Drug & supplement interaction

Elderflower + Esketamine

Esketamine brand name: Spravato.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Elderflower and Esketamine 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.

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Interaction report

Elderflower and Esketamine

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 Esketamine and Elderflower 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.

Elderflower safety at a glance

Elderflower overall Use caution Properly prepared flowers are generally well tolerated, but raw plant parts can be toxic.
Pregnancy Avoid There is not enough reliable safety information, so it is best to avoid.
Breastfeeding Avoid Safety has not been studied, so avoid unless your doctor approves.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Esketamine and Elderflower? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Esketamine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Esketamine is filed under 2 classifications — tricyclic antidepressants (tcas), antidepressant drugs. Elderflower has documented interactions with 1 drug class — the most serious being antidiabetes drugs (moderate) — and none of Esketamine’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

Elderflower Does Interact With Other Medications

Elderflower has 86 moderate known drug interactions in our database — Esketamine isn’t one of them. If you take anything else, check it against the full list below.

Moderate 86 No known interaction 2,744 (incl. Esketamine)
Taking anything else?

Check Another of Your Medications Against Elderflower

Covers the 2,830 medications we’ve checked against Elderflower. Pick one to open its full report.

What to actually watch for

What Elderflower Itself Has Been Linked To

This is not an interaction — nothing below involves Esketamine. It is the side-effect record for Elderflower on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Elderflower, this list is the first place to look.

  • Diarrhea Additional detail

    “Diarrhea and colic have been reported after drinking a tea made from elderflower, anise fruit, fennel fruit, and senna flowers. It is not clear if these effects were due to elderflower or the other ingredients.”

    Elderflower · Natural Medicines adverse-effect record, reported in diarrhea.

    1 source cited
    1. 49494. Picon, P. D., Picon, R. V., Costa, A. F., Sander, G. B., Amaral, K. M., Aboy, A. L., and Henriques, A. T. Randomized clinical trial of a phytotherapic compound containing Pimpinella anisum, Foeniculum vulgare, Sambucus nigra, and Cassia augustifolia for

Everything above comes from the Natural Medicines adverse-effect record for Elderflower — expand a row for the licensed statement it rests on. We read the ADVERSE REACTIONS section of Esketamine’s FDA label too, and the two lists don’t meaningfully overlap — which is why no Esketamine column appears here.

Everything else you take

See Every Supplement That Interacts With Esketamine

This page covers Elderflower only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Esketamine page lists 11 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Scopolia (major), Cowhage (moderate), Dhea (moderate), Griffonia Simplicifolia (moderate) and Indian Snakeroot (moderate).

By severity: 1 major · 6 moderate · 4 minor.

From our pharmacist’s overview on the Esketamine page

“Esketamine (Spravato) is the nasal spray for depression that hasn't responded to standard treatment, and its supplement list deserves genuine respect. Scopolia carries the only major rating and is the entry to understand before any other; pairing it with the medication can raise the risk of anticholinergic effects, meaning dry mouth, b…”

Reviewed by 2 · Jul 18, 2026

Open the Esketamine interaction page

How much people look this up

Where Elderflower and Esketamine 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 Elderflower
Steady interest

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

29 days ago today
Medication Esketamine
Steady interest

#2,247 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 Elderflower reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Elderflower and Esketamine 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 Elderflower

What is Elderflower?

  • Colds and flu
  • Sinus congestion
  • Fever and sweating
  • Sore throat
  • Coughs

Elderflower comes from the elder plant (Sambucus nigra) and is traditionally used as a tea or extract for colds, sinus congestion, and fever. Good-quality human evidence is limited, so it should be seen as a soothing traditional remedy rather than a proven treatment. Raw or unripe parts of the plant can be toxic, so use only properly prepared products, and check with your pharmacist or doctor first.

Sambucus nigra · Adoxaceae · Dried flowers · Tea, liquid extract, tincture, capsules, syrups, lozenges

An interaction check asks whether these two react with each other — it does not ask whether Elderflower is a good idea for someone in your situation. Here is what our Elderflower record says about it on its own.

Elderflower: dosing

There is no official standardized dose for elderflower. The right amount depends on the product, its strength, and how it is prepared (tea, extract, or tincture).The safest approach is to follow the directions on the product label and not exceed the recommended amount.

From our Elderflower monograph — the full record covers uses, side effects and every documented interaction.

Read the full Elderflower monograph & all interactions
Medication

About Esketamine Nasal Spray

What Is Esketamine Nasal Spray Used For?

Brand name: Spravato

Spravato nasal spray is approved for two uses in adults. First, it treats treatment-resistant depression (TRD) — depression that has not responded to other antidepressants — either on its own or alongside an oral antidepressant. Second, it treats depressive symptoms in adults with major depressive disorder (MDD) who have acute suicidal ideation or behavior, always used together with an oral antidepressant in this case.

Important limits: Spravato has not been shown to prevent suicide or reduce suicidal thoughts or behavior on its own. It is not a replacement for hospitalization if that is clinically needed, and it is not approved as an anesthetic.

Most-Reported Side Effects for Esketamine

From FAERS, the FDA’s public side-effect reporting system (17,728 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Dissociation 3,733 reports
Sedation 2,706 reports
Suicidal ideation 1,351 reports
Nausea 957 reports
Depression 873 reports
See full Esketamine Nasal Spray drug information
Keep checking

Other Drugs & Elderflower

Browse every other medication we’ve checked against Elderflower — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
86Moderate
0Minor
2,743No known interaction
86 Moderate 2,743 No interaction
Moderate

86 interactions

Showing 60 of 86 moderate interactions — see all 86 on the Elderflower page.

No interaction 2,743 drugs checked — show the list

We also checked Elderflower against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,743 medications checked with no known interaction — see the full Elderflower list.

See the full Elderflower interactions page
See every supplement checked against Esketamine, ranked by severity
Evidence & sources

Elderflower References

The 2 references that drive our Elderflower 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. Gray AM, Abdel-Wahab YH, Flatt PR. The traditional plant treatment, Sambucus nigra (elder), exhibits insulin-like and insulin-releasing actions in vitro. J Nutr 2000;130:15-20. PubMed
  2. Picon, P. D., Picon, R. V., Costa, A. F., Sander, G. B., Amaral, K. M., Aboy, A. L., and Henriques, A. T. Randomized clinical trial of a phytotherapic compound containing Pimpinella anisum, Foeniculum vulgare, Sambucus nigra, and Cassia augustifolia for

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 Elderflower and Esketamine Together: Common Questions

Is it safe to take Elderflower with Esketamine?
We do not list a known interaction between Elderflower and Esketamine. 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.
How was the Elderflower and Esketamine combination checked?
Interactions in our licensed database are recorded against drug classes. Esketamine is filed under 2 classifications, and Elderflower has documented interactions with 1 drug class — none of Esketamine'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 Elderflower interact with any other medications?
Yes. Elderflower has 86 documented drug interactions in our database — Esketamine 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 Esketamine interact with any supplements?
Yes. Esketamine has documented interactions with 11 supplements in our database — Elderflower is not one of them. The Esketamine 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

Elderflower monograph Uses, safety profile, and every drug interaction in one place Esketamine Nasal Spray drug information The full plain-English guide to this medication Esketamine supplement interactions Every supplement checked against Esketamine, 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 2 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Esketamine and Elderflower?

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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.