Drug & supplement interaction

Elderberry + Ribavirin Aerosol

Ribavirin Aerosol brand name: Virazole.

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 Ribavirin Aerosol 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 Ribavirin Aerosol 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 Ribavirin Aerosol

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

Why No Interaction Is Listed for Ribavirin Aerosol

Interactions in our licensed database are recorded against drug classes, not just single drug names. Ribavirin Aerosol is filed under a single classification — oral drugs. Elderberry has documented interactions with 2 drug classes — the most serious being immunosuppressants (moderate) and pazopanib (votrient) (moderate) — and none of Ribavirin Aerosol’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 — Ribavirin Aerosol 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. Ribavirin Aerosol)
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 Ribavirin Aerosol 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

    Ribavirin Aerosol

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

  • Nausea / Vomiting / Diarrhea reported in 11.6% of FDA reports for Ribavirin Aerosol 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).

    Ribavirin Aerosol

    Listed in the ADVERSE REACTIONS section of the FDA label for Ribavirin Aerosol, and in voluntary FDA adverse-event reports. 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).

    Ribavirin Aerosol

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

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

Effects for Ribavirin Aerosol 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 63,877 voluntary FDA FAERS reports for Ribavirin Aerosol 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 Ribavirin Aerosol Products Have a Food Rule — Elderberry Should Not Break It

At least one FDA label for a product containing Ribavirin Aerosol says to take it with food. If you take Elderberry on an empty stomach out of habit, keep them separate — and take Ribavirin Aerosol 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 Ribavirin Aerosol 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.

Ribavirin capsules should be taken with food [see Clinical Pharmacology (12.3) ].

From the Dosage and Administration section of the FDA label we read for Ribavirin Aerosol — 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.

Overlapping uses

What Ribavirin Aerosol Is Prescribed For, and What Elderberry Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Ribavirin Aerosol is a prescription medicine with approved uses on its FDA label. Elderberry is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Ribavirin Aerosol is prescribed for: Ribavirin comes in different forms for different uses. Ribavirin capsules are used in combination with interferon alfa-2b (pegylated or non-pegylated) to treat chronic hepatitis C (CHC) in patients 3 years and older with compensated liver disease. Ribavirin tablets are used in combination with PEGASYS® (peginterferon alfa-2a) to treat chronic hepatitis C in patients 5 years and older with compensated liver disease who have not previously been treated with interferon — including adults who also have HIV. Ribavirin for inhalation solution is a separate product used to treat hospitalized infants and young children with severe lower respiratory tract infections caused by respiratory syncytial virus (RSV).

Read the rest of what Ribavirin Aerosol is prescribed for

Ribavirin must never be used alone to treat hepatitis C — it only works as part of combination therapy. Only the most severe RSV infections requiring hospitalization should be treated with the inhaled form; mild RSV illness in children does not require this treatment.

Elderberry has been studied for:

  • Respiratory tract infections studied, not established Elderberry has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Elderberry for respiratory tract infections

    Oral elderberry has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

  • Lower respiratory tract infections studied, not established Elderberry has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Elderberry for lower respiratory tract infections

    Oral elderberry extract has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Ribavirin Aerosol on your own; if you are taking Elderberry for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Elderberry or Ribavirin Aerosol

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 Ribavirin Aerosol, 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 Ribavirin Aerosol

This page covers Elderberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ribavirin Aerosol page lists 17 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 7 moderate · 9 minor.

From our pharmacist’s overview on the Ribavirin Aerosol page

“Ribavirin Aerosol (Virazole) is an inhaled antiviral used mostly in hospitals against severe RSV infection, and with an infection that serious, losing drug exposure is not a small problem, so I would approach this list with genuine care. Its one major-rated interaction, activated charcoal, can pull ribavirin out of the body even though…”

Reviewed by 2 · Jul 18, 2026

Open the Ribavirin Aerosol 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 Ribavirin Aerosol, 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 Ribavirin Aerosol 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%

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

29 days ago today
Medication Ribavirin Aerosol
Top 10%

#146 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 Ribavirin Aerosol 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 Ribavirin

What Is Ribavirin Used For?

Brand name: Virazole

Ribavirin comes in different forms for different uses. Ribavirin capsules are used in combination with interferon alfa-2b (pegylated or non-pegylated) to treat chronic hepatitis C (CHC) in patients 3 years and older with compensated liver disease. Ribavirin tablets are used in combination with PEGASYS® (peginterferon alfa-2a) to treat chronic hepatitis C in patients 5 years and older with compensated liver disease who have not previously been treated with interferon — including adults who also have HIV. Ribavirin for inhalation solution is a separate product used to treat hospitalized infants and young children with severe lower respiratory tract infections caused by respiratory syncytial virus (RSV).

Ribavirin must never be used alone to treat hepatitis C — it only works as part of combination therapy. Only the most severe RSV infections requiring hospitalization should be treated with the inhaled form; mild RSV illness in children does not require this treatment.

See full Ribavirin 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 Ribavirin Aerosol, 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 Ribavirin Aerosol Together: Common Questions

Is it safe to take Elderberry with Ribavirin Aerosol?
We do not list a known interaction between Elderberry and Ribavirin Aerosol. 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 Ribavirin Aerosol 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 Ribavirin Aerosol at the same time of day?
At least one FDA label for a product containing Ribavirin Aerosol says to take it with food. If you take Elderberry on an empty stomach out of habit, keep them separate and take Ribavirin Aerosol with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Ribavirin Aerosol products can differ — so check the directions on your own box. This is about absorption, not an interaction.
Are Elderberry and Ribavirin Aerosol used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Elderberry in each. That is a conversation for your prescriber, especially if Ribavirin Aerosol is being adjusted to a target.
How was the Elderberry and Ribavirin Aerosol combination checked?
Interactions in our licensed database are recorded against drug classes. Ribavirin Aerosol is filed under 1 classification, and Elderberry has documented interactions with 2 drug classes — none of Ribavirin Aerosol'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 — Ribavirin Aerosol 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 Ribavirin Aerosol interact with any supplements?
Yes. Ribavirin Aerosol has documented interactions with 17 supplements in our database — Elderberry is not one of them. The Ribavirin Aerosol 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 Ribavirin drug information The full plain-English guide to this medication Ribavirin Aerosol supplement interactions Every supplement checked against Ribavirin Aerosol, 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 Ribavirin Aerosol 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.