Interactions on record — worth a quick check against your medications. Based on 4 of 5 ingredients. Check your meds →
Dietary supplement

Black Elderberry NightTime Syrup Ingredients & Drug Interactions

by Gaia Herbs

Black Elderberry NightTime Syrup label
See full label image
Liquid Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Black Elderberry NightTime Syrup 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

The interaction bottom line Most serious interaction: Moderate

Black Elderberry NightTime Syrup is a dietary supplement by Gaia Herbs with 5 active ingredients. Its ingredients are commonly taken for anxiety and stress, sleep problems, digestive upset.Based on those ingredients, 492 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Lemon Balm (Melissa officinalis) leaf extract, California Poppy (Eschscholzia californica) leaf extract, Acerola (Malpighia glabra) fruit extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Black Elderberry NightTime Syrup by Gaia Herbs

Ask about any prescription or over-the-counter medication and we check it for interactions with Black Elderberry NightTime Syrup by Gaia Herbs — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Black Elderberry NightTime Syrup 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.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 12, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 2 of its 5 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (104 mg) without saying how much of each component you get.

This syrup contains 5 ingredients, including four active herbal extracts. Black elderberry fruit juice concentrate is the primary ingredient — a juice from ripe elderberries.

It's paired with acerola, a tropical fruit extract rich in vitamin C. Lemon balm leaf extract and California poppy leaf extract are added for their traditional calming properties, and grindelia flowering tops round out the blend.

The remaining ingredients are inactive fillers — cane sugar, water, lemon, and xanthan gum — which give the syrup its taste and texture.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: immune support and occasional restless nights.
  • We looked for evidence on: Common cold, Upper respiratory tract infection (URTI), Lower respiratory tract infections, Respiratory tract infections, Insomnia, Stress — and 4 related terms.
  • The strongest evidence on file: Lemon Balm is rated "Possibly Effective" for Stress (Natural Medicines).
  • Also on file: California Poppy is rated "Insufficient Reliable Evidence To Rate" for Anxiety, Insomnia.
  • Also on file: Elderberry is rated "Insufficient Reliable Evidence To Rate" for Lower respiratory tract infections.

The evidence for what this product actually does is limited. For black elderberry, we have insufficient reliable evidence to rate its effectiveness for respiratory infections, allergies, fatigue, or cognitive function — the conditions people most often buy it for.

Acerola is possibly effective for vitamin C deficiency, but insufficient evidence supports it for colds, atherosclerosis, or diarrhea. Lemon balm shows possibly effective evidence for cold sores (herpes labialis), stress, and depression.

California poppy's effectiveness for anxiety and insomnia has not been established in the data we hold.

The evidence, ingredient by ingredient Lemon Balm California Poppy Elderberry Acerola

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 4 of the 4 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 4 of 4.
  • General safety write-ups exist for 4 of 4.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Black elderberry made from ripe, cooked fruit is generally well tolerated. However, raw or unripe berries, seeds, leaves, and bark contain toxins that can cause nausea, vomiting, severe diarrhea, weakness, dizziness, numbness, and even stupor — though cooking eliminates the risk.

In one case report, a woman with autoimmune disease developed liver inflammation (autoimmune hepatitis) after taking elderberry for years. There is not enough safety information to recommend elderberry during pregnancy or breastfeeding.

Acerola from food amounts is safe, but concentrated supplements need more study. Lemon balm is generally well tolerated short-term but carries limited long-term safety data; it's best avoided in pregnancy without medical guidance.

California poppy has very limited human safety data and should be avoided in pregnancy and while breastfeeding. Avoid raw or unripe elderberries entirely.

Side effects, ingredient by ingredient Lemon Balm California Poppy Elderberry Acerola

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 4 of the 4 matched ingredients can interact with medications — California Poppy, Elderberry, Lemon Balm, Acerola.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; cancer treatments.
  • For scale: 492 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check your medications before taking this product if you use immunosuppressants (after transplant or for immune conditions), pazopanib or other cancer drugs, thyroid hormone replacement, CNS depressants (sleep aids, sedatives, anxiety medications, or alcohol), or warfarin or other blood thinners. The most serious interactions are Moderate and involve immune-suppressing drugs and chemotherapy agents.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This product combines herbal extracts with limited evidence for the conditions people typically use elderberry syrups for. The main concern is interactions — particularly if you take immunosuppressants, cancer drugs, thyroid medication, sedating drugs, or blood thinners.

If you're pregnant, breastfeeding, or on any prescription medication, talk to your pharmacist or doctor before starting.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 4 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jul 21, 2022.

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

At a glance

General information

Key facts about Black Elderberry NightTime Syrup, straight from the product label.

Brand Gaia Herbs
Net contents 5.4 Fluid Ounce(s); 160 Milliliter(s)
Market status On market
Date entered into DSLD Jul 21, 2022
DSLD ID 270978
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Children 4 or More Years of Age, Vegan, Vegetarian, Adult (18 - 50 Years), Women (not pregnant or lactating), Organic
From the label
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 NightTime Syrup by Gaia Herbs, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
5 mL
Maximum serving Sizes:
5 mL
Servings per container
32
IngredientAmount% DV
Calories20 Calorie(s)--
Total Carbohydrates5 Gram(s)2%
Total Sugars4 Gram(s)--
Proprietary Blend104 mg--
added Sugars4 Gram(s)8%
Black Elderberry (Sambucus nigra) fruit juice concentrate1903 mg--
Acerola (Malpighia glabra) fruit extract147 mg--
Lemon Balm (Melissa officinalis) leaf extract0 NP--
Grindelia (Grindelia camporum) flowering tops extract0 NP--
California Poppy (Eschscholzia californica) leaf extract0 NP--

Other ingredients: Cane Sugar, Water, Lemon, Xanthan Gum

Tap any ingredient to jump to its full detail below.

Label statements
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.
Formulation

New look same formula

USDA Organic

Immune support Traditionally take for immune health Delicious tonic for occasional restless nights

Certified Organic by Oregon Tilth

Product of Italy

Vegan

Gluten-free Soy-free

Formula

Black Elderberry NightTime Syrup with California Poppy

Each teaspoon contains the equivalent of 14.5 g (14,500 mg) of fresh Elderberries.

FDA Statement of Identity

Herbal Supplement

Suggested/Recommended/Usage/Directions

Suggested Use Take within one hour before bedtime. Adults: 1 teaspoon Ages 6-8: 1/4 teaspoon Ages 9-12: 1/2 teaspoon Shake well before use.

Consume within 6 months of opening.

Storage

Refrigerate after opening.

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.

Do not use if cap seal is broken.

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

meetyourherbs.com Gaia Herbs delivers unprecedented traceability by screening every product and sharing the results online. See for yourself, and learn more about your herbs, by entering the unique ID # below at meetyourherbs.com

Purity - Keep it clean All products are screened for pesticides, microbes & heavy metals. Integrity - Keep it real See the proof at meetyourherbs.com, the world's first herb traceability platform. Potency - Keep it strong Concentrated plant extracts are delivered in our patented Phyto-Caps technology. Discover our guiding truths at: Facebook Instagram @gaiaherbs

A partnership of mutual beliefs Black Elderberry NightTime Syrup is produced in Tuscany, Italy, by Aboca, the herbal supplement leader in Europe since 1978. Gaia Herbs' partnership with Aboca is born from a mutual belief in sustainable product development, dedication to quality, and a deep respect for science and nature working in harmony. Aboca

Seals/Symbols

USDA Organic Integrity Purity Potency EST 1987 USA Certified B Corporation

Brand IP Statement(s)

Gaia Herbs Connecting plants & people since 1987

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Black Elderberry NightTime Syrup by Gaia Herbs label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Black Elderberry NightTime Syrup label

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)
What’s inside

The Ingredients in Black Elderberry NightTime Syrup by Gaia Herbs

These are the 5 active ingredients this product is made of. Select any to open its full monograph.

Serving size5 mL Dosage formLiquid Servings per container32 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.

Proprietary Blend

104 mg per serving

Black Elderberry (Sambucus nigra) fruit juice concentrate

Interacts with
121 drugs
1903 mg per serving

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 (Sambucus nigra) fruit juice concentrate monograph & interactions

Acerola (Malpighia glabra) fruit extract

Interacts with
128 drugs
147 mg per serving

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 (Malpighia glabra) fruit extract monograph & interactions

Other (inactive) ingredients: Cane Sugar, Water, Lemon, Xanthan Gum. These complete the product’s ingredient list but are not active constituents.

Interaction report

Black Elderberry NightTime Syrup by Gaia Herbs Drug Interactions

Want to check YOUR meds against Black Elderberry NightTime Syrup?

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 checker
492Drugs
419 Moderate 73 Minor

Ingredients driving the most interactions

Lemon Balm (Melissa officinalis) leaf extract 264
California Poppy (Eschscholzia californica) leaf extract 248
Acerola (Malpighia glabra) fruit extract 128
Black Elderberry (Sambucus nigra) fruit juice concentrate 121

Individual Drug Interactions

The ingredients in Black Elderberry NightTime Syrup interact with 492 drugs. Click any drug to see the details.

4 of the 5 ingredients in Black Elderberry NightTime Syrup interact with drugs. Each result below shows which ingredient is responsible. Lemon Balm (Melissa officinalis) leaf extract California Poppy (Eschscholzia californica) leaf extract Acerola (Malpighia glabra) fruit extract Black Elderberry (Sambucus nigra) fruit juice concentrate

Each ingredient & the kinds of drugs it affects

For each ingredient in Black Elderberry NightTime Syrup 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.

Lemon Balm (Melissa officinalis) leaf extract2 drug types · 264 drugs

Cns Depressants

Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Lemon balm seems to have CNS depressant activity in animals and in humans.

Likelihood Possible Evidence B
Thyroid Hormone

Theoretically, lemon balm might interfere with thyroid hormone replacement therapy.
In vitro, constituents of lemon balm extract bind to thyroid stimulating hormone (TSH), preventing TSH receptor-binding and leading to the inhibition of TSH-stimulated adenylate cyclase activity. In animals, lemon balm extract has been shown to decrease levels of circulating TSH and inhibit thyroid secretion.

Likelihood Possible Evidence D
Lemon Balm (Melissa officinalis) leaf extract full monograph & interactions

California Poppy (Eschscholzia californica) leaf extract1 drug type · 248 drugs

Cns Depressants

Theoretically, taking California poppy with drugs with sedative effects may increase the risk of sedative effects.
Laboratory research shows that California poppy has sedative effects.

Likelihood Possible Evidence D
California Poppy (Eschscholzia californica) leaf extract full monograph & interactions

Acerola (Malpighia glabra) fruit extract6 drug types · 128 drugs

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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Unlikely Evidence B
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.

Likelihood Possible Evidence D
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.

Likelihood Unlikely Evidence D
Acerola (Malpighia glabra) fruit extract full monograph & interactions

Black Elderberry (Sambucus nigra) fruit juice concentrate2 drug types · 121 drugs

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.

Likelihood Possible Evidence B
Pazopanib (Votrient)

Theoretically, elderberry might interact with pazopanib, potentially increasing the risk of adverse effects.
In one case, a 65-year-old patient taking pazopanib for 4 weeks for soft-tissue sarcoma developed severe nausea, loose stools, and elevated alanine transaminase and aspartate transaminase levels and was diagnosed with grade 3 liver injury. The patient reported taking elderberry supplements for 2 years, dose unspecified, and was also taking a multivitamin and a calcium supplement. The patient's symptoms and liver enzyme levels improved upon discontinuation of pazopanib and all supplements. Pazopanib treatment was re-initiated, at a lower dose, with no further evidence of liver injury. It was unclear in this case report if the elderberry supplements were derived from the berry, the flower, or the combination.

Likelihood Possible Evidence D
Black Elderberry (Sambucus nigra) fruit juice concentrate full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Black Elderberry NightTime Syrup, from the product label.

Gaia Herbs

See all Gaia Herbs products
Name
Gaia Herbs, Inc.
Street Address
101 Gaia Herbs Drive
City
Brevard
State
NC
ZipCode
28712
Web Address
www.gaiaherbs.com
Pharmacist Counseling Corner

Black Elderberry NightTime Syrup by Gaia Herbs: Common Questions

Does Black Elderberry NightTime Syrup by Gaia Herbs interact with any medications?
Yes. Based on its ingredients, Black Elderberry NightTime Syrup has a known interaction with 492 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Black Elderberry NightTime Syrup contains 5 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Does black elderberry actually help with colds or flu?
The evidence isn't established enough to rate. We have insufficient reliable evidence for elderberry's effectiveness against respiratory infections, allergies, or any of the main reasons people buy it. That doesn't mean it doesn't work — it means the research isn't solid enough to say.
Is this safe for kids?
The facts we have don't address pediatric safety specifically. What matters: this syrup is made from cooked elderberry, which is the safe form. Never give anyone raw or unripe elderberries, seeds, or other elder tree parts — those contain toxins. Talk to your child's doctor before starting any new supplement.
Can I take this while pregnant or breastfeeding?
For black elderberry, there isn't enough safety information to know either way — the data advises against it during pregnancy and breastfeeding unless your doctor says otherwise. Lemon balm and California poppy also lack enough safety data in pregnancy and breastfeeding. Talk with your OB or pharmacist before using.
What's acerola in this?
Acerola is a tropical fruit high in vitamin C. It's added as a source of that vitamin. When used in food amounts or as directed on a label it's safe, but concentrated supplements haven't been studied as thoroughly.
Does this interact with my thyroid medicine?
Lemon balm in this product theoretically can interfere with thyroid hormone replacement therapy by blocking how your thyroid receptor responds to medication. If you take thyroid medication, check with your pharmacist before using this syrup.
Will this make me drowsy?
Lemon balm and California poppy both have sedative effects and can interact with other sleep-promoting drugs or alcohol, potentially increasing drowsiness. If you take sedating medications or sleep aids, talk to your pharmacist before adding this product.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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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.

Black Elderberry NightTime Syrup label
Go deeper

The Full Monographs Behind Black Elderberry NightTime Syrup’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Lemon Balm

Interacts with 264 drugs

Lemon balm is a gentle, lemon-scented mint-family herb traditionally used to ease stress, support sleep, and calm digestion, and topically for cold sores. Early studies are promising but gen...

Read the full Lemon Balm monograph → Herb & supplement monograph

California Poppy

Interacts with 248 drugs

California poppy is a traditional herbal remedy used mainly for anxiety and sleep problems, often combined with other calming herbs. Human research is very limited, so its true benefits are...

Read the full California Poppy monograph → Herb & supplement monograph

Elderberry

Interacts with 121 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 symptoms, but the evidence is limited and n...

Read the full Elderberry monograph → Herb & supplement monograph

Acerola

Interacts with 128 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 antioxidants. While vitamin C itself has w...

Read the full Acerola monograph →
Sources

Sources & How We Checked

Black Elderberry NightTime Syrup'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.

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 41 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.

Elderberry 6 references
  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

See these in context on the Elderberry monograph →

Acerola 20 references
  1. 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.
  2. Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
  3. Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
  4. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  5. 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/.
  6. Rosenthal G. Interaction of ascorbic acid and warfarin. JAMA 1971;215:1671. DOI
  7. Hume R, Johnstone JM, Weyers E. Interaction of ascorbic acid and warfarin. JAMA 1972;219:1479. DOI
  8. Smith EC, Skalski RJ, Johnson GC, Rossi GV. Interaction of ascorbic acid and warfarin. JAMA 1972;221:1166. DOI
  9. Domingo JL, Gomez M, Llobet JM, Richart C. Effect of ascorbic acid on gastrointestinal aluminum absorption (letter). Lancet 1991;338:1467.
  10. 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
  11. Partridge NA, Regnier FE, White JL, Hem SL. Influence of dietary constituents on intestinal absorption of aluminum. Kidney Int 1989;35:1413-7. PubMed
  12. Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
  13. Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
  14. 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
  15. 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
  16. Weintraub M, Griner PF. Warfarin and ascorbic acid: lack of evidence for a drug interaction. Toxicol Appl Pharmacol 1974;28:53-6. PubMed
  17. 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
  18. Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
  19. Denadai R, Souza FM, Valle MR. Fecal impaction by rectal acerola bezoar. Indian J Pediatr 2013;80(5):432-3. PubMed
  20. 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

See these in context on the Acerola monograph →

Lemon Balm 12 references
  1. Wolbling RH, Leonhardt K. Local therapy of herpes simplex with dried extract from Melissa officinalis. Phytomedicine 1994;1:25-31.
  2. Akhondzadeh S, Noroozian M, Mohammadi M, et al. Melissa officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomised, placebo controlled trial. J Neurol Neurosurg Psychiatry 2003;74:863-6. PubMed
  3. Kennedy DO, Scholey AB, Tildesley NT, et al. Modulation of mood and cognitive performance following acute administration of Melissa officinalis (lemon balm). Pharmacol Biochem Behav 2002;72:953-64. PubMed
  4. Albrecht M, Berger W, Laux P, Schmidt U, et al. Psychopharmaka und Verkehrssicherheit. Der Einfluß von Euvegal® - Dragees forte auf die Fahrtüchtigkeit und Kombinationswirkungen mit Alkohol Z Allg Med 1995;71:1215-25.
  5. Herberg, KW. Nebenwirkungen pflanzlicher Beruhigungsmittel/ Leistung und Befinden nach Einnahme einer Baldrian-Hopfen-Kombination. Z.Allg Med 1996;72:234-240.
  6. Soulimani R, Fleurentin J, Mortier F, et al. Neurotropic action of the hydroalcoholic extract of Melissa officinalis in the mouse. Planta Med. 1991 Apr;57:105-9.
  7. Sourgens H, Winterhoff H, Gumbinger HG, et al. Antihormonal effects of plant extracts. TSH- and prolactin-suppressing properties of Lithospermum officinale and other plants. Planta Med. 1982 Jun;45:78-86. DOI
  8. Auf'mkolk M, Ingbar JC, Amir SM, et al. Inhibition by certain plant extracts of the binding and adenylate cyclase stimulatory effect of bovine thyrotropin in human thyroid membranes. Endocrinology. 1984 Aug;115:527-34. PubMed
  9. Santini F, Vitti P, Ceccarini G, et al. In vitro assay of thyroid disruptors affecting TSH-stimulated adenylate cyclase activity. J Endocrinol Invest. 2003 Oct;26:950-5. PubMed
  10. Alijaniha F, et al. Heart palpitation relief with Melissa officinalis leaf extract: double blind, randomized, placebo controlled trial of efficacy and safety. J Ethnopharmacol. 2015;164:378-384. doi: 10.1016/j.jep.2015.02.007. Epub 2015 Feb 11. PubMed
  11. Araj-Khodaei M, Noorbala AA, Yarani R, et al. A double-blind, randomized pilot study for comparison of Melissa officinalis L. and Lavandula angustifolia Mill. with Fluoxetine for the treatment of depression. BMC Complement Med Ther. 2020;20(1):207. PubMed
  12. Kucuk U, Pham M, Raza Raja MH, Saad Shaukat MH, Clark R. Transient complete atrioventricular block associated with herbal supplement use. S D Med 2023;76(7):311-313.

See these in context on the Lemon Balm monograph →

California Poppy 3 references
  1. Hanus M, Lafon J, Mathieu M. Double-blind, randomised, placebo-controlled study to evaluate the efficacy and safety of a fixed combination containing two plant extracts (Crataegus oxyacantha and Eschscholtzia californica) and magnesium in mild-to-moderate
  2. Paul LD, Springer D, Staack RF, et al. Cytochrome P450 isoenzymes involved in rat liver microsomal metabolism of californine and protopine. Eur J Pharmacol 2004;485:69-79. PubMed
  3. Paul LD, Maurer HH. Studies on the metabolism and toxicological detection of the Eschscholtzia californica alkaloids californine and protopine in urine using gas chromatography-mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2003;789:43-5

See these in context on the California Poppy monograph →

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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

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