Black Elderberry with SambuActin Natural Elderberry Flavor Ingredients & Drug Interactions
by Solaray
What is this page for?
First and foremost: checking Black Elderberry with SambuActin Natural Elderberry Flavor 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 with SambuActin Natural Elderberry Flavor is a dietary supplement by Solaray with 2 active ingredients. Its ingredients are commonly taken for common cold and immune support, antioxidant support, skin health and collagen formation.Based on those ingredients, 326 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Vitamin C, Black Elderberry Berry Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Black Elderberry with SambuActin Natural Elderberry Flavor by Solaray
Ask about any prescription or over-the-counter medication and we check it for interactions with Black Elderberry with SambuActin Natural Elderberry Flavor by Solaray — and tell you which ingredient is responsible.
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 with SambuActin Natural Elderberry Flavor by Solaray
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 lozenge contains 2 active ingredients: vitamin C and polyphenols from black elderberry berry extract. The black elderberry component is a blend, so its specific active compounds work together in the extract form.
The product also contains inactive ingredients — sorbitol, xylitol, natural berry and other flavors, stearic acid, silica, citric acid, and Beflora Plus — which serve as sweeteners, flavorings, thickeners, and binders to form the lozenge.
Does it work?
Moderate evidence
Vitamin C is effective for treating vitamin C deficiency. The data we hold shows it's possibly effective for anemia of chronic disease, atrial fibrillation, cataracts, and reducing respiratory infections after exercise.
Effectiveness data for the polyphenols and black elderberry extract themselves isn't in the facts we have on file.
How safe is it?
Well-documented data
Vitamin C is generally well tolerated at normal dietary and supplement doses. At higher doses, side effects can include abdominal cramps, heartburn, nausea, osmotic diarrhea, and kidney stones in people prone to them — adverse effects become more likely above 2 grams daily.
The safety data advises caution with high-dose vitamin C supplements in pregnancy; normal amounts from food and prenatal vitamins are considered safe, but high-dose supplements should only be used if your doctor advises it. For breastfeeding, recommended dietary amounts are safe; avoid high-dose supplements unless directed by your healthcare provider.
Meds to double-check
Moderate interaction found
Before taking this, double-check your medications against these drug types: birth control and hormone replacement therapy (estrogens), blood thinners like warfarin, thyroid replacement (levothyroxine), HIV medications (indinavir), antipsychotics (fluphenazine), chemotherapy drugs, and aluminum-containing products. All of these interactions are documented as Moderate severity.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
This supplement is mainly useful if you're low in vitamin C or looking at black elderberry's possible benefits for immunity. If you take birth control, hormone therapy, blood thinners, thyroid medication, HIV drugs, or chemotherapy, you'll want to check your exact medications with the tool on this page before starting.
Talk to your pharmacist about whether this product fits your situation.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 1 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 25, 2025.
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 with SambuActin Natural Elderberry Flavor, straight from the product label.
| Brand | Solaray |
|---|---|
| Barcode (UPC) | 076280034073 |
| Net contents | 60 Lozenge(s) |
| Market status | On market |
| Date entered into DSLD | Sep 25, 2025 |
| DSLD ID | 338238 |
| Product type | Botanical With Nutrients |
| Supplement form | Lozenge |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Children 4 or More Years of Age, Adult (18 - 50 Years), Gluten Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Black Elderberry with SambuActin Natural Elderberry Flavor by Solaray, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 10 Calorie(s) | -- |
| Total Carbohydrates | 2 Gram(s) | 1% |
| Vitamin C | 190 mg | 211% |
| Polyphenols | 8 mg | -- |
| Black Elderberry Berry Extract | 400 mg | -- |
Other ingredients: Sorbitol, Xylitol, Mixed Berry Flavor, Natural, other Natural flavors, Stearic Acid, Silica, Citric Acid, Beflora Plus
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.
Brand IP Statement(s)
Solaray Est. 1973 A brighter way 1973
Formulation
Immune support
Gluten free Made without soy
FDA Statement of Identity
Dietary Supplement
Seals/Symbols
Lab Verified
General Statements
Since 1973, we've scoured the globe for the highest quality ingredients, connecting you with the most efficacious supplements that help you live brighter & embrace the moments that matter most.
100% PCR bottles
Precautions
Warning: Do not use if safety seal is broken or missing. Keep your licensed health care practitioner informed when using his product. Directions: Use only as directed.
Keep out of reach of children.
Suggested/Recommended/Usage/Directions
Directions: Use only as directed. Take 2 lozenges daily. For children under the age of 6, reduce dosage to 1 lozenge.
Storage
Store in a cool, dry place.
Formula
Discussions: Solaray SambuActin supplement is designed to be a superior extract of high quality black elderberry. Formulated with the latest research, this unique product contains polyphenols, elderberry's key active component.
FDA Disclaimer Statement
These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Black Elderberry with SambuActin Natural Elderberry Flavor by Solaray 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 with SambuActin Natural Elderberry Flavor by Solaray
These are the 2 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Lozenge(s) Dosage formLozenge Servings per container30 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Vitamin C
Interacts with207 drugs
Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...
Vitamin C monograph & interactionsBlack Elderberry Berry Extract
Interacts with121 drugs
Elderberry is a popular herbal supplement, mainly taken to help with colds and flu. Some small studies suggest it may modestly shorten cold or flu sym...
Black Elderberry Berry Extract monograph & interactions- › Polyphenols
Other (inactive) ingredients: Sorbitol, Xylitol, Mixed Berry Flavor, Natural, Other Natural flavors, Stearic Acid, Silica, Citric Acid, Beflora Plus. These complete the product’s ingredient list but are not active constituents.
Black Elderberry with SambuActin Natural Elderberry Flavor by Solaray Drug Interactions
HelloPharmacist Interaction Report
Solaray Black Elderberry with SambuActin contains vitamin C, which interacts with over 200 individual medications across several drug categories.
The most serious concern is with estrogens — birth control pills and hormone replacement therapy can see estrogen levels rise by up to 55% when taken with vitamin C, which may reduce contraceptive reliability or intensify hormone therapy effects.
Read the full breakdown — every affected drug type, severity by severity
Vitamin C also interacts with blood thinners like warfarin (Coumadin) at high doses, potentially making them less effective. It can reduce levels of the HIV medication indinavir (Crixivan) and the antipsychotic fluphenazine (Prolixin), and it may interfere with thyroid replacement therapy (levothyroxine/Synthroid).
Additionally, vitamin C can increase aluminum absorption from aluminum-containing compounds, and it theoretically may reduce the effectiveness of certain chemotherapy drugs, including alkylating agents and antitumor antibiotics.
We could not check two other ingredients in this product — polyphenols and black elderberry extract's individual components. Altogether, these interactions span 207 individual medications.
Use the medication checker below with your exact prescriptions before starting this supplement.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Black Elderberry with SambuActin Natural Elderberry Flavor?
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 with SambuActin Natural Elderberry Flavor interact with 326 drugs. Click any drug to see the details.
2 of the 2 ingredients in Black Elderberry with SambuActin Natural Elderberry Flavor interact with drugs. Each result below shows which ingredient is responsible. Vitamin C Black Elderberry Berry Extract
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + 6-mercaptopurine interactionAbrocitinibCibinqo
How Abrocitinib interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + Abrocitinib interactionAdalimumabHumira
How Adalimumab interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + Adalimumab interactionAdalimumab-adazHyrimoz
How Adalimumab-adaz interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + Adalimumab-adaz interactionAdalimumab-adbmCyltezo
How Adalimumab-adbm interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + Adalimumab-adbm interactionAdalimumab-afzbAbrilada
How Adalimumab-afzb interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + Adalimumab-afzb interactionAdalimumab-attoAmjevita
How Adalimumab-atto interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + Adalimumab-atto interactionAdalimumab-bwwdHadlima
How Adalimumab-bwwd interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + Adalimumab-bwwd interactionAdalimumab-fkjpHulio
How Adalimumab-fkjp interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + Adalimumab-fkjp interactionAlefaceptAmevive
How Alefacept interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + Alefacept interactionAlemtuzumabCampath
How Alemtuzumab interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + Alemtuzumab interactionAlginic Acid, Aluminum HydroxideRafton
How Alginic Acid, Aluminum Hydroxide interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Alginic Acid, Aluminum Hydroxide interactionAltretamineHexalen
How Altretamine interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAlkylating Agents Moderate
Interaction Summary
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
Read the full Vitamin C + Altretamine interactionAluminum Acetate, Benzethonium ChlorideBuro-Sol Otic Solution
How Aluminum Acetate, Benzethonium Chloride interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum Acetate, Benzethonium Chloride interactionAluminum ChlorideAluminum Chloride, Anhydrol Forte, Driclor, Drysol
How Aluminum Chloride interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum Chloride interactionAluminum HydroxideAlu-Cap, Amphojel, Gaviscon
How Aluminum Hydroxide interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum Hydroxide interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAspirin, Aluminum Moderate
Interaction Summary
Acidification of the urine by vitamin C might increase aspirin levels.
Read the full Vitamin C + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAspirin, Aluminum Moderate
Interaction Summary
Acidification of the urine by vitamin C might increase aspirin levels.
Read the full Vitamin C + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAluminum Hydroxide, Magnesium Hydroxide (otc Drug)Maalox, Mucogel
How Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interactionAluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug)Mylanta
How Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interactionAluminum, CalciumDomeboro
How Aluminum, Calcium interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum, Calcium interactionAluminum, Magnesium (otc Drug)Almagel
How Aluminum, Magnesium (otc Drug) interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum, Magnesium (otc Drug) interactionAluminum, Magnesium Hydroxide (otc Drug)Wingel
How Aluminum, Magnesium Hydroxide (otc Drug) interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum, Magnesium Hydroxide (otc Drug) interactionAnifrolumab-fniaSaphnelo
How Anifrolumab-fnia interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + Anifrolumab-fnia interactionAntithymocyte GlobulinThymoglobulin
How Antithymocyte Globulin interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + Antithymocyte Globulin interactionAspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #3
How Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAspirin, Aluminum Moderate
Interaction Summary
Acidification of the urine by vitamin C might increase aspirin levels.
Read the full Vitamin C + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interactionAtezolizumabTecentriq
How Atezolizumab interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + Atezolizumab interactionAzamuneImmunoprin
How Azamune interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + Azamune interactionAzathioprineAzamune, Imuran
How Azathioprine interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + Azathioprine interactionBasiliximabSimulect
How Basiliximab interacts with Black Elderberry with SambuActin Natural Elderberry Flavor — through 1 ingredient. Tap an ingredient for the detail:
Black Elderberry Berry ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Black Elderberry Berry Extract + Basiliximab interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Black Elderberry with SambuActin Natural Elderberry Flavor 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.
Vitamin C
Alkylating Agents
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make 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.
Aluminum
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.
Antitumor Antibiotics
Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make 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 chemotherapy.
Estrogens
Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur 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. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.
Fluphenazine (Prolixin)
Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.
Indinavir (Crixivan)
Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.
Levothyroxine (Synthroid, Others)
Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.
Warfarin (Coumadin)
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.
Acetaminophen (Tylenol, Others)
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.
Aspirin
Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase 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, suggesting this interaction is not clinically significant.
Choline Magnesium Trisalicylate (Trilisate)
Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase 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, suggesting this interaction probably is not clinically significant.
Niacin
Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.
Salsalate (Disalcid)
Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Black Elderberry Berry Extract
Immunosuppressants
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Elderberry has immunostimulant activity, increasing the production of cytokines, including interleukin and tumor necrosis factor.
Pazopanib (Votrient)
Theoretically, elderberry might interact with pazopanib, potentially increasing the risk of adverse effects.
Brand information
Manufacturer and brand details for Black Elderberry with SambuActin Natural Elderberry Flavor, from the product label.
Black Elderberry with SambuActin Natural Elderberry Flavor by Solaray: Common Questions
Does Black Elderberry with SambuActin Natural Elderberry Flavor by Solaray interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Can I take this if I'm on birth control?
Is this safe during pregnancy?
What's black elderberry supposed to do?
Does this have any fillers?
Can I take this with my thyroid medication?
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.
The Full Monographs Behind Black Elderberry with SambuActin Natural Elderberry Flavor’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin C
Interacts with 207 drugsVitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...
Read the full Vitamin C monograph → Herb & supplement monographElderberry
Interacts with 121 drugsElderberry is a popular herbal supplement, mainly taken to help with colds and flu. Some small studies suggest it may modestly shorten cold or flu symptoms, but the evidence is limited and n...
Read the full Elderberry monograph →Sources & How We Checked
Black Elderberry with SambuActin Natural Elderberry Flavor'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 57 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.
Vitamin C 51 references
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
- 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.
- Dwyer JH, Merz NB, Shirocre AM, et al. Progression of early atherosclerosis and intake of vitamin C and vitamin E from supplements and food. The Los Angeles Atherosclerosis Study. 41st Annual Conference on Cardiovascular Disease Epidemiology and Prevent
- Levine M, Rumsey SC, Daruwala R, et al. Criteria and recommendations for vitamin C intake. JAMA 1999;281:1415-23. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Segal S, Kaminski S. Drug-nutrient interactions. American Druggist 1996 Jul;42-8.
- 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/.
- Houston JB, Levy G. Drug biotransformation interactions in man VI: Acetaminophen and ascorbic acid. J Pharm Sci 1976;65:1218-21. PubMed
- Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
- 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
- Traxer O, Huet B, Poindexter J, et al. Effect of ascorbic acid consumption on urinary stone risk factors. J Urol 2003;170:397-401.. PubMed
- 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
- Dysken MW, Cumming RJ, Channon RA, Davis JM. Drug interaction between ascorbic acid and fluphenazine. JAMA 1979;241:2008. DOI
- 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
- Slain D, Amsden JR, Khakoo RA, et al. Effect of high-dose vitamin C on the steady-state pharmacokinetics of the protease inhibitor indinavir in healthy volunteers. Pharmacotherapy 2005;25:165-70. PubMed
- Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. 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
- Lee DH, Folsom AR, Harnack L, et al. Does supplemental vitamin C increase cardiovascular disease risk in women with diabetes? Am J Clin Nutr 2004;80:1194-200. PubMed
- Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol 2004;15:3225-32. PubMed
- Ward NC, Hodgson JM, Croft KD, et al. The combination of vitamin C and grape-seed polyphenols increases blood pressure: a randomized, double-blind, placebo-controlled trial. J Hypertens 2005;23:427-34.. 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
- Fairweather-Tait S, Hickson K, McGaw B, et al. Orange juice enhances aluminium absorption from antacid preparation. Eur J Clin Nutr. 1994;48(1):71-3.
- Gruenwald, J., Graubaum, H. J., Busch, R., and Bentley, C. Safety and tolerance of ester-C compared with regular ascorbic acid. Adv.Ther. 2006;23(1):171-178.
- Rahimi, R., Nikfar, S., Rezaie, A., and Abdollahi, M. A meta-analysis on the efficacy and safety of combined vitamin C and E supplementation in preeclamptic women. Hypertens.Pregnancy. 2009;28(4):417-434. PubMed
- Einerson, B., Nathorn, C., Kitiyakara, C., Sirada, M., and Thamlikitkul, V. The efficacy of ascorbic acid in suboptimal responsive anemic hemodialysis patients receiving erythropoietin: a meta-analysis. J Med.Assoc.Thai. 2011;94 Suppl 1:S134-S146.
- Li, G., Li, L., Yu, C., and Chen, L. Effect of vitamins C and E supplementation on Helicobacter pylori eradication: a meta-analysis. Br.J Nutr 2011;106(11):1632-1637.
- Chen X, Shen L, Gu X, et al. High-dose supplementation with vitamin C--induced pediatric urolithiasis: the first case report in a child and literature review. Urology. 2014;84(4):922-4. PubMed
- Sattar A, Willman JE, Kolluri R. Possible warfarin resistance due to interaction with ascorbic acid: case report and literature review. Am J Health Syst Pharm. 2013;70(9):782-6. PubMed
- Yaich S, Chaabouni Y, Charfeddine K, et al. Secondary oxalosis due to excess vitamin C intake: a cause of graft loss in a renal transplant recipient. Saudi J Kidney Dis Transpl. 2014;25(1):113-6. PubMed
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Rumbold A, Ota E, Nagata C, Shahrook S, Crowther CA. Vitamin C supplementation in pregnancy. Cochrane Database Syst Rev. 2015;(9):CD004072. PubMed
- Seo MS, Kim JK, Shim JY. High-dose vitamin C promotes regression of multiple pulmonary metastases originating from hepatocellular carcinoma. Yonsei Med J. 2015;56(5):1449-52. PubMed
- Skelin M, Lucijanic T, Amidzic Klaric D, et al. Factors Affecting Gastrointestinal Absorption of Levothyroxine: A Review. Clin Ther. 2017 Feb;39(2):378-403. PubMed
- Jiang K, Tang K, Liu H, Xu H, Ye Z, Chen Z. Ascorbic acid supplements and kidney stones incidence among men and women: a systematic review and meta-analysis. Urol J. 2019;16(2):115-120.
- Thomas S, Patel D, Bittel B, et al. Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial. JAMA Netw Open. 2 PubMed
- Giffen MA, McLemore JL. Hyperoxalosis Secondary to Intravenous Vitamin C Administration as a Non-Allopathic Treatment for Cancer. Acad Forensic Pathol 2019;9(1-2):118-126. PubMed
- Maike A, Sturgill D, Gallan A. Oxalate Nephropathy in a Renal Transplant Recipient After Receiving High Dose Ascorbic Acid. Am J Med Sci 2021. PubMed
- Shen ZY, Chen YR, Wang MC, Chang SS. High-dose vitamin C-induced acute oxalate nephropathy in a renal transplant recipient: a case report and literature review. Asian J Surg 2022. PubMed
- Yanase F, Spano S, Maeda A, et al. Mega-dose sodium ascorbate: a pilot, single-dose, physiological effect, double-blind, randomized, controlled trial. Crit Care 2023;27(1):371. PubMed
- Sharma Y, Sumanadasa S, Shahi R, et al. Efficacy and safety of vitamin C supplementation in the treatment of community-acquired pneumonia: a systematic review and meta-analysis with trial sequential analysis. Sci Rep 2024;14(1):11846. PubMed
- Pejcic AV, Petrovic NZ, Djordjic MD, Milosavljevic MN. Vitamin C Levels in Pregnant Women and the Efficacy of Vitamin C Supplements in Preventing Premature Rupture of Membranes: A Systematic Review and Meta-Analysis. Balkan Med J 2024;41(4):248-260. PubMed
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
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