Major interaction on record — check this product against your medications before combining. Check your meds →
Dietary supplement

Elderberry Ingredients & Drug Interactions

by JoySpring

Elderberry label
See full label image
Liquid Category: Botanical
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 23, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Elderberry against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Major

Elderberry is a dietary supplement by JoySpring with 6 active ingredients. Its ingredients are commonly taken for colds, flu (influenza), other respiratory infections.Based on those ingredients, 2,153 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Marshmallow, Calendula, Orange. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Elderberry by JoySpring

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

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Elderberry by JoySpring

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

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

Why this rating?
  • The label discloses an exact amount for 0 of its 6 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (1 mL) without saying how much of each component you get.

JoySpring Elderberry Liquid contains 6 ingredients, including the active ones: elderberry (the main ingredient), angelica, orange, calendula, mullein, and marshmallow. Elderberry is the star of the formula — it's a dark berry known for its traditional use in supporting respiratory and immune health.

The other herbs are traditionally used to support respiratory wellness and soothe irritation. The product also contains glycerin and purified water as inactive ingredients — these help deliver the formula and preserve it.

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: May support immunity.
  • We looked for evidence on: Cough, Influenza, Lower respiratory tract infections, Respiratory tract infections, Upper respiratory tract infection (URTI), Bronchitis — and 3 related terms.
  • 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: Mullein is rated "Insufficient Reliable Evidence To Rate" for Bronchitis, Cough, Influenza.

The evidence we hold for elderberry's effectiveness doesn't yet establish it for the conditions it's traditionally used for. The data rates elderberry as having insufficient reliable evidence for allergic rhinitis (hay fever), cardiovascular disease, chronic fatigue syndrome, chronic obstructive pulmonary disease (COPD), cognitive function, and respiratory tract infections.

The same applies to the other active ingredients in this blend — calendula, mullein, and marshmallow all lack established effectiveness for the conditions listed in our data. That doesn't mean they don't work; it means high-quality clinical trials haven't yet confirmed their benefits.

The evidence, ingredient by ingredient Elderberry Ashitaba Sweet Orange Calendula Mullein Marshmallow

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 4 of the 6 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 6 of 6.
  • General safety write-ups exist for 6 of 6.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Properly prepared elderberry products like this one are generally well tolerated. The main caution is to avoid raw or unripe elderberries, leaves, bark, and seeds — these contain compounds that can cause nausea, vomiting, severe diarrhea, weakness, and dizziness.

Cooking eliminates the risk, so this liquid form should be safe from that standpoint. Rarely, case reports have described autoimmune liver inflammation in someone taking elderberry long-term, and nausea and vomiting in a product combining elderberry with echinacea, though it's unclear which herb caused it.

During pregnancy, the safety data for elderberry isn't strong enough, so it's best avoided. The same goes for breastfeeding.

Calendula, mullein, and marshmallow also lack adequate safety information for pregnancy and breastfeeding — these should be avoided during those times unless your doctor approves. Calendula can trigger allergic reactions in people sensitive to ragweed or related plants.

Side effects, ingredient by ingredient Elderberry Ashitaba Sweet Orange Calendula Mullein Marshmallow

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 6 of the 6 matched ingredients can interact with medications — Calendula, Elderberry, Mullein, Marshmallow, Sweet Orange, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; lithium.
  • For scale: 2,154 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.

Before taking JoySpring Elderberry Liquid, check with your pharmacist if you take immunosuppressants or pazopanib (Votrient) — Moderate interactions. Also mention any blood thinners (anticoagulants or antiplatelet drugs like warfarin or aspirin), lithium, sedating medications, or other oral drugs you take — these have Minor interactions.

No interactions are documented for angelica or orange, which we couldn't fully check.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.

If you take immunosuppressants, pazopanib, blood thinners, lithium, or central nervous system depressants, check with your pharmacist before starting this product. It's not for pregnancy or breastfeeding.

For anyone else, it's generally well tolerated — but remember that effectiveness for most conditions in this formula hasn't been established yet.

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

Assessment coverage: 6 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 23, 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

At a glance

General information

Key facts about Elderberry, straight from the product label.

Brand JoySpring
Barcode (UPC) 850008889011
Net contents 30 mL; 1 Fluid Ounce(s)
Market status On market
Date entered into DSLD Feb 23, 2025
DSLD ID 323373
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Children 4 or More Years of Age, Gluten Free, Sugar 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 Elderberry by JoySpring, 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:
1 mL
Maximum serving Sizes:
2 mL
Servings per container
30
UPC/BARCODE
850008889011
IngredientAmount% DV
Proprietary Blend1 mL--
Elderberry0 NP--
Angelica0 NP--
Orange0 NP--
Calendula0 NP--
Mullein0 NP--
Marshmallow0 NP--

Other ingredients: Glycerin, Water, Purified

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.
Suggested/Recommended/Usage/Directions

Suggested use 1 dropper means 1 squeeze Up to 3x daily Shake well 2+ years 1-2 droppers daily

Precautions

Warning: Do not use if the product appears to be tampered with or if seal is broken.

Not intended for children under 2 years of age. Keep out of reach of children.

Use only under adult supervision.

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.

Formulation

May support immunity

Gluten-free Sugar-free

Formula

Mullein leaf & marshmallow root

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

See for yourself

Elderberry by JoySpring label

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

Elderberry label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Elderberry by JoySpring

These are the 6 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 mL Dosage formLiquid 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.

Proprietary Blend

1 mL per serving

Other (inactive) ingredients: Glycerin, Water, Purified. These complete the product’s ingredient list but are not active constituents.

Interaction report

Elderberry by JoySpring Drug Interactions

Want to check YOUR meds against Elderberry?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
2,153Drugs
48 Major 449 Moderate 1,656 Minor

Ingredients driving the most interactions

Marshmallow 2,040
Calendula 248
Orange 246
Angelica 186
Mullein 122

Individual Drug Interactions

The ingredients in Elderberry interact with 2,153 drugs. Click any drug to see the details.

6 of the 6 ingredients in Elderberry interact with drugs. Each result below shows which ingredient is responsible. Marshmallow Calendula Orange Angelica Mullein Elderberry

Each ingredient & the kinds of drugs it affects

For each ingredient in Elderberry with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Marshmallow3 drug types · 2,040 drugs

Lithium

Theoretically, due to potential diuretic effects, marshmallow might reduce excretion and increase levels of lithium.
Marshmallow is thought to have diuretic properties. To avoid lithium toxicity, the dose of lithium might need to be decreased when used with marshmallow.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, marshmallow flower might have antiplatelet effects.
Animal research suggests that marshmallow flower extract has antiplatelet effects. However, the root and leaf of marshmallow, not the flower, are the plant parts most commonly found in dietary supplements. Theoretically, use of marshmallow flower with anticoagulant/antiplatelet drugs can have additive effects, and might increase the risk for bleeding in some patients.

Likelihood Unlikely Evidence D
Oral Drugs

Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Marshmallow contains mucilage which can affect oral drug absorption. To avoid changes in absorption, take marshmallow 30-60 minutes after oral medications.

Likelihood Possible Evidence D
Marshmallow full monograph & interactions

Calendula1 drug type · 248 drugs

Cns Depressants

Theoretically, calendula might have additive effects when used with CNS depressants, although this appears to be unlikely.
Although some animal research has suggested that a saponoside constituent in calendula may have sedative effects, calendula has been used for over 30 years without reports of sedation in humans.

Likelihood Unlikely Evidence D
Calendula full monograph & interactions

Orange7 drug types · 246 drugs

Celiprolol (Celicard)

Consuming sweet orange with celiprolol can decrease oral absorption of celiprolol.
A pharmacokinetic study in healthy volunteers shows that celiprolol levels, after a single dose of 100 mg, are decreased by up to 90% in people who drink sweet orange juice 200 mL three times daily. It's not known if lower consumption of sweet orange juice will have the same effect. Theoretically, this occurs due to short-term inhibition of organic anion transporting polypeptide (OATP). Recommend separating drug administration and consumption of sweet orange by at least 4 hours.

Likelihood Likely Evidence B
Ivermectin (Stromectol, Others)

Consuming sweet orange juice with ivermectin can decrease the oral absorption of ivermectin.
A pharmacokinetic study in healthy volunteers shows that taking ivermectin orally with sweet orange juice 750 mL over 4 hours reduces the bioavailability of ivermectin. This effect does not seem to be related to effects on P-glycoprotein. The effect on ivermectin is more pronounced in males compared to females.

Likelihood Likely Evidence B
Organic Anion-Transporting Polypeptide Substrates (Oatp)

Consuming sweet orange juice can decrease oral absorption of OATP substrates. Separate administration by at least 4 hours.
Clinical research shows that consuming sweet orange juice inhibits OATP, which reduces bioavailability of oral drugs that are substrates of OATP. For example, sweet orange juice decreases bioavailability of fexofenadine, a substrate of OATP, by about 72% and of celiprolol, another OATP substrate, by up to 90%. Since sweet orange juice seems to affect OATP for a short time, recommend separating drug administration and consumption of sweet orange juice by at least 4 hours.

Likelihood Likely Evidence B
Pravastatin (Pravachol)

Consuming sweet orange juice with pravastatin can increase the absorption of pravastatin.
A small pharmacokinetic study in healthy volunteers shows that consuming sweet orange juice 800 mL over 3 hours, including before, during, and after taking pravastatin 10 mg, increases pravastatin levels by about 149%, without affecting pravastatin elimination. Theoretically this effect might be due to modulation of organic anion transporting polypeptides (OATPs) by sweet orange juice. Sweet orange juice does not seem to affect simvastatin levels, but it is not known if sweet orange affects any of the other statins.

Likelihood Likely Evidence B
Fexofenadine (Allegra)

Consuming sweet orange juice with fexofenadine can decrease oral absorption of fexofenadine.
Clinical research shows that coadministration of sweet orange juice 1200 mL decreases bioavailability of fexofenadine by about 72%. In an animal model, sweet orange juice decreased bioavailability of fexofenadine by 31%. Fexofenadine manufacturer data indicates that concomitant administration of sweet orange juice and fexofenadine results in larger wheal and flare sizes in research models. This suggests that sweet orange reduces the clinical response to fexofenadine. Theoretically, this occurs due to short-term inhibition of organic anion transporting polypeptide (OATP). Recommend separating drug administration and consumption of sweet orange by at least 4 hours.

Likelihood Likely Evidence B
P-Glycoprotein Substrates

Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Animal and in vitro research suggest that orange juice extract inhibits drug efflux by P-gp, increasing absorption and levels of P-gp substrates. In contrast, pharmacokinetic research in humans shows that drinking large amounts of sweet orange juice decreases absorption and levels of the P-gp substrate celiprolol. This suggests that orange juice actually induces drug efflux by P-gp or affects drug levels by another mechanism such as inhibiting the gut drug transporter called organic anion transporting polypeptide (OATP). Until more is known, sweet orange juice should be used cautiously in people taking P-gp substrates.

Likelihood Possible Evidence B
Quinolone Antibiotics

Calcium-fortified sweet orange juice might reduce quinolone absorption.
Calcium binds to quinolones in the gut. Theoretically, the calcium in certain fortified orange juices can also bind to quinolone antibiotics and reduce their absorption and levels.

Likelihood Possible Evidence D
Orange full monograph & interactions

Angelica1 drug type · 186 drugs

Cytochrome P450 1A2 (Cyp1A2) Substrates

In vitro research shows that ashitaba extract inhibits cytochrome P450 (CYP) 1A2. Theoretically, concomitant use of ashitaba with CYP1A2 substrates might decrease the clearance of these substrates and increase the risk for adverse effects. However, this interaction has yet to be reported in humans. Until more is known, use with caution.

Likelihood Possible Evidence D
Angelica full monograph & interactions

Mullein1 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Lab tests on extracts from different parts of common and dense-flowered mullein plants show that they do have some blood-thinning effects, as they increase the time it takes for blood to clot. This is likely due to at least one of the known constituents of muellein, triterpenoid saponins. However, the effects appear to be mild and results have been inconsistent. Extracts from different plant parts have been show to have varying anticoagulant strengths, with water-based ones being more potent than alcohol-based extracts.

Likelihood Unlikely Evidence A
Mullein full monograph & interactions

Elderberry2 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
Elderberry full monograph & interactions
The maker

Brand information

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

JoySpring

See all JoySpring products
Name
JoySpring
Street Address
Po Box 656
City
Waxhaw
State
NC
ZipCode
28173
Pharmacist Counseling Corner

Elderberry by JoySpring: Common Questions

Does Elderberry by JoySpring interact with any medications?
Yes. Based on its ingredients, Elderberry has a known interaction with 2,153 medications, including 48 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Elderberry contains 6 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 take while I'm pregnant or breastfeeding?
The safety data for elderberry during pregnancy and breastfeeding isn't solid enough to recommend it, so it's best to avoid it during those times. Calendula, mullein, and marshmallow in this blend also lack adequate pregnancy and breastfeeding data. Talk with your doctor or pharmacist about what's right for you.
What does elderberry actually do?
Elderberry is traditionally used to support respiratory and immune health, but the clinical evidence we hold doesn't yet establish that it works for conditions like hay fever, colds, COPD, or fatigue. That doesn't mean it won't help — it just means strong clinical trials haven't confirmed it yet.
Can I take this if I'm on blood thinners like warfarin?
Both mullein and marshmallow in this product have Minor interactions with blood thinners. The effects appear mild, but you should check with your pharmacist before starting, as blood thinners need careful monitoring.
Will this reduce how my other medications work?
Marshmallow contains a sticky substance that might reduce how your body absorbs oral drugs if taken at the same time. To be safe, take marshmallow-containing products 30–60 minutes after your other medications. Your pharmacist can help you time everything correctly.
Are there any side effects from this product?
Properly prepared elderberry is well tolerated. The product's other herbs are also generally well tolerated for short-term use, though calendula can cause allergic reactions in people sensitive to ragweed or similar plants. Raw or unripe elderberry parts can cause nausea, vomiting, or severe diarrhea — this formula shouldn't have that risk.
What if I'm taking a medication that suppresses my immune system?
Elderberry stimulates immune activity, which could interfere with immunosuppressant drugs — this is a Moderate interaction. Check with your pharmacist or doctor before starting this product if you take any medication that dampens your immune response.

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.

Elderberry label
Go deeper

The Full Monographs Behind Elderberry’s Ingredients

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

Herb & supplement monograph

Elderberry

Interacts with 121 drugs

Elderberry is a popular herbal supplement, mainly taken to help with colds and flu. Some small studies suggest it may modestly shorten cold or flu symptoms, but the evidence is limited and n...

Read the full Elderberry monograph → Herb & supplement monograph

Ashitaba

Interacts with 186 drugs

Ashitaba is a leafy plant from Japan that is eaten as a vegetable and taken as a supplement for general health, antioxidant, and heart benefits. Most of the supporting research comes from la...

Read the full Ashitaba monograph → Herb & supplement monograph

Sweet Orange

Interacts with 246 drugs

Sweet orange is a common citrus fruit that is a good source of vitamin C, fiber, and antioxidants, and is enjoyed as a food worldwide. Its peel and essential oil are used in aromatherapy and...

Read the full Sweet Orange monograph → Herb & supplement monograph

Calendula

Interacts with 248 drugs

Calendula is a flowering plant whose petals are used mainly in skin creams, oils, and ointments to soothe minor irritation and support wound healing. Some early research is promising for ski...

Read the full Calendula monograph → Herb & supplement monograph

Mullein

Interacts with 122 drugs

Mullein is a traditional herbal remedy most often used as a tea or syrup to soothe coughs, sore throats, and respiratory irritation. High-quality human studies are lacking, so its benefits a...

Read the full Mullein monograph → Herb & supplement monograph

Marshmallow

Interacts with 2,040 drugs

Marshmallow root is a traditional herb rich in soothing, gel-like fibers called mucilage, which is why it has long been used for coughs, sore throats, and stomach irritation. Evidence for th...

Read the full Marshmallow monograph →
Sources

Sources & How We Checked

Elderberry's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 41 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Elderberry 6 references
  1. Barak V, Halperin T, Kalickman I. The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw 2001;12:290-6..
  2. Elderberry (Sambucus species). The Poison Plant Patch, Novia Scotia Museum, 2007. Available at: http://museum.gov.ns.ca/poison/?section=species&id=117 (Accessed 16 October 2009).
  3. European elder. Canadian Poisonous Plants Information System. Available at: http://www.cbif.gc.ca/pls/pp/ppack.jump?p_null=all&p_psn=121&p_type=all&p_sci=comm&p_x=px (Accessed 16 October 2009).
  4. Raus K, Pleschka S, Klein P, Schoop R, Fisher P. Effect of an echinacea-based hot drink versus oseltamivir in Influenza treatment: a randomized, double-blind, double-dummy, multicenter, noninferiority clinical trial. . Curr Ther Res Clin Exp. 2015;20;77:6 PubMed
  5. Ramachandran A, Antala D, Pudasainee P, Panginikkod S, Gupta H. A Plausible Association Between the Use of Elderberry and Autoimmune Hepatitis. Cureus 2022;14(4):e24250. PubMed
  6. Agarwal N, Mangla A. Elderberry interaction with pazopanib in a patient with soft-tissue sarcoma: A case report and literature review. Mol Clin Oncol 2024;20(5):36. PubMed

See these in context on the Elderberry monograph →

Ashitaba 2 references
  1. Kwon D, Yoon S, Carter O, Bailey GS, Dashwood RH. Antioxidant and antigenotoxic activities of Angelica keiskei, Oenanthe javanica and Brassica oleracea in the Salmonella mutagenicity assay and in HCT116 human colon cancer cells. Biofactors. 2006;26(4):231
  2. Noh HM, Ahn EM, Yun JM, Cho BL, Paek YJ. Angelica keiskei Koidzumi extracts improve some markers of liver function in habitual alcohol drinkers: a randomized double-blind clinical trial. J Med Food. 2015;18(2):166-72.

See these in context on the Ashitaba monograph →

Sweet Orange 17 references
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. FDA, CFSAN. FDA-approved potassium health claim notification for potassium containing foods. 2000. Available at: www.cfsan.fda.gov/~dms/hclm-k.html.
  3. Kurowska EM, Spence JD, Jordan J, et al. HDL-cholesterol-raising effect of orange juice in subjects with hypercholesterolemia. Am J Clin Nutr 2000;72:1095-100. PubMed
  4. Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
  5. Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.
  6. Pletz MW, Petzold P, Allen A, et al. Effect of calcium carbonate on bioavailability of orally administered gemifloxacin. Antimicrob Agents Chemother 2003;47:2158-60.. PubMed
  7. Lilja JJ, Juntti-Patinen L, Neuvonen PJ. Orange juice substantially reduces the bioavailability of the beta-adrenergic-blocking agent celiprolol. Clin Pharmacol Ther 2004;75:184-90.
  8. Tian R, Koyabu N, Takanaga H, et al. Effects of grapefruit juice and orange juice on the intestinal efflux of P-glycoprotein substrates. Pharm Res 2002;19:802-9. PubMed
  9. Vanapalli SR, Chen Y, Ellingrod VL, et al. Orange juice decreases the oral bioavailability of ivermectin in health volunteers. Clin Pharmacol Ther 2003;73 (Abstract PDII-A-10):P94.
  10. Huang SM, Lesko LJ. Drug-drug, drug-dietary supplement, and drug-citrus fruit and other food interactions: what have we learned? J Clin Pharmacol 2004;44:559-69. PubMed
  11. Koitabashi Y, Kumai T, Matsumoto N, et al. Orange juice increased the bioavailability of pravastatin, 3-hydroxy-3-methylglutaryl CoA reductase inhibitor, in rats and healthy human subjects. Life Sci 2006;78:2852-9. PubMed
  12. Takanaga H, Ohnishi A, Yamada S, et al. Polymethoxylated flavones in orange juice are inhibitors of P-glycoprotein but not cytochrome P450 3A4. J Pharmacol Exp Ther 2000;293:230-6. DOI
  13. Greenblatt DJ. Analysis of drug interactions involving fruit beverages and organic anion-transporting polypeptides. J Clin Pharmacol 2009;49:1403-7. PubMed
  14. Bailey DG. Fruit juice inhibition of uptake transport: a new type of food-drug interaction. Br J Clin Pharmacol 2010;70:645-55. PubMed
  15. Kamath AV, Yao M, Zhang Y, Chong S. Effect of fruit juices on the oral bioavailability of fexofenadine in rats. J Pharm Sci 2005;94:233-9. PubMed
  16. Kays MB, Overholser BR, Mueller BA, et al. Effects of sevelamer hydrochloride and calcium acetate on the oral bioavailability of ciprofloxacin. Am J Kidney Dis. 2003;42(6):1253-9. PubMed
  17. Neuhofel, A. L., Wilton, J. H., Victory, J. M., Hejmanowsk, L. G., and Amsden, G. W. Lack of bioequivalence of ciprofloxacin when administered with calcium-fortified orange juice: a new twist on an old interaction. J Clin Pharmacol. 2002;42(4):461-466. DOI

See these in context on the Sweet Orange monograph →

Calendula 9 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. Reider N, Komericki P, Hausen BM, et al. The seamy side of natural medicines: contact sensitization to arnica (Arnica montana L.) and marigold (Calendula officinalis L.). Contact Dermatitis 2001;45:269-72..
  3. Gol'dman II. [Anaphylactic shock after gargling with an infusion of Calendula]. Klin Med (Mosk) 1974;52:142-3.
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  9. Puaratanaarunkon T, Washrawirul C, Chuenboonngarm N, Noppakun N, Asawanonda P, Kumtornrut C. Efficacy and safety of a facial serum containing snail secretion filtrate, Calendula officinalis, and Glycyrrhiza glaba root extract in the treatment of maskne: A

See these in context on the Calendula monograph →

Mullein 2 references
  1. Castro AI, Carmona JB, Gonzales FG, Nestar OB. Occupational airborne dermatitis from gordolobo (Verbascum densiflorum). Contact Dermatitis 2006;55(5):301.
  2. Flores Echaiz C, Al Ali A, Cao AQ, Sasseville D. Simultaneous contact dermatitis caused by Asteraceae and Verbascum thapsus. Contact Dermatitis 2017;76(5):316-8.

See these in context on the Mullein monograph →

Marshmallow 5 references
  1. Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  4. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  5. Hage-Sleiman R, Mroueh M, Daher CF. Pharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon. Pharm Biol 2011;49(3):327-33.

See these in context on the Marshmallow monograph →

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

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