Black Elderberry Ingredients & Drug Interactions
by Gaia Herbs
What is this page for?
First and foremost: checking Black Elderberry against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Black Elderberry is a dietary supplement by Gaia Herbs with 2 active ingredients. Its ingredients are commonly taken for vitamin c source, immune support, antioxidant support.Based on those ingredients, 247 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Acerola Fruit Extract, Black Elderberry Fruit Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Black Elderberry by Gaia Herbs
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HelloPharmacist Scorecard of Black Elderberry by Gaia Herbs
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
This product contains 2 active ingredients: acerola fruit extract, which is a source of vitamin C, and black elderberry fruit extract. The capsules also contain two inactive ingredients — acacia gum and hypromellose — which are used as binders and capsule material.
Does it work?
Not established
The data we hold shows mixed evidence for acerola. It's rated possibly effective for vitamin C deficiency; however, for common cold, atherosclerosis, and diarrhea, the evidence isn't reliable enough to establish whether it works.
For black elderberry extract, we have no established effectiveness ratings — the evidence for allergic rhinitis, heart disease, chronic fatigue, lung disease, cognition, and respiratory infections is insufficient to rate. In short, this product's ability to treat any particular condition hasn't been well established in the data we have.
How safe is it?
Well-documented data
Acerola from properly prepared supplements is generally well tolerated when used as directed, though concentrated forms aren't well studied. High doses of vitamin C (over 2,000 mg daily) can cause diarrhea and stomach upset.
Black elderberry extracts made from ripe fruit are also well tolerated; the safety concern is raw or unripe berries and other plant parts like seeds and bark, which contain toxins that cooking removes. During pregnancy, avoid elderberry supplements — there isn't enough safety information.
The same goes for breastfeeding. There's a case report of autoimmune hepatitis in someone who took elderberry long-term, and one of severe liver injury in a person taking it alongside a cancer drug; also, one person experienced an allergic reaction (rash, breathing difficulty, fast heart rate) after acerola, though they had a history of latex allergy and cross-reactivity was suspected.
Meds to double-check
Moderate interaction found
Check before taking if you're on chemotherapy (alkylating agents or antitumor antibiotics), immunosuppressants, the cancer drug pazopanib, blood thinners like warfarin, aspirin, estrogens (birth control or hormone replacement), or aluminum-containing antacids. The interactions range from Moderate (chemotherapy and immunosuppressants) to Minor (the others).
The bottom line
Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
If you take chemotherapy, immunosuppressants, pazopanib, blood thinners, aspirin, birth control, hormone therapy, or antacids, check your exact medications with our tool before starting this product. Pregnant or breastfeeding — skip it.
Otherwise, for a healthy adult with no relevant medications, the properly prepared herbs are generally well tolerated, though we don't have strong evidence they treat any specific condition.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 2 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 23, 2024.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Black Elderberry, straight from the product label.
| Brand | Gaia Herbs |
|---|---|
| Net contents | 60 Vegan Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Apr 23, 2024 |
| DSLD ID | 309551 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), Women (not pregnant or lactating), Gluten Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Black Elderberry by Gaia Herbs, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Acerola Fruit Extract | 550 mg | -- |
| Black Elderberry Fruit Extract | 158 mg | -- |
Other ingredients: Acacia Gum, Hypromellose
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formula
Small berry, big benefits Black Elderberries are tiny but mighty, used for centuries in traditional remedies to maintain immune health. Our capsules pack a potent punch in a petite package, delivering concentrated Elderberry extract with Acerola for extra antioxidant support.
10g elderberries per serving Each serving contains 10,112mg of Black Elderberry fresh herb equivalent With Acerola
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
General Statements
Discover our guiding truths at: Facebook Instagram gaiaherbs.com @gaiaherbs
Gaia herbs delivers unprecedented tradeability by screening every product and sharing results online. To learn more, enter the unique ID # below at meetyourherbs.com.
Formulation
The Gaia difference Sustainably sourced Extracted without harsh solvents 6 distinct quality tests
Vegan
Gluten
Immune support Concentrated formula Full spectrum Plant powered wellness
Seals/Symbols
Certified B Corporation
FDA Statement of Identity
Herbal Supplement
Suggested/Recommended/Usage/Directions
Suggested use Adults take 1 capsule daily between meals. For additional support take 2 capsules 2 times daily.
Precautions
Not for use during pregnancy or lactation. If you have a medical condition or take medications, please consult with your doctor before use.
Store away from children.
Storage
Store away from children. Keep bottle capped at all times and store in a cool, dry place.
Brand IP Statement(s)
Gaia Herbs EST 1987
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Black Elderberry by Gaia Herbs label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Black Elderberry by Gaia Herbs
These are the 2 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Acerola Fruit Extract
Interacts with128 drugs
Acerola is a small tropical fruit prized for its very high natural vitamin C content, and it is mostly used as a food-based source of vitamin C and an...
Acerola Fruit Extract monograph & interactionsBlack Elderberry Fruit Extract
Interacts with121 drugs
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 sym...
Black Elderberry Fruit Extract monograph & interactionsOther (inactive) ingredients: Acacia Gum, Hypromellose. These complete the product’s ingredient list but are not active constituents.
Black Elderberry by Gaia Herbs Drug Interactions
HelloPharmacist Interaction Report
Black Elderberry by Gaia Herbs contains two active ingredients, and the acerola component has documented interactions with several medication types.
The most serious concern is with chemotherapy drugs — specifically alkylating agents and antitumor antibiotics (both Moderate severity) — where acerola's antioxidant vitamin C content may theoretically reduce drug effectiveness. The product also carries Moderate-severity risk with immunosuppressants, because elderberry stimulates immune activity and could interfere with drugs meant to dampen immunity.
Additionally, a single case report links elderberry to potential liver injury when taken with pazopanib, a cancer medication.
Read the full breakdown — every affected drug type, severity by severity
Minor interactions are documented with estrogens (including birth control and hormone replacement therapy), where acerola's vitamin C may increase estrogen levels; aspirin and warfarin (blood thinners), where vitamin C might reduce drug clearance or effectiveness, though the amount in acerola is thought too low for major problems; and aluminum-containing antacids, where vitamin C can increase aluminum absorption.
Alternatingly, no interactions are documented for black elderberry fruit extract alone beyond the ones named above. Altogether, these interactions span 243 individual medications.
Run your exact medications through the interaction checker on this page before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Black Elderberry?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Black Elderberry interact with 247 drugs. Click any drug to see the details.
2 of the 2 ingredients in Black Elderberry interact with drugs. Each result below shows which ingredient is responsible. Acerola Fruit Extract Black Elderberry Fruit Extract
CarboplatinParaplatin
How Carboplatin interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Acerola Fruit ExtractAlkylating Agents Moderate
Interaction Summary
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of alkylating agents.
Read the full Acerola Fruit Extract + Carboplatin interactionCarmustineBiCNU, Gliadel, Gliadel Wafer
How Carmustine interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Acerola Fruit ExtractAlkylating Agents Moderate
Interaction Summary
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of alkylating agents.
Read the full Acerola Fruit Extract + Carmustine interactionChlorambucilLeukeran
How Chlorambucil interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Acerola Fruit ExtractAlkylating Agents Moderate
Interaction Summary
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of alkylating agents.
Read the full Acerola Fruit Extract + Chlorambucil interactionCiclesonideAlvesco, Omnaris, Zetonna
How Ciclesonide interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Ciclesonide interactionCisplatinPlatinol-AQ
How Cisplatin interacts with Black Elderberry — through 2 ingredients. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Cisplatin interactionAcerola Fruit ExtractAlkylating Agents Moderate
Interaction Summary
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of alkylating agents.
Read the full Acerola Fruit Extract + Cisplatin interactionCladribineLeustatin, Mavenclad
How Cladribine interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Cladribine interactionCopanlisibAliqopa
How Copanlisib interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Copanlisib interactionCortisone AcetateCortisone Tablets, Cortone
How Cortisone Acetate interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Cortisone Acetate interactionCyclophosphamideCytoxan, Neosar
How Cyclophosphamide interacts with Black Elderberry — through 2 ingredients. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Cyclophosphamide interactionAcerola Fruit ExtractAlkylating Agents Moderate
Interaction Summary
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of alkylating agents.
Read the full Acerola Fruit Extract + Cyclophosphamide interactionCyclosporineCequa, Ciclosporine, Gengraf, Neoral, Sandimmune, Verkazia +1 more
How Cyclosporine interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Cyclosporine interactionDacarbazineDTIC-Dome
How Dacarbazine interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Acerola Fruit ExtractAlkylating Agents Moderate
Interaction Summary
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of alkylating agents.
Read the full Acerola Fruit Extract + Dacarbazine interactionDaclizumabZenapax, Zinbryta
How Daclizumab interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Daclizumab interactionDactinomycinCosmegan, Cosmegen
How Dactinomycin interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Acerola Fruit ExtractAntitumor Antibiotics Moderate
Interaction Summary
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of antitumor antibiotics.
Read the full Acerola Fruit Extract + Dactinomycin interactionDaunorubicin CitrateDaunoXome
How Daunorubicin Citrate interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Acerola Fruit ExtractAntitumor Antibiotics Moderate
Interaction Summary
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of antitumor antibiotics.
Read the full Acerola Fruit Extract + Daunorubicin Citrate interactionDaunorubicin HydrochlorideCerubidine
How Daunorubicin Hydrochloride interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Acerola Fruit ExtractAntitumor Antibiotics Moderate
Interaction Summary
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of antitumor antibiotics.
Read the full Acerola Fruit Extract + Daunorubicin Hydrochloride interactionDaunorubicin, CytarabineVyxeos
How Daunorubicin, Cytarabine interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Acerola Fruit ExtractAntitumor Antibiotics Moderate
Interaction Summary
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of antitumor antibiotics.
Read the full Acerola Fruit Extract + Daunorubicin, Cytarabine interactionDeflazacortEmflaza
How Deflazacort interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Deflazacort interactionDenosumabProlia, XGEVA
How Denosumab interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Denosumab interactionDeucravacitinibSotyktu
How Deucravacitinib interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Deucravacitinib interactionDexamethasoneDecadron, Dexone, Dextenza, Dexycu, Hemady, Hexadrol +1 more
How Dexamethasone interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Dexamethasone interactionDiroximel FumarateVumerity
How Diroximel Fumarate interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Diroximel Fumarate interactionDoripenemDoribax
How Doripenem interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Acerola Fruit ExtractAntitumor Antibiotics Moderate
Interaction Summary
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of antitumor antibiotics.
Read the full Acerola Fruit Extract + Doripenem interactionDoxorubicinAdriamycin, Caelyx, Doxil, Myocet, Rubex
How Doxorubicin interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Acerola Fruit ExtractAntitumor Antibiotics Moderate
Interaction Summary
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of antitumor antibiotics.
Read the full Acerola Fruit Extract + Doxorubicin interactionDurvalumabImfinzi
How Durvalumab interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Durvalumab interactionEculizumabSoliris
How Eculizumab interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Eculizumab interactionEfalizumabRaptiva
How Efalizumab interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Efalizumab interactionEfgartigimod Alfa-fcabVyvgart
How Efgartigimod Alfa-fcab interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Efgartigimod Alfa-fcab interactionElranatamabElrexfio
How Elranatamab interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Elranatamab interactionEmapalumab-lzsgGamifant
How Emapalumab-lzsg interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Emapalumab-lzsg interactionEpcoritamab-byspEpkinly
How Epcoritamab-bysp interacts with Black Elderberry — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Fruit Extract + Epcoritamab-bysp interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Black Elderberry with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Acerola Fruit Extract
Alkylating Agents
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of alkylating agents.
Acerola contains vitamin C, an antioxidant. There is concern that antioxidants might reduce the activity of chemotherapy drugs that generate free radicals, such as alkylating agents. In contrast, other researchers theorize that antioxidants might make alkylating chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.
Antitumor Antibiotics
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of antitumor antibiotics.
Acerola contains vitamin C, an antioxidant. There is concern that antioxidants might reduce the activity of chemotherapy drugs that generate free radicals, such as antitumor antibiotics. In contrast, other researchers theorize that antioxidants might make antitumor antibiotic chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on antitumor antibiotic chemotherapy.
Aluminum
Theoretically, concomitant use of acerola with aluminum salts might increase the amount of aluminum absorbed.
Acerola contains vitamin C. It is thought that vitamin C chelates aluminum, keeping it in solution and available for absorption. In people with normal renal function, urinary excretion of aluminum likely increases, making aluminum retention and toxicity unlikely. However, patients with renal failure who take aluminum-containing compounds, such as phosphate binders, should avoid acerola in doses that provide more vitamin C than the recommended dietary allowances.
Aspirin
Theoretically, acerola might reduce the clearance of aspirin; however, its vitamin C content is likely too low to produce clinically significant effects.
Acerola contains vitamin C. It has been suggested that acidification of the urine by vitamin C can decrease the urinary excretion of salicylates, increasing plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion. The vitamin C content of acerola is typically about 2000 mg per 100 grams. Thus, a clinically significant interaction between acerola and aspirin is unlikely.
Estrogens
Theoretically, concomitant use of acerola with estrogens might increase estrogenic effects.
Acerola contains vitamin C. Increases in plasma estrogen levels of up to 55% have occurred under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. However, increases in plasma estrogen levels may occur when women who are deficient in vitamin C take supplements.
Warfarin (Coumadin)
Theoretically, acerola might reduce the effectiveness of warfarin; however, its vitamin C content is likely too low to produce clinically significant effects.
Acerola contains vitamin C. High doses of vitamin C may reduce the response to warfarin, possibly by causing diarrhea and reducing warfarin absorption. This occurred in two people who took up to 16 grams daily of vitamin C, and resulted in decreased prothrombin time. Lower doses of 5-10 grams daily of vitamin C can also reduce warfarin absorption, but this does not seem to be clinically significant. The vitamin C content of acerola is typically about 2000 mg per 100 grams. Thus, a clinically significant interaction between acerola and warfarin is unlikely.
Black Elderberry Fruit Extract
Immunosuppressants
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.
Pazopanib (Votrient)
Theoretically, elderberry might interact with pazopanib, potentially increasing the risk of adverse effects.
Brand information
Manufacturer and brand details for Black Elderberry, from the product label.
Gaia Herbs
See all Gaia Herbs products- Name
- Gaia Herbs, Inc.
- Street Address
- 101 Gaia Herbs Dr.
- City
- Brevard
- State
- NC
- ZipCode
- 28712
- Web Address
- meetyourherbs.com
Black Elderberry by Gaia Herbs: Common Questions
Does Black Elderberry by Gaia Herbs interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Can I take this if I'm pregnant or breastfeeding?
What exactly is acerola?
Is it safe if I take it long-term?
What are the side effects?
Does this help with colds?
Are there any fillers in here?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Black Elderberry is safe with your meds?
Our pharmacists answer your medication & supplement questions — free.
Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Black Elderberry’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Acerola
Interacts with 128 drugsAcerola is a small tropical fruit prized for its very high natural vitamin C content, and it is mostly used as a food-based source of vitamin C and antioxidants. While vitamin C itself has w...
Read the full Acerola monograph → Herb & supplement monographElderberry
Interacts with 121 drugsElderberry 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 n...
Read the full Elderberry monograph →Sources & How We Checked
Black Elderberry's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 26 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Acerola 20 references
- Back DJ, Breckenridge AM, MacIver M, et al. Interaction of ethinyloestradiol with ascorbic acid in man. Br Med J (Clin Res Ed) 1981;282:1516.
- Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
- Rosenthal G. Interaction of ascorbic acid and warfarin. JAMA 1971;215:1671. DOI
- Hume R, Johnstone JM, Weyers E. Interaction of ascorbic acid and warfarin. JAMA 1972;219:1479. DOI
- Smith EC, Skalski RJ, Johnson GC, Rossi GV. Interaction of ascorbic acid and warfarin. JAMA 1972;221:1166. DOI
- Domingo JL, Gomez M, Llobet JM, Richart C. Effect of ascorbic acid on gastrointestinal aluminum absorption (letter). Lancet 1991;338:1467.
- Domingo JL, Gomez M, Llobet JM, Corbella J. Influence of some dietary constituents on aluminum absorption and retention in rats. Kidney Int 1991;39:598-601. PubMed
- Partridge NA, Regnier FE, White JL, Hem SL. Influence of dietary constituents on intestinal absorption of aluminum. Kidney Int 1989;35:1413-7. PubMed
- Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
- Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
- Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed
- Feetam CL, Leach RH, Meynell MJ. Lack of a clinically important interaction between warfarin and ascorbic acid. Toxicol Appl Pharmacol 1975;31:544-7. PubMed
- Weintraub M, Griner PF. Warfarin and ascorbic acid: lack of evidence for a drug interaction. Toxicol Appl Pharmacol 1974;28:53-6. PubMed
- Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
- Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
- Denadai R, Souza FM, Valle MR. Fecal impaction by rectal acerola bezoar. Indian J Pediatr 2013;80(5):432-3. PubMed
- Raulf-Heimsoth M, Stark R, Sander I, et al. Anaphylactic reaction to apple juice containing acerola: cross-reactivity to latex due to prohevein. J Allergy Clin Immunol 2002;109(4):715-6. PubMed
Elderberry 6 references
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- 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).
- 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).
- 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
- 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
- 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
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