Drug & supplement interaction

Elderflower + Ospemifene

Ospemifene brand name: Osphena.

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 Ospemifene 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 Ospemifene states a food rule worth keeping to.

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Interaction report

Elderflower and Ospemifene

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 Ospemifene 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 Ospemifene and Elderflower? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Ospemifene

Interactions in our licensed database are recorded against drug classes, not just single drug names. Ospemifene is filed under 3 classifications — thyroid hormone, cytochrome p450 3a4 (cyp3a4) substrates, oral drugs. Elderflower has documented interactions with 1 drug class — the most serious being antidiabetes drugs (moderate) — and none of Ospemifene’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 — Ospemifene 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. Ospemifene)
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 Ospemifene. 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 Ospemifene’s FDA label too, and the two lists don’t meaningfully overlap — which is why no Ospemifene column appears here.

How to take them

Some Ospemifene Products Have a Food Rule — Elderflower Should Not Break It

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

One tablet taken orally once daily with food.

From the Dosage and Administration section of the FDA label we read for Ospemifene — where that label names a specific product, the instruction is that product's. See the Ospemifene drug page ›

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.

Everything else you take

See Every Supplement That Interacts With Ospemifene

This page covers Elderflower only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ospemifene page lists 155 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), Tiratricol (major) and Acacia Rigidula (moderate).

By severity: 4 major · 112 moderate · 39 minor.

From our pharmacist’s overview on the Ospemifene page

“Women prescribed ospemifene (Osphena) for painful intercourse after menopause are often the same women reaching for St. John's wort for mood or grapefruit juice at breakfast, and both sit among the four major-rated interactions on this page, so the list deserves genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Ospemifene interaction page

How much people look this up

Where Elderflower and Ospemifene 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 Ospemifene
Steady interest

#2,044 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 Ospemifene 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 Ospemifene

What Is Ospemifene Used For?

Brand name: Osphena

Osphena (ospemifene) is used to treat two specific symptoms of vulvar and vaginal atrophy — the thinning and drying of vaginal tissues that can happen after menopause. The first is moderate to severe dyspareunia (painful intercourse), and the second is moderate to severe vaginal dryness.

Both of these uses are for postmenopausal women only. Osphena is not used in children or in women who are pregnant or may become pregnant.

Most-Reported Side Effects for Ospemifene

From FAERS, the FDA’s public side-effect reporting system (2,601 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Hot flush 372 reports
Headache 209 reports
Muscle spasms 194 reports
Vaginal haemorrhage 150 reports
Vaginal discharge 134 reports
See full Ospemifene 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 Ospemifene, 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 Ospemifene Together: Common Questions

Is it safe to take Elderflower with Ospemifene?
We do not list a known interaction between Elderflower and Ospemifene. 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.
Should I take Elderflower and Ospemifene at the same time of day?
At least one FDA label for a product containing Ospemifene says to take it with food. If you take Elderflower on an empty stomach out of habit, keep them separate and take Ospemifene with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Ospemifene products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the Elderflower and Ospemifene combination checked?
Interactions in our licensed database are recorded against drug classes. Ospemifene is filed under 3 classifications, and Elderflower has documented interactions with 1 drug class — none of Ospemifene'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 — Ospemifene 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 Ospemifene interact with any supplements?
Yes. Ospemifene has documented interactions with 155 supplements in our database — Elderflower is not one of them. The Ospemifene 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 Ospemifene drug information The full plain-English guide to this medication Ospemifene supplement interactions Every supplement checked against Ospemifene, 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 Ospemifene 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.