Drug & supplement interaction

Elderberry + Eculizumab

Eculizumab brand name: Soliris.

Moderate Interaction
The bottom line Moderate

Elderberry has a moderate interaction with Eculizumab. 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 Eculizumab

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

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Eculizumab

Eculizumab 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 the thinking behind this one. Eculizumab (Soliris) works by quieting down part of your immune system, specifically a piece of your immune response called complement. Elderberry, on the other hand, is thought to do the opposite in lab studies. It may nudge your immune system to make more signaling chemicals like interleukins and tumor necrosis factor. So in theory, elderberry could push against what eculizumab is trying to accomplish, possibly making your treatment work less effectively.

I want to be honest, though: this concern is mostly theoretical and based on test tube and animal data, not real-world studies in people taking this drug. Still, since eculizumab treats serious conditions like PNH or aHUS, it's worth a quick chat with your doctor or pharmacist before adding elderberry, just to be safe.

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 Eculizumab 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 Eculizumab

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 Eculizumab, 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 Eculizumab

This page covers Elderberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Eculizumab page lists 53 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 · 1 minor.

From our pharmacist’s overview on the Eculizumab page

“People prescribed eculizumab (Soliris) are usually managing a rare blood or nerve condition, and many of them reach for supplements marketed as immune boosters, things like echinacea, ginseng, or medicinal mushrooms. That instinct is exactly what this list is about.”

Reviewed by 2 · Jul 18, 2026

Open the Eculizumab 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 Eculizumab 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 Eculizumab 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%

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

29 days ago today
Medication Eculizumab
Steady interest

#1,776 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 Eculizumab Injection

What Is Eculizumab Injection Used For?

Brand name: Soliris

Soliris (eculizumab) injection is approved to treat four serious conditions: paroxysmal nocturnal hemoglobinuria (PNH), a rare blood disorder that causes red blood cell destruction; atypical hemolytic uremic syndrome (aHUS), a condition that causes abnormal blood clotting in small blood vessels; generalized myasthenia gravis (gMG), a neuromuscular disease causing muscle weakness; and neuromyelitis optica spectrum disorder (NMOSD), an inflammatory disease affecting the optic nerves and spinal cord.

For gMG, Soliris is approved for adults and children 6 years and older who test positive for anti-acetylcholine receptor (AChR) antibodies. For NMOSD, Soliris is approved for adults who test positive for anti-aquaporin-4 (AQP4) antibodies. Soliris is not indicated for hemolytic uremic syndrome caused by Shiga toxin-producing E. coli (STEC-HUS).

See full Eculizumab 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 Eculizumab Together: Common Questions

Can you take Elderberry with Eculizumab?
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 Eculizumab 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 Eculizumab 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.