Drug & supplement interaction

Elderberry + Cobicistat

Cobicistat brand name: Tybost.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Elderberry and Cobicistat 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 Cobicistat 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

Elderberry and Cobicistat

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 Cobicistat 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 Cobicistat and Elderberry? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Cobicistat

Interactions in our licensed database are recorded against drug classes, not just single drug names. Cobicistat is filed under 2 classifications — cytochrome p450 3a4 (cyp3a4) inhibitors, oral drugs. Elderberry has documented interactions with 2 drug classes — the most serious being immunosuppressants (moderate) and pazopanib (votrient) (moderate) — and none of Cobicistat’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 — Cobicistat 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. Cobicistat)
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 Cobicistat 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. One of them is worth acting on rather than waiting out — marked below.

  • Yellowing of the skin or eyes Worth acting on 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

    Cobicistat

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

  • Stomach pain Additional detail

    Elderberry

    Recorded for Elderberry in the same Natural Medicines adverse-effect record shown under Yellowing of the skin or eyes above.

    Cobicistat

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

  • Diarrhea / Vomiting / 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).

    Cobicistat

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

Reported for Elderberry but not commonly for Cobicistat: dizziness, liver problems and numbness or tingling.

Effects for Cobicistat 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 20,779 voluntary FDA FAERS reports for Cobicistat 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

How to take them

Some Cobicistat Products Have a Food Rule — Elderberry Should Not Break It

At least one FDA label for a product containing Cobicistat says to take it with food. If you take Elderberry on an empty stomach out of habit, keep them separate — and take Cobicistat 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 Cobicistat 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 DOSAGE AND ADMINISTRATION TYBOST must be coadministered with atazanavir or darunavir at the same time, with food, and in combination with other HIV-1 antiretroviral agents.

From the Dosage and Administration section of the FDA label we read for Cobicistat — 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 Elderberry or Cobicistat

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 Cobicistat, 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 Cobicistat

This page covers Elderberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cobicistat page lists 30 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Adrafinil (moderate), Cannabidiol (cbd) (moderate), Cannabinol (cbn) (moderate) and Cannabis (moderate).

By severity: 1 major · 19 moderate · 10 minor.

From our pharmacist’s overview on the Cobicistat page

“Activated charcoal is the one entry to understand first if you take cobicistat (Tybost). Charcoal soaks up drugs in the gut, and since cobicistat's entire job is boosting an HIV medicine to protective levels, blunting its absorption can put the whole regimen at risk.”

Reviewed by 2 · Jul 18, 2026

Open the Cobicistat 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 Cobicistat, 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 Cobicistat 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%

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

29 days ago today
Medication Cobicistat
Steady interest

#1,683 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 13, 2026. The Elderberry and Cobicistat 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 Cobicistat

What Is Cobicistat Used For?

Brand name: Tybost

Tybost (cobicistat) is not itself an HIV treatment — it works by slowing the breakdown of certain HIV medicines so they stay active in your body long enough to work. Specifically, Tybost is used to boost the HIV medicines atazanavir or darunavir (once-daily dosing) as part of a complete HIV-1 treatment regimen in adults and in children weighing at least 14 kg (about 31 lbs).

Tybost is not interchangeable with ritonavir (another booster) for all HIV medicines. It is not recommended with darunavir twice-daily, fosamprenavir, saquinavir, or tipranavir.

Most-Reported Side Effects for Cobicistat

From FAERS, the FDA’s public side-effect reporting system (20,779 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Bone density decreased 8,112 reports
Chronic kidney disease 4,754 reports
Renal injury 4,577 reports
Tooth loss 4,186 reports
Bone loss 4,107 reports
See full Cobicistat 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 Cobicistat, 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 Cobicistat Together: Common Questions

Is it safe to take Elderberry with Cobicistat?
We do not list a known interaction between Elderberry and Cobicistat. 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 Cobicistat have any of the same side effects?
Yes — our sources link each of them separately to 5 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 Elderberry and Cobicistat at the same time of day?
At least one FDA label for a product containing Cobicistat says to take it with food. If you take Elderberry on an empty stomach out of habit, keep them separate and take Cobicistat with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Cobicistat products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the Elderberry and Cobicistat combination checked?
Interactions in our licensed database are recorded against drug classes. Cobicistat is filed under 2 classifications, and Elderberry has documented interactions with 2 drug classes — none of Cobicistat'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 — Cobicistat 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 Cobicistat interact with any supplements?
Yes. Cobicistat has documented interactions with 30 supplements in our database — Elderberry is not one of them. The Cobicistat 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 Cobicistat drug information The full plain-English guide to this medication Cobicistat supplement interactions Every supplement checked against Cobicistat, 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 Cobicistat and Elderberry?

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.