Interactions on record — worth a quick check against your medications. Based on 2 of 3 ingredients. Check your meds →
Dietary supplement

Elderberry Ingredients & Drug Interactions

by Karuna

Elderberry label
See full label image
Liquid Category: Botanical
Most serious interaction: Moderate
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: Moderate

Elderberry is a dietary supplement by Karuna with 3 active ingredients. Its ingredients are commonly taken for colds, flu (influenza), other respiratory infections.Based on those ingredients, 254 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Raspberry, Elderberry. 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 Karuna

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

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HelloPharmacist Scorecard of Elderberry by Karuna

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 23, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 3 of its 3 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Elderberry by Karuna contains 3 active ingredients: elderberry appears twice in the formula, and red raspberry (also called red raspberry leaf) rounds out the blend. Elderberry is a traditional fruit extract, and raspberry leaf is the leafy part of the plant—both are used in herbal wellness products.

There are no inactive ingredients (fillers or binders) listed for this liquid formula.

Does it work?

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

There isn't enough reliable clinical evidence to rate this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: immune support and respiratory health.
  • We looked for evidence on: Influenza, Lower respiratory tract infections, Respiratory tract infections, Upper respiratory tract infection (URTI), Rhinosinusitis, Pharyngitis — and 3 related terms.
  • The closest evidence on file: Red Raspberry is rated "Insufficient Reliable Evidence To Rate" for Respiratory tract infections (Natural Medicines).
  • Also on file: Red Raspberry is rated "Insufficient Reliable Evidence To Rate" for Influenza, Pharyngitis.
  • Also on file: Elderberry is rated "Insufficient Reliable Evidence To Rate" for Respiratory tract infections, Rhinosinusitis, Upper respiratory tract infection (URTI), Lower respiratory tract infections.

The evidence we hold doesn't establish that elderberry works for the conditions it's often used for—allergic rhinitis, heart health, chronic fatigue, lung disease, cognitive function, or respiratory infections all carry an "insufficient reliable evidence" rating. Red raspberry leaf also shows insufficient evidence for aging skin, heart health, respiratory infections, heart failure, and diabetes.

In short, the claims you might hear about these ingredients aren't backed by solid data yet.

The evidence, ingredient by ingredient Elderberry Red Raspberry

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 2 of the 2 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 2 of 2.
  • General safety write-ups exist for 2 of 2.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Properly prepared elderberry extracts from ripe fruit are generally well tolerated. Raw or unripe elderberries, seeds, leaves, and bark can be toxic because they contain compounds that cause nausea, vomiting, severe diarrhea, weakness, dizziness, numbness, and even stupor—but cooking eliminates this risk, and since this is a processed liquid supplement, that's unlikely to apply.

There's one case report of autoimmune hepatitis in a patient taking elderberry for years alongside an underlying autoimmune condition, so caution applies there. Red raspberry is generally well tolerated, though diarrhea and stomach upset can occur.

For pregnancy, the facts note there isn't enough reliable safety data for elderberry, so it's best to avoid it during pregnancy and breastfeeding. Red raspberry carries mixed evidence—it's listed as "possibly safe" and "likely unsafe" for pregnancy depending on the dose and stage, so talk with your doctor before using it if you're pregnant or nursing.

Side effects, ingredient by ingredient Elderberry Red Raspberry

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

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

Why this rating?
  • 2 of the 2 matched ingredients can interact with medications — Red Raspberry, Elderberry.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications.
  • For scale: 254 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 this product, double-check with your doctor or pharmacist if you take immunosuppressant drugs (after transplant or for autoimmune conditions), pazopanib (Votrient), blood thinners or antiplatelet drugs like warfarin or clopidogrel, or insulin. All of these carry documented moderate interactions with the ingredients in this blend.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with insufficient evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This product is an herbal blend with no established effectiveness for the common reasons people take it. More importantly, if you take immunosuppressants, pazopanib, blood thinners, or insulin, you need to check with your doctor or pharmacist before adding it—the interactions could be serious.

If you're pregnant or breastfeeding, the safety data isn't there, so steer clear unless your provider says otherwise.

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

Assessment coverage: 3 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 23, 2013.

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 Karuna
Barcode (UPC) 018647051217
Net contents 4 fl. Oz.
Market status On market
Date entered into DSLD Aug 23, 2013
DSLD ID 24372
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other
Intended target group(s) Adult (18 - 50 Years), Dairy Free, Sugar Free
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 Karuna, 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 Teaspoon(s)
Maximum serving Sizes:
2 Teaspoon(s)
Servings per container
24
UPC/BARCODE
018647051217
IngredientAmount% DV
Elderberry700 mg--
Elderberry800 mg--
Raspberry500 mg--

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.
Seals/Symbols

KARUNA(R) RESPONSIBLE NUTRITION(TM)

KARUNA LIQUID SUPPLEMENTS Great Taste!

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Suggested use for adults: One to two teaspoons in water per day, or as directed by your health care practitioner.

General Statements

This product is intended for professional use and is manufactured under strict quality control to ensure the optimum in purity, potency and reliability.

Formulation

This product contains no yeast, wheat, soy, corn, milk, salt, sugar, artificial coloring, preservatives or flavoring.

Storage

Keep in a cool, dry place, tightly capped.

Formula

Elderberry Extract

General

5121-LB5

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

See for yourself

Elderberry by Karuna 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 Karuna

These are the 3 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Teaspoon(s) Dosage formLiquid Servings per container24 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.

Elderberry

Interacts with
121 drugs
700 mg per serving Form: Glycerine, purified Water

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...

Elderberry monograph & interactions

Elderberry

Interacts with
121 drugs
800 mg per serving Form: Glycerine, purified Water

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...

Elderberry monograph & interactions

Raspberry

Interacts with
135 drugs
500 mg per serving Form: Glycerine, purified Water

Red raspberry leaf is a traditional herbal remedy most often used as a tea in late pregnancy and for menstrual discomfort, but solid scientific eviden...

Raspberry monograph & interactions
Interaction report

Elderberry by Karuna 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
254Drugs
254 Moderate

Ingredients driving the most interactions

Raspberry 135
Elderberry 121

Individual Drug Interactions

The ingredients in Elderberry interact with 254 drugs. Click any drug to see the details.

2 of the 3 ingredients in Elderberry interact with drugs. Each result below shows which ingredient is responsible. Raspberry 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.

Raspberry2 drug types · 135 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, taking red raspberry leaf with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
In vitro research suggests that red raspberry leaf extract has antiplatelet activity and enhances the in vitro effects of the antiplatelet medication cangrelor. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Insulin

Red raspberry leaf might reduce glucose levels in patients being treated with insulin.
In one case report, a 38-year-old patient with gestational diabetes, whose blood glucose was being controlled with medical nutrition therapy and insulin, developed hypoglycemia after consuming two servings of raspberry leaf tea daily for 3 days beginning at 32 weeks' gestation. The patient required an insulin dose reduction. The hypoglycemia was considered to be probably related to use of red raspberry leaf tea.

Likelihood Possible Evidence D
Raspberry 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.

Karuna

See all Karuna products
Name
Karuna Corporation
Street Address
42 Digital Drive #7
City
Novato
State
CA
ZipCode
94949
Pharmacist Counseling Corner

Elderberry by Karuna: Common Questions

Does Elderberry by Karuna interact with any medications?
Yes. Based on its ingredients, Elderberry has a known interaction with 254 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Elderberry contains 3 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 if I'm pregnant or breastfeeding?
The facts show there isn't enough reliable safety data for elderberry during pregnancy or breastfeeding, so it's best to avoid it. Red raspberry is mixed—some data suggest it's possibly safe or likely unsafe depending on timing and dose. Talk with your doctor before taking this product if you're pregnant, nursing, or planning to be.
What are the side effects I should watch for?
Properly prepared elderberry extracts are generally well tolerated. Red raspberry may cause diarrhea, stomach upset, or epigastric pain, though these don't happen often at typical doses. The main risk is if you're on certain medications—immunosuppressants, cancer drugs, blood thinners, or insulin—where the interactions could trigger more serious problems.
Does this product actually work for colds or the flu?
The evidence we have doesn't establish that elderberry works for respiratory infections or similar conditions. The data rate it as insufficient—meaning the research just isn't there yet to say either way.
Can I use this if I had an organ transplant?
No, not without checking with your transplant team first. Elderberry has immunostimulant activity, which could interfere with the immunosuppressant medications you take to protect your new organ. Talk with your doctor before starting.
What's in a liquid elderberry supplement versus a capsule?
This liquid form contains the same active ingredients—elderberry and raspberry leaf—just delivered as a liquid rather than in a pill. There are no other fillers or inactive ingredients in this particular product.
Is raw elderberry safer than this extract?
No—raw or unripe elderberries, seeds, leaves, and bark can be toxic because they contain compounds that cause nausea, vomiting, severe diarrhea, and other problems. Cooking eliminates the toxin, and this product is a processed extract, so it should be safe on that front. The risk here is with drug interactions, not the plant material itself.

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

Red Raspberry

Interacts with 135 drugs

Red raspberry leaf is a traditional herbal remedy most often used as a tea in late pregnancy and for menstrual discomfort, but solid scientific evidence for these uses is limited. It is gene...

Read the full Red Raspberry 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 14 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 →

Red Raspberry 8 references
  1. Eagon PK, Elm MS, Hunter DS, et al. Medicinal herbs: modulation of estrogen action. Era of Hope Mtg, Dept Defense; Breast Cancer Res Prog, Atlanta, GA 2000;Jun 8-11.
  2. Parsons M, Simpson M, Ponton T. Raspberry leaf and its effects on labour: safety and efficacy. Aust Coll Midwives Inc J 1999;12:20-5.
  3. Simpson M, Parsons M, Greenwood J, Wade K. Raspberry leaf in pregnancy: its safety and efficacy in labor. J Midwifery Womens Health 2001;46:51-9.. PubMed
  4. Mullen W, McGinn J, Lean ME, et al. Ellagitannins, flavonoids, and other phenolics in red raspberries and their contribution to antioxidant capacity and vasorelaxation properties. J Agric Food Chem 2002;50:5191-6.. PubMed
  5. Sherson, D., Andersen, B., Hansen, I., and Kjoller, H. Occupational asthma due to freeze-dried raspberry. Ann Allergy Asthma Immunol. 2003;90(6):660-663. PubMed
  6. Cheang KI, Nguyen TT, Karjane NW, Salley KE. Raspberry Leaf and Hypoglycemia in Gestational Diabetes Mellitus. Obstet Gynecol. 2016;128(6):1421-4. PubMed
  7. Dudzinska D, Bednarska K, Boncler M, Luzak B, Watala C. The influence of Rubus idaeus and Rubus caesius leaf extracts on platelet aggregation in whole blood. Cross-talk of platelets and neutrophils. Platelets. 2016;27(5):433-9.
  8. Henrotin Y, Cozannet RL, Fança-Berthon P, et al. Rubus idaeus extract improves symptoms in knee osteoarthritis patients: results from a phase II double-blind randomized controlled trial. BMC Musculoskelet Disord 2022;23(1):650. PubMed

See these in context on the Red Raspberry monograph →

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

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

© 2021 Therapeutic Research Center, LLC

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