Drug & supplement interaction

Elderberry + Durvalumab

Durvalumab brand name: Imfinzi.

Moderate Interaction
The bottom line Moderate

Elderberry has a moderate interaction with Durvalumab. Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Elderberry and Durvalumab

Here is the interaction we found between these two, with the evidence behind it.

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Durvalumab

Durvalumab falls under IMMUNOSUPPRESSANTS — the group Elderberry interacts with.

Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Elderberry has immunostimulant activity, increasing the production of cytokines, including interleukin and tumor necrosis factor.
Severity Moderate Likelihood Possible Evidence B

Interaction 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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's something worth knowing about pairing elderberry with Imfinzi (durvalumab). Durvalumab is a type of cancer immunotherapy that works by waking up your immune system so it can attack the tumor. It isn't broken down by the usual liver enzymes the way many drugs are, so this isn't a typical metabolism issue. The concern is more about how each one acts on your immune system.

Elderberry has been shown in lab studies to nudge the immune system, raising signals like interleukins and tumor necrosis factor. Because durvalumab is already revving up immune activity, there's a theoretical worry the two together could overstimulate things, possibly affecting how you respond or your risk of immune-related side effects (like inflammation in the lungs, skin, or gut). I want to be honest: this is based on weak lab-level evidence, not strong human studies. Still, because you're in active cancer treatment, please run any elderberry product past your oncology team first.

References
  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..

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • 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.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Elderberry Also Interacts With Other Medications

Elderberry has 120 moderate known drug interactions in our database — the Durvalumab one above is one of them. If you take anything else, check it against the full list below.

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.

From our Q&A

Questions About Elderberry or Durvalumab

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 Durvalumab, 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 Durvalumab

This page covers Elderberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Durvalumab page lists 54 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Active Hexose Correlated Compound (ahcc) (moderate), Alfalfa (moderate), American Ginseng (moderate), Andrographis (moderate) and Ashwagandha (moderate).

By severity: 52 moderate · 2 minor.

From our pharmacist’s overview on the Durvalumab page

“Nearly everything on this page interacts with durvalumab (Imfinzi) for the same underlying reason, immune stimulation. Durvalumab is a cancer immunotherapy, and because the treatment works through the immune system itself, supplements that push immune activity in their own direction (echinacea, ashwagandha, astragalus, and dozens of si…”

Reviewed by 2 · Jul 18, 2026

Open the Durvalumab 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. Your product may carry other ingredients that interact with Durvalumab too, on top of Elderberry — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Elderberry and Durvalumab 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%

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

29 days ago today
Medication Durvalumab
Steady interest

#2,208 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.

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.

Read the full Elderberry monograph & all interactions
Medication

About Durvalumab Injection

What Is Durvalumab Injection Used For?

Brand name: Imfinzi

Imfinzi is used to treat a wide range of cancers in adults. For lung cancer, it is approved for resectable non-small cell lung cancer (given before and after surgery), unresectable Stage III non-small cell lung cancer (after chemoradiation), metastatic non-small cell lung cancer, limited-stage small cell lung cancer (after chemoradiation), and extensive-stage small cell lung cancer.

Beyond lung cancer, Imfinzi is also approved for locally advanced or metastatic biliary tract cancer (cancers of the bile ducts and gallbladder), unresectable hepatocellular carcinoma (liver cancer), mismatch repair deficient (dMMR) advanced or recurrent endometrial cancer, BCG-naive high-risk non-muscle-invasive bladder cancer, muscle-invasive bladder cancer, and resectable gastric or gastroesophageal junction adenocarcinoma (stomach cancer at the junction with the esophagus). Most of these uses involve Imfinzi given alongside other chemotherapy drugs.

See full Durvalumab Injection 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
120Moderate
0Minor
2,709No known interaction
Moderate

120 interactions

Showing 60 of 120 moderate interactions — see all 120 on the Elderberry page.

No interaction 2,709 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

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

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Pharmacist Counseling Corner

Taking Elderberry and Durvalumab Together: Common Questions

Can you take Elderberry with Durvalumab?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Elderberry and Durvalumab interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Durvalumab 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.