://www.cbif.gc.ca/pls/pp/ppack.jump?p_null=all&p_psn=121&p_type=all&p_sci=comm&p_x=px (Accessed 16 October 2009).

    Brexpiprazole

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

  • Diarrhea / Nausea Additional detail

    Elderberry

    “Orally, nausea and vomiting have been reported after consuming a specific elderberry and echinacea product (Echinaforce Hot Drink, A. Vogel Bioforce AG). However, it is unclear if this was due to the elderberry or Echinacea contained in the product.

    Raw and unripe elderberries, and the seeds, leaves, and other elder tree parts might cause nausea, vomiting, or severe diarrhea due to cyanogenic glycosides.”

    Elderberry · Natural Medicines adverse-effect record, reported in diarrhea.

    3 sources cited
    1. 95650. Raus K, Pleschka S, Klein P, Schoop R, Fisher P. Effect of an echinacea-based hot drink versus oseltamivir in Influenza treatment: a randomized, double-blind, double-dummy, multicenter, noninferiority clinical trial. . Curr Ther Res Clin Exp. 2015;20;77:6 PubMed
    2. 17020. Elderberry (Sambucus species). The Poison Plant Patch, Novia Scotia Museum, 2007. Available at: http://museum.gov.ns.ca/poison/?section=species&id=117 (Accessed 16 October 2009).
    3. 17021. European elder. Canadian Poisonous Plants Information System. Available at: http://www.cbif.gc.ca/pls/pp/ppack.jump?p_null=all&p_psn=121&p_type=all&p_sci=comm&p_x=px (Accessed 16 October 2009).

    Brexpiprazole

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

Reported for Elderberry but not commonly for Brexpiprazole: liver problems, vomiting, numbness or tingling and yellowing of the skin or eyes.

Effects for Brexpiprazole come from the ADVERSE REACTIONS section of its FDA label; effects for Elderberry come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 16,505 voluntary FDA FAERS reports for Brexpiprazole 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

Elderberry in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Safe

When consumed in the amounts typically found in foods. There is insufficient reliable information available about the safety of elderberry when used for medicinal purposes; avoid using in amounts greater than those found in foods.

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

From our Q&A

Questions About Elderberry or Brexpiprazole

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Elderberry or Brexpiprazole, 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 Brexpiprazole

This page covers Elderberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Brexpiprazole page lists 177 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Indian Snakeroot (major), Lithium (major) and Rauvolfia Vomitoria (major).

By severity: 6 major · 130 moderate · 41 minor.

From our pharmacist’s overview on the Brexpiprazole page

“Brexpiprazole (Rexulti) treats schizophrenia and is added to antidepressants for depression, and its supplement list warrants real care before you add anything to it. The bulk of the 177 entries change how your liver clears the drug, so grapefruit can push levels up while St.”

Reviewed by 2 · Jul 18, 2026

Open the Brexpiprazole interaction page

One more smart check

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

We hold 226 real supplement products containing Elderberry, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Elderberry. Even though Elderberry itself has no known interaction with Brexpiprazole, 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 Elderberry and Brexpiprazole 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 Elderberry
Top 25%

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

29 days ago today
Medication Brexpiprazole
Top half

#796 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 Elderberry reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Elderberry and Brexpiprazole 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 Elderberry

What is Elderberry?

Elderberry
  • Colds
  • Flu (influenza)
  • Other respiratory infections
  • Immune support
  • Sinus and upper respiratory symptoms

Elderberry is a popular herbal supplement, mainly taken to help with colds and flu. Some small studies suggest it may modestly shorten cold or flu symptoms, but the evidence is limited and not conclusive. Cooked berries and properly prepared products are generally well tolerated, but raw or unripe parts can cause nausea and should be avoided.

Sambucus nigra · Adoxaceae · Berries and flowers (ripe, cooked fruit and dried flowers) · Syrup, gummies, lozenges, capsules, tablets, teas, and liquid extracts

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

Elderberry: dosing

There is no official standardized dose for elderberry. Products vary widely in strength and form, from syrups and gummies to capsules and teas, so the amount of active ingredient differs from one product to another.The best approach is to follow the directions on the product label and not exceed the recommended amount.

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

Read the full Elderberry monograph & all interactions
Medication

About Brexpiprazole

What Is Brexpiprazole Used For?

Brand name: Rexulti

Brexpiprazole tablets are approved for two uses in adults: as an add-on (adjunctive) treatment alongside antidepressants for major depressive disorder (MDD), and as a treatment for schizophrenia. These uses apply to both the generic brexpiprazole tablets and Rexulti.

Rexulti has one additional approved use: treating agitation associated with dementia due to Alzheimer's disease in adults. Rexulti is also approved for schizophrenia in adolescents ages 13 and older. Note that Rexulti is not approved for dementia-related psychosis without agitation from Alzheimer's disease, and it is not meant to be used on an as-needed basis for Alzheimer's-related agitation.

Most-Reported Side Effects for Brexpiprazole

From FAERS, the FDA’s public side-effect reporting system (16,505 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Weight increased 1,702 reports
Akathisia 869 reports
Tremor 654 reports
Anxiety 612 reports
Tardive dyskinesia 599 reports
See full Brexpiprazole drug information
Keep checking

Other Drugs & Elderberry

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

0Major
121Moderate
0Minor
2,708No known interaction
121 Moderate 2,708 No interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Elderberry page.

No interaction 2,708 drugs checked — show the list

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

Showing the 60 most looked-up of 2,708 medications checked with no known interaction — see the full Elderberry list.

See the full Elderberry interactions page
See every supplement checked against Brexpiprazole, ranked by severity
Evidence & sources

Elderberry References

The 6 references that drive our Elderberry 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. 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..
  2. Elderberry (Sambucus species). The Poison Plant Patch, Novia Scotia Museum, 2007. Available at: http://museum.gov.ns.ca/poison/?section=species&id=117 (Accessed 16 October 2009).
  3. European elder. Canadian Poisonous Plants Information System. Available at: http://www.cbif.gc.ca/pls/pp/ppack.jump?p_null=all&p_psn=121&p_type=all&p_sci=comm&p_x=px (Accessed 16 October 2009).
  4. Raus K, Pleschka S, Klein P, Schoop R, Fisher P. Effect of an echinacea-based hot drink versus oseltamivir in Influenza treatment: a randomized, double-blind, double-dummy, multicenter, noninferiority clinical trial. . Curr Ther Res Clin Exp. 2015;20;77:6 PubMed
  5. Ramachandran A, Antala D, Pudasainee P, Panginikkod S, Gupta H. A Plausible Association Between the Use of Elderberry and Autoimmune Hepatitis. Cureus 2022;14(4):e24250. PubMed
  6. Agarwal N, Mangla A. Elderberry interaction with pazopanib in a patient with soft-tissue sarcoma: A case report and literature review. Mol Clin Oncol 2024;20(5):36. 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 Elderberry and Brexpiprazole Together: Common Questions

Is it safe to take Elderberry with Brexpiprazole?
We do not list a known interaction between Elderberry and Brexpiprazole. 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 Elderberry and Brexpiprazole have any of the same side effects?
Yes — our sources link each of them separately to 4 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.
How was the Elderberry and Brexpiprazole combination checked?
Interactions in our licensed database are recorded against drug classes. Brexpiprazole is filed under 8 classifications, and Elderberry has documented interactions with 2 drug classes — none of Brexpiprazole'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 Elderberry interact with any other medications?
Yes. Elderberry has 121 documented drug interactions in our database — Brexpiprazole 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 Brexpiprazole interact with any supplements?
Yes. Brexpiprazole has documented interactions with 177 supplements in our database — Elderberry is not one of them. The Brexpiprazole 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

Elderberry monograph Uses, safety profile, and every drug interaction in one place Brexpiprazole drug information The full plain-English guide to this medication Brexpiprazole supplement interactions Every supplement checked against Brexpiprazole, 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 6 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Brexpiprazole and Elderberry?

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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.