Drug & supplement interaction

Elderberry + Letrozole

Letrozole brand name: Femara.

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 Letrozole 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 Letrozole

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

Why No Interaction Is Listed for Letrozole

Interactions in our licensed database are recorded against drug classes, not just single drug names. Letrozole is filed under 4 classifications — including aromatase inhibitors, cytochrome p450 2c19 (cyp2c19) inhibitors, cytochrome p450 3a4 (cyp3a4) substrates. Elderberry has documented interactions with 2 drug classes — the most serious being immunosuppressants (moderate) and pazopanib (votrient) (moderate) — and none of Letrozole’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 — Letrozole 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. Letrozole)
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 Letrozole 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.

  • 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).

    Letrozole

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

  • 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).

    Letrozole

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

Reported for Elderberry but not commonly for Letrozole: stomach pain, liver problems, vomiting and diarrhea.

Effects for Letrozole come from the ADVERSE REACTIONS section of its FDA label; effects for Elderberry come from the Natural Medicines adverse-effect record, quoted above. 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 Letrozole

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 Letrozole, 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 Letrozole

This page covers Elderberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Letrozole page lists 142 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), 7-methoxyflavone (moderate) and Acacia Rigidula (moderate).

By severity: 3 major · 99 moderate · 40 minor.

From our pharmacist’s overview on the Letrozole page

“Letrozole (Femara) is prescribed to keep hormone-driven breast cancer from returning, so a supplement that shifts its blood level can quietly undercut treatment. Give this list of 142 ingredients genuine respect, and learn the three major entries first.”

Reviewed by 2 · Jul 18, 2026

Open the Letrozole 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 Letrozole, 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 Letrozole 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 Letrozole
Top 5%

#50 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 Letrozole 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 Letrozole

What Is Letrozole Used For?

Brand name: Femara

Letrozole (brand name Femara) is used to treat breast cancer in postmenopausal women whose tumors are driven by estrogen. It is used in three settings: as adjuvant (after-surgery) treatment for hormone receptor positive early breast cancer; as extended adjuvant treatment for women who have already completed about five years of tamoxifen therapy; and as first- or second-line treatment for locally advanced or metastatic (spread) breast cancer.

Femara is specifically indicated for first-line treatment of hormone receptor positive or receptor-unknown locally advanced or metastatic breast cancer, and for advanced breast cancer in women whose disease has progressed after antiestrogen therapy.

See full Letrozole 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 Letrozole, 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 Letrozole Together: Common Questions

Is it safe to take Elderberry with Letrozole?
We do not list a known interaction between Elderberry and Letrozole. 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 Letrozole have any of the same side effects?
Yes — our sources link each of them separately to 2 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 Letrozole combination checked?
Interactions in our licensed database are recorded against drug classes. Letrozole is filed under 4 classifications, and Elderberry has documented interactions with 2 drug classes — none of Letrozole'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 — Letrozole 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 Letrozole interact with any supplements?
Yes. Letrozole has documented interactions with 142 supplements in our database — Elderberry is not one of them. The Letrozole 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 Letrozole drug information The full plain-English guide to this medication Letrozole supplement interactions Every supplement checked against Letrozole, 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 Letrozole 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.