Black Elderberry Syrup Ingredients & Drug Interactions
by GaiaKids
What is this page for?
First and foremost: checking Black Elderberry 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
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.
Check Your Meds Against Black Elderberry Syrup by GaiaKids
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AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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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.
What’s inside
Full disclosure
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
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.
How safe is it?
Well-documented data
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.
Meds to double-check
Moderate interaction found
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.
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
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 |
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
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 10 Calorie(s), 20 Calorie(s) | -- |
| Total Carbohydrates | 2 Gram(s), 4 Gram(s) | 1%, 2% |
| Added Sugars | 2 Gram(s), 4 Gram(s) | 8%, 8% |
| Total Sugars | 2 Gram(s), 4 Gram(s) | -- |
| Black Elderberry (Sambucus nigra) fruit juice concentrate | 476 mg, 951 mg | -- |
| Acerola fruit extract | 50 mg, 101 mg | -- |
Other ingredients: Cane Sugar, Water, Honey, Lemon
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.
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
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Black Elderberry Syrup by GaiaKids 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 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.
Black Elderberry (Sambucus nigra) fruit juice concentrate
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 (Sambucus nigra) fruit juice concentrate monograph & interactionsAcerola 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 & interactionsOther (inactive) ingredients: Cane Sugar, Water, Honey, Lemon. These complete the product’s ingredient list but are not active constituents.
Black Elderberry Syrup by GaiaKids Drug Interactions
HelloPharmacist Interaction Report
Black Elderberry Syrup by GaiaKids contains two active ingredients that each have documented interactions with medications.
Black elderberry is the main concern here: it has immunostimulant activity that can theoretically interfere with immunosuppressants (drugs that dampen immune function), which is a Moderate-severity interaction. There's also a case report of severe liver injury in someone taking pazopanib (a cancer medication) alongside elderberry, also Moderate severity.
Read the full breakdown — every affected drug type, severity by severity
Acerola fruit extract, the second active ingredient, interacts with several chemotherapy drugs—alkylating agents and antitumor antibiotics—because its vitamin C content may reduce their effectiveness (both Moderate severity). It also has Minor-severity interactions with estrogens (including hormonal contraceptives and hormone replacement), aspirin, aluminum salts, and warfarin, though the vitamin C amount in this product is likely too low to cause clinically meaningful effects in most cases.
One ingredient we could not fully check for interactions is acerola's pregnancy and lactation information, as that data was not on file. Altogether, these interactions span 243 individual medications.
Use the search tool below to check your exact medications before starting this product.
Check your own medications below · Editorial policy · How we use AI
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 checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Black Elderberry Syrup interact with 247 drugs. Click any drug to see the details.
2 of the 2 ingredients in Black Elderberry Syrup interact with drugs. Each result below shows which ingredient is responsible. Acerola fruit extract Black Elderberry (Sambucus nigra) fruit juice concentrate
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + 6-mercaptopurine interactionAbrocitinibCibinqo
How Abrocitinib interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Abrocitinib interactionAdalimumabHumira
How Adalimumab interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Adalimumab interactionAdalimumab-adazHyrimoz
How Adalimumab-adaz interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Adalimumab-adaz interactionAdalimumab-adbmCyltezo
How Adalimumab-adbm interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Adalimumab-adbm interactionAdalimumab-afzbAbrilada
How Adalimumab-afzb interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Adalimumab-afzb interactionAdalimumab-attoAmjevita
How Adalimumab-atto interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Adalimumab-atto interactionAdalimumab-bwwdHadlima
How Adalimumab-bwwd interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Adalimumab-bwwd interactionAdalimumab-fkjpHulio
How Adalimumab-fkjp interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Adalimumab-fkjp interactionAlefaceptAmevive
How Alefacept interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Alefacept interactionAlemtuzumabCampath
How Alemtuzumab interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Alemtuzumab interactionAltretamineHexalen
How Altretamine interacts with Black Elderberry Syrup — 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 + Altretamine interactionAnifrolumab-fniaSaphnelo
How Anifrolumab-fnia interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Anifrolumab-fnia interactionAntithymocyte GlobulinThymoglobulin
How Antithymocyte Globulin interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Antithymocyte Globulin interactionAtezolizumabTecentriq
How Atezolizumab interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Atezolizumab interactionAzamuneImmunoprin
How Azamune interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Azamune interactionAzathioprineAzamune, Imuran
How Azathioprine interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Azathioprine interactionBasiliximabSimulect
How Basiliximab interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Basiliximab interactionBeclometasone DipropionateBecotide
How Beclometasone Dipropionate interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Beclometasone Dipropionate interactionBeclomethasoneBeclovent, Vanceril
How Beclomethasone interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Beclomethasone interactionBeclomethasone DipropionateQNASL, Qvar
How Beclomethasone Dipropionate interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Beclomethasone Dipropionate interactionBendamustineBelrapzo, Treanda, Vivimusta
How Bendamustine interacts with Black Elderberry Syrup — 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 + Bendamustine interactionBendamustine HydrochlorideBendeka
How Bendamustine Hydrochloride interacts with Black Elderberry Syrup — 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 + Bendamustine Hydrochloride interactionBetamethasoneCelestone, Diprolene AF, Diprosone
How Betamethasone interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Betamethasone interactionBetamethasone DipropionateSernivo
How Betamethasone Dipropionate interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Betamethasone Dipropionate interactionBetamethasone Dipropionate, CalcipotrieneEnstilar, Wynzora
How Betamethasone Dipropionate, Calcipotriene interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Betamethasone Dipropionate, Calcipotriene interactionBetamethasone ValerateLuxiq
How Betamethasone Valerate interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Betamethasone Valerate interactionBimekizumab-bkzxBimzelx
How Bimekizumab-bkzx interacts with Black Elderberry Syrup — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry (sambucus Nigra) Fruit Juice ConcentrateImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry (sambucus Nigra) Fruit Juice Concentrate + Bimekizumab-bkzx interactionBleomycinBlenoxane
How Bleomycin interacts with Black Elderberry Syrup — 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 + Bleomycin interactionBusulfanBusulfex, Myleran
How Busulfan interacts with Black Elderberry Syrup — 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 + Busulfan interactionEach 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 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 (Sambucus nigra) fruit juice concentrate
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 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
Black Elderberry Syrup by GaiaKids: Common Questions
Does Black Elderberry Syrup by GaiaKids interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Is this safe to give my kids?
Can I use this while pregnant or breastfeeding?
Does elderberry actually prevent colds?
What if I accidentally used raw elderberries instead of this syrup?
Is there anything else in this besides the elderberry and acerola?
My child is on an antibiotic. Can they take this?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Black Elderberry Syrup is safe with your meds?
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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.
The Full Monographs Behind Black Elderberry Syrup’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Elderberry
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 → Herb & supplement monographAcerola
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 →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.
- 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.
Elderberry 6 references
- 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..
- 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
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
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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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