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Dietary supplement

Black Elderberry Syrup Ingredients & Drug Interactions

by GaiaKids

Liquid Category: Botanical
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Black Elderberry Syrup is a dietary supplement by GaiaKids with 2 active ingredients. Its ingredients are commonly taken for colds, flu (influenza), other respiratory infections.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 (Sambucus nigra) fruit juice concentrate. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Black Elderberry Syrup by GaiaKids

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

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 2 of its 2 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

This syrup contains 2 active ingredients: black elderberry fruit juice concentrate and acerola fruit extract. The black elderberry is the star here—it's the juice concentrate of the ripe berries.

Acerola is a tropical fruit rich in vitamin C and is included for nutritional support. The product also contains inactive ingredients (water, cane sugar, honey, and lemon) to make it a drinkable syrup.

Does it work?

Not established
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
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use.

Why this rating?
  • The label markets this product for: Immune support.
  • We looked for evidence on: Common cold, Upper respiratory tract infection (URTI), Lower respiratory tract infections, Respiratory tract infections, Influenza, Immune function.
  • The closest evidence on file: Elderberry is rated "Insufficient Reliable Evidence To Rate" for Respiratory tract infections (Natural Medicines).
  • Also on file: Elderberry is rated "Insufficient Reliable Evidence To Rate" for Upper respiratory tract infection (URTI), Lower respiratory tract infections.
  • Also on file: Acerola is rated "Insufficient Reliable Evidence To Rate" for Common cold.

The evidence for what black elderberry does is limited. We hold insufficient reliable evidence to rate its effectiveness for hay fever, cardiovascular disease, chronic fatigue, COPD, cognitive function, or respiratory tract infections.

Acerola is possibly effective for vitamin C deficiency, but evidence for other uses—like the common cold, atherosclerosis, or diarrhea—is also insufficient to rate in our data.

The evidence, ingredient by ingredient 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 2 of the 2 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 2 of 2.
  • General safety write-ups exist for 2 of 2.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Properly cooked elderberry products (like this syrup) are generally well tolerated. The main caution is that raw or unripe berries, seeds, leaves, and bark can be toxic due to compounds called cyanogenic glycosides—cooking eliminates the toxin, so a prepared syrup should be safe from that standpoint.

Acerola from food amounts or as directed on labels is generally considered safe, though concentrated supplements are less well studied. Very high doses of acerola's vitamin C content (over 2,000 mg daily) may cause diarrhea and gastrointestinal upset, and there's one rare case report of an allergic reaction to acerola in someone with latex sensitivity.

Side effects, ingredient by ingredient 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?
  • 2 of the 2 matched ingredients can interact with medications — Elderberry, 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: 247 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 before starting if you take immunosuppressant medications, cancer chemotherapy drugs (alkylating agents, antitumor antibiotics, or pazopanib specifically), estrogen-based hormonal contraceptives or hormone replacement therapy, or warfarin and other blood thinners. If you take aspirin or aluminum-containing antacids, a conversation with us is worth it—the risk is lower, but it's worth confirming your dose.

Check your own medication Run your meds through the checker above

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.

This is a well-tolerated syrup for kids when used as directed, but it's not for everyone. If you take immunosuppressants, cancer drugs (especially pazopanib), hormonal contraceptives, or blood thinners like warfarin, you need to check with your pharmacist first.

Avoid it during pregnancy and breastfeeding, as there isn't enough safety data. If you have any doubt, reach out—we're here to help.

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 Sep 22, 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 Syrup, straight from the product label.

Brand GaiaKids
Net contents 3 Fluid Ounce(s); 89 Milliliter(s)
Market status On market
Date entered into DSLD Sep 22, 2022
DSLD ID 272169
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Children 4 or More Years of Age, Organic, Gluten Free, Dairy Free, Children more than 1 but less than 4
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 Syrup by GaiaKids, 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:
2.5 mL, 5 mL
Maximum serving Sizes:
2.5 mL, 5 mL
Servings per container
18
IngredientAmount% DV
Calories10 Calorie(s), 20 Calorie(s)--
Total Carbohydrates2 Gram(s), 4 Gram(s)1%, 2%
Added Sugars2 Gram(s), 4 Gram(s)8%, 8%
Total Sugars2 Gram(s), 4 Gram(s)--
Black Elderberry (Sambucus nigra) fruit juice concentrate476 mg, 951 mg--
Acerola fruit extract50 mg, 101 mg--

Other ingredients: Cane Sugar, Water, Honey, Lemon

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 for supporting immune health

Certified Organic by Oregon Tilth

Product of Italy

Dairy-free Gluten-free

Certified Organic

Seals/Symbols

USDA Organic

EST 1987 USA Integrity Purity Potency Certified B Corporation

Suggested/Recommended/Usage/Directions

Delicious daily tonic your kids will love

Suggested Use Ages 1-3: 1/2 teaspoon daily Ages 4-11: 1 teaspoon daily For additional support, take 2 times daily. Shake well before use.

Consume within 6 months of opening.

FDA Statement of Identity

Herbal Supplement

Storage

Refrigerate after opening.

Precautions

This product contains honey - not for use by children under 1 year old.

If your child has a medical condition or takes medications, please consult with your doctor before use.

Use only as directed on label. Do not use if cap seal is broken.

Store away from children.

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 extracts provide a delicious & convenient way to get your daily dose of herbs. Discover our guiding truths at: Facebook Instagram @gaiaherbs

Black Elderberry 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

Brand IP Statement(s)

Gaia Herbs Connecting plants & people since 1987

See for yourself

Black Elderberry Syrup by GaiaKids label

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

What’s inside

The Ingredients in Black Elderberry Syrup by GaiaKids

These are the 2 active ingredients this product is made of. Select any to open its full monograph.

Serving size2.5 mL Dosage formLiquid Servings per container18 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.

476 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 fruit extract

Interacts with
128 drugs
50 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 fruit extract monograph & interactions

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

Interaction report

Black Elderberry Syrup by GaiaKids Drug Interactions

Want to check YOUR meds against Black Elderberry 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
247Drugs
158 Moderate 89 Minor

Ingredients driving the most interactions

Each ingredient & the kinds of drugs it affects

For each ingredient in Black Elderberry 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.

Acerola 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

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
The maker

Brand information

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

GaiaKids

See all GaiaKids products
Name
Gaia Herbs, Inc.
Street Address
101 Gaia Herbs Dr.
City
Brevard
State
NC
ZipCode
28712
Web Address
GaiaHerbs.com
Pharmacist Counseling Corner

Black Elderberry Syrup by GaiaKids: Common Questions

Does Black Elderberry Syrup by GaiaKids interact with any medications?
Yes. Based on its ingredients, Black Elderberry Syrup has a known interaction with 247 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Black Elderberry Syrup contains 2 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.
Is this safe to give my kids?
This syrup is formulated for kids (it's GaiaKids brand) and the properly cooked elderberry and acerola are generally well tolerated in food or supplement amounts. The main thing to watch is keeping the dose as directed on the label and making sure it doesn't interact with any medications they take. If your child is on any prescriptions, run it through the interaction checker on this page first.
Can I use this while pregnant or breastfeeding?
There isn't enough reliable safety information for elderberry during pregnancy or breastfeeding, so it's best to avoid it during those times. Talk with your doctor or pharmacist about whether this is right for you in those situations.
Does elderberry actually prevent colds?
We don't have enough reliable evidence to rate whether it works for respiratory infections or the common cold. That doesn't mean it doesn't work—just that the science isn't solid enough yet to say either way.
What if I accidentally used raw elderberries instead of this syrup?
Raw or unripe elderberries, seeds, and other parts of the plant can cause nausea, vomiting, diarrhea, weakness, and dizziness because they contain compounds that cooking destroys. This syrup is made from cooked fruit, so it avoids that risk—but don't use raw berries.
Is there anything else in this besides the elderberry and acerola?
Yes—there's water, cane sugar, honey, and lemon juice to make it into a syrup. These are inactive ingredients (fillers and flavoring), not active medicinal ingredients.
My child is on an antibiotic. Can they take this?
The ingredients in this product don't have documented interactions with most common antibiotics, but some meds are affected. Use the interaction checker on this page with your child's specific antibiotic, or ask us—we can look it up for you quickly.

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 Syrup label
Sources

Sources & How We Checked

Black Elderberry 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 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.

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 →

Parts of this content are provided by the Therapeutic Research Center, LLC.

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.

© 2021 Therapeutic Research Center, LLC

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