Elderberry+ Ingredients & Drug Interactions
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
Elderberry+ is a dietary supplement by Quantum Health with 3 active ingredients. Its ingredients are commonly taken for common cold, flu and respiratory infections, immune support.Based on those ingredients, 893 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Echinacea purpurea, Mullein, Elderberry. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Elderberry+ by Quantum Health
Ask about any prescription or over-the-counter medication and we check it for interactions with Elderberry+ by Quantum Health — 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 Elderberry+ by Quantum Health
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
Elderberry+ contains 3 active ingredients: echinacea purpurea (a plant used in herbal medicine), elderberry (the fruit of the elder plant), and mullein (a traditional respiratory herb). The product is a liquid formulation with inactive ingredients including honey, water, alcohol, peppermint oil, eucalyptus oil, thyme oil, and myrrh oil.
Does it work?
Not established
The evidence we hold doesn't establish that echinacea, elderberry, or mullein works for any of their common uses. All effectiveness ratings for these ingredients show insufficient reliable evidence—meaning the science isn't settled yet on whether they help with anxiety, athletic performance, respiratory infections, cognitive function, cough, or other conditions listed.
That doesn't mean they don't work; it means we don't have solid proof either way from the data available to us.
How safe is it?
Well-documented data
Echinacea is generally well tolerated in the short term, but may cause stomach upset, nausea, diarrhea, rashes, or heartburn. Allergic reactions (including severe ones like anaphylaxis) are rare but possible, especially in people sensitive to ragweed or related plants.
Elderberry prepared from ripe fruit is generally well tolerated; however, the safety data advises against elderberry supplements during pregnancy and while breastfeeding. Raw or unripe elderberries and other parts of the plant can be toxic due to compounds that cause nausea, vomiting, and severe diarrhea—but cooking removes this toxin.
Mullein is generally well tolerated for short-term use, though human safety data are limited; the safety data advises against it during pregnancy and while breastfeeding. Rare cases of liver inflammation (hepatitis) have been reported with echinacea and elderberry after longer-term use.
Meds to double-check
Moderate interaction found
Before taking Elderberry+, double-check with your pharmacist or doctor if you take blood pressure medications, blood thinners (anticoagulants), cancer drugs (especially etoposide or pazopanib), immunosuppressants, or any drugs metabolized by your liver (CYP1A2 or CYP3A4)—these are moderate to minor severity interactions. Additionally, if you regularly consume caffeine, echinacea in this product may boost caffeine levels by about 30%.
The bottom line
Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
This product combines three herbal ingredients with limited evidence for their claimed uses and several documented drug interactions, most notably through echinacea's effects on liver metabolism. If you take any prescription medications—especially blood thinners, cancer drugs, immunosuppressants, or drugs processed by your liver—check your exact medications with your pharmacist or doctor before starting this product.
Even if you're otherwise healthy, talk it over with your own healthcare provider to make sure it's right for you.
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 Nov 22, 2023.
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 Elderberry+, straight from the product label.
| Brand | Quantum Health |
|---|---|
| Barcode (UPC) | 046985016407 |
| Net contents | 4 Fluid Ounce(s); 118 Milliliter(s) |
| Market status | On market |
| Date entered into DSLD | Nov 22, 2023 |
| DSLD ID | 299878 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
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 Quantum Health, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 20 Calorie(s) | -- |
| Total Carbohydrates | 3 Gram(s) | 1% |
| Added Sugars | 3 Gram(s) | 7% |
| Total Sugars | 3 Gram(s) | -- |
| Echinacea purpurea | 200 mg | -- |
| Elderberry | 200 mg | -- |
| Mullein | 10 mg | -- |
Other ingredients: Honey, Water, Alcohol, Peppermint Oil, Eucalyptus Oil, Thyme Oil, Myrrh Oil
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formulation
No refined sugars
Immune support formula Single teaspoon dose Syrup
Immune support
Elderberry+ syrup provides your body with what it needs for immune support. All of the herbs in Quantum Health's Elderberry+ syrup are examined by master herbalists whose knowledge and experience ensure the highest quality.
Suggested/Recommended/Usage/Directions
Suggested use: Take 1 teaspoon 4 times daily.
Precautions
Warnings: Keep out of reach of children.
If pregnant or breastfeeding or if you have a medical condition or if taking any medications or other supplements, consult a health professional before use.
Safety sealed for your protection
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Formula
Sambucus nigra with echinacea and mullein leaf
Elderberry+ syrup is formulated with: Sambucus nigra elderberry: recognized for its unique immune support properties. Echinacea: This native American flowering plant has been used to support the immune system for centuries. Mullein: This flowering biennial is a member of the snapdragon family an has traditional use for throat health.
FDA Statement of Identity
Dietary Supplement
General Statements
This box is 100% recyclable
FPO
Quantum Health's full line of Elderberry products are designed to give you many options. Look for these Elderberry products at your favorite store. Elderberry lozenges A tasty raspberry way to enjoy the benefits of elderberry. Elderberry herbal capsules Standardized herbal extracts assure you of consistency and efficacy. Elderberry liquid extract Herbal support in liquid. Take it straight from the dropper or mix it with your favorite tea. No varnish
Seals/Symbols
Sustainable Forestry Initiative Certified Sourcing www.sfiprogram.org SFI-000000
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Elderberry+ by Quantum Health 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 Elderberry+ by Quantum Health
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size5 mL 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.
Echinacea purpurea
Interacts with816 drugs
Echinacea is a popular herb taken to help prevent or shorten the common cold, but study results are mixed and the overall benefit appears small at bes...
Echinacea purpurea monograph & interactionsElderberry
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...
Elderberry monograph & interactionsMullein
Interacts with122 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 huma...
Mullein monograph & interactionsOther (inactive) ingredients: Honey, Water, Alcohol, Peppermint Oil, Eucalyptus Oil, Thyme Oil, Myrrh Oil. These complete the product’s ingredient list but are not active constituents.
Elderberry+ by Quantum Health Drug Interactions
HelloPharmacist Interaction Report
Elderberry+ by Quantum Health contains three active ingredients—echinacea, elderberry, and mullein—and has documented interactions with medications.
The most serious concern is echinacea's moderate-severity effect on drugs metabolized by CYP1A2 enzymes (a liver pathway); it can raise caffeine levels by about 30% and potentially increase levels of other drugs broken down this way.
Read the full breakdown — every affected drug type, severity by severity
Echinacea also has moderate interactions with CYP3A4 substrates (another liver pathway where it may either raise or lower drug levels), immunosuppressants, etoposide (a cancer drug), and warfarin (a blood thinner)—though the warfarin effect is minor. Elderberry carries moderate interactions with immunosuppressants and pazopanib (a cancer medication).
Mullein has a minor interaction with blood thinners (anticoagulants).
Altogether, these interactions span 894 individual medications. Because the affected drug types are broad and span cancer therapies, blood thinners, immunosuppressants, and common medications metabolized by the liver, it's important to check your exact prescriptions with the tool on this page before starting this product.
Check your own medications below · Editorial policy · How we use AI
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 checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Elderberry+ interact with 893 drugs. Click any drug to see the details.
3 of the 3 ingredients in Elderberry+ interact with drugs. Each result below shows which ingredient is responsible. Echinacea purpurea Mullein Elderberry
Aspirin, Caffeine, HydrocodoneDamason-P
How Aspirin, Caffeine, Hydrocodone interacts with Elderberry+ — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates, Caffeine +1 Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Aspirin, Caffeine, Hydrocodone interactionMulleinAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
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.
Read the full Mullein + Aspirin, Caffeine, Hydrocodone interactionAspirin, Caffeine, Isobutylallylbarbituric Acid, PhenacetinLanorinal
How Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin interacts with Elderberry+ — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea + Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin interactionMulleinAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
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.
Read the full Mullein + Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin interactionAspirin, Caffeine, OrphenadrineInvagesic, Invagesic Forte, Norgesic, Norgesic Forte, Orphengesic, Orphengesic Forte
How Aspirin, Caffeine, Orphenadrine interacts with Elderberry+ — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea + Aspirin, Caffeine, Orphenadrine interactionMulleinAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
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.
Read the full Mullein + Aspirin, Caffeine, Orphenadrine interactionAspirin, Caffeine, Phenacetin, PropoxypheneMargesic Comp. 65
How Aspirin, Caffeine, Phenacetin, Propoxyphene interacts with Elderberry+ — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates, Caffeine +1 Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Aspirin, Caffeine, Phenacetin, Propoxyphene interactionMulleinAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
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.
Read the full Mullein + Aspirin, Caffeine, Phenacetin, Propoxyphene interactionAspirin, Chlorpheniramine, PhenylpropanolamineAlka-Seltzer Plus Cold
How Aspirin, Chlorpheniramine, Phenylpropanolamine interacts with Elderberry+ — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Aspirin, Chlorpheniramine, Phenylpropanolamine interactionMulleinAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
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.
Read the full Mullein + Aspirin, Chlorpheniramine, Phenylpropanolamine interactionAspirin, HydrocodoneAlor 5 500, Lortab ASA
How Aspirin, Hydrocodone interacts with Elderberry+ — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Aspirin, Hydrocodone interactionMulleinAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
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.
Read the full Mullein + Aspirin, Hydrocodone interactionAspirin, OmeprazoleYosprala
How Aspirin, Omeprazole interacts with Elderberry+ — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Aspirin, Omeprazole interactionMulleinAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
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.
Read the full Mullein + Aspirin, Omeprazole interactionAspirin, PentazocineTalwin Compound
How Aspirin, Pentazocine interacts with Elderberry+ — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea Purpurea + Aspirin, Pentazocine interactionMulleinAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
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.
Read the full Mullein + Aspirin, Pentazocine interactionAtazanavirReyataz
How Atazanavir interacts with Elderberry+ — through 1 ingredient. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Atazanavir interactionAtazanavir, CobicistatEvotaz
How Atazanavir, Cobicistat interacts with Elderberry+ — through 1 ingredient. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Atazanavir, Cobicistat interactionAtezolizumabTecentriq
How Atezolizumab interacts with Elderberry+ — through 2 ingredients. Tap an ingredient for the detail:
ElderberryImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Elderberry + Atezolizumab interactionEchinacea PurpureaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea + Atezolizumab interactionAtogepantQulipta
How Atogepant interacts with Elderberry+ — through 1 ingredient. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Atogepant interactionAtorvastatinAtorvaliq
How Atorvastatin interacts with Elderberry+ — through 1 ingredient. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Atorvastatin interactionAtorvastatin CalciumLipitor
How Atorvastatin Calcium interacts with Elderberry+ — through 1 ingredient. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Atorvastatin Calcium interactionAtropine, Chlorpheniramine, Hyoscyamine, Phenylephrine, Phenylpropanolamine, ScopolamineAtrohist Plus, Pro Tuss, Ru-tuss, Stahist
How Atropine, Chlorpheniramine, Hyoscyamine, Phenylephrine, Phenylpropanolamine, Scopolamine interacts with Elderberry+ — through 1 ingredient. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Atropine, Chlorpheniramine, Hyoscyamine, Phenylephrine, Phenylpropanolamine, Scopolamine interactionAvacopanTavneos
How Avacopan interacts with Elderberry+ — through 1 ingredient. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Avacopan interactionAvanafilStendra
How Avanafil interacts with Elderberry+ — through 1 ingredient. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Avanafil interactionAvapritinibAyvakit
How Avapritinib interacts with Elderberry+ — through 1 ingredient. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Avapritinib interactionAxitinibInlyta
How Axitinib interacts with Elderberry+ — through 1 ingredient. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Axitinib interactionAzamuneImmunoprin
How Azamune interacts with Elderberry+ — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea + Azamune interactionElderberryImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Elderberry + Azamune interactionAzathioprineAzamune, Imuran
How Azathioprine interacts with Elderberry+ — through 2 ingredients. Tap an ingredient for the detail:
ElderberryImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Elderberry + Azathioprine interactionEchinacea PurpureaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea + Azathioprine interactionAzelastine Hydrochloride, Fluticasone PropionateDymista
How Azelastine Hydrochloride, Fluticasone Propionate interacts with Elderberry+ — through 1 ingredient. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Azelastine Hydrochloride, Fluticasone Propionate interactionBasiliximabSimulect
How Basiliximab interacts with Elderberry+ — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea + Basiliximab interactionElderberryImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Elderberry + Basiliximab interactionBazedoxifene Acetate, Conjugated EstrogensDuavee
How Bazedoxifene Acetate, Conjugated Estrogens interacts with Elderberry+ — through 1 ingredient. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Bazedoxifene Acetate, Conjugated Estrogens interactionBeclometasone DipropionateBecotide
How Beclometasone Dipropionate interacts with Elderberry+ — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates, Immunosuppressants Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Beclometasone Dipropionate interactionElderberryImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Elderberry + Beclometasone Dipropionate interactionBeclomethasoneBeclovent, Vanceril
How Beclomethasone interacts with Elderberry+ — through 2 ingredients. Tap an ingredient for the detail:
Echinacea PurpureaImmunosuppressants, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea + Beclomethasone interactionElderberryImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Elderberry + Beclomethasone interactionBeclomethasone DipropionateQNASL, Qvar
How Beclomethasone Dipropionate interacts with Elderberry+ — through 2 ingredients. Tap an ingredient for the detail:
ElderberryImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Elderberry + Beclomethasone Dipropionate interactionEchinacea PurpureaImmunosuppressants, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea + Beclomethasone Dipropionate interactionBedaquilineSirturo
How Bedaquiline interacts with Elderberry+ — through 1 ingredient. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Bedaquiline interactionBelladonna Alkaloids, Chlorpheniramine, Phenylephrine, PhenylpropanolamineRespa ARM
How Belladonna Alkaloids, Chlorpheniramine, Phenylephrine, Phenylpropanolamine interacts with Elderberry+ — through 1 ingredient. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Belladonna Alkaloids, Chlorpheniramine, Phenylephrine, Phenylpropanolamine interactionBelladonna Alkaloids, Ergotamine Tartrate, PhenobarbitalBel Tabs, Bellamine-S, Bellaphen-S, Duragal S, Phenarbal S, Spastrin
How Belladonna Alkaloids, Ergotamine Tartrate, Phenobarbital interacts with Elderberry+ — through 1 ingredient. Tap an ingredient for the detail:
Echinacea PurpureaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea + Belladonna Alkaloids, Ergotamine Tartrate, Phenobarbital interactionEach 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.
Echinacea purpurea
Caffeine
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Echinacea seems to increase plasma concentrations of caffeine by around 30%. This is likely due to inhibition of cytochrome P450 1A2 (CYP1A2) by echinacea.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Echinacea appears to inhibit CYP1A2 enzymes in humans. Additionally, echinacea seems to increase plasma concentrations of caffeine, a CYP1A2 substrate, by around 30%. Theoretically, echinacea might increase levels of other drugs metabolized by CYP1A2.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4. This may increase or decrease levels of drugs metabolized by CYP3A4.
Several clinical trials have shown that taking echinacea for up to one month does not significantly affect the metabolism of various CYP3A4 substrates, including midazolam, docetaxel, etravirine, lopinavir-ritonavir, and darunavir-ritonavir. However, other clinical research shows that echinacea may increase the clearance of midazolam, suggesting that echinacea might induce CYP3A4. The discrepancy is thought to be due to differing effects of echinacea on intestinal versus hepatic CYP3A4 enzymes. Echinacea appears to induce hepatic CYP3A4 but inhibit intestinal CYP3A4. In some cases, these effects might cancel each other out, but in others, drug levels may be increased or decreased depending on the level of effect at hepatic and intestinal sites. The effect of echinacea on CYP3A4 activity may differ depending on the CYP3A4 substrate.
Etoposide (Vepesid)
Echinacea may increase levels of etoposide.
In one report, concomitant use of etoposide and echinacea was associated with more severe thrombocytopenia than the use of etoposide alone, suggesting inhibition of etoposide metabolism. Etoposide is a cytochrome P450 3A4 (CYP3A4) substrate. Echinacea has variable effects on CYP3A4, but some studies have reported inhibition of the enzyme.
Immunosuppressants
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Theoretically, echinacea may interfere with immunosuppressant therapy because of its immunostimulant activity.
Darunavir (Prezista)
Theoretically, echinacea may interfere with the metabolism of darunavir; however, a small clinical study found no effect.
Darunavir is metabolized by cytochrome P450 3A4 (CYP3A4) and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Echinacea has variable effects on CYP3A4, but administration of an E. purpurea root extract (Arkocapsulas Echinacea, Arkopharma) 500 mg four times daily for 14 days did not affect darunavir/ritonavir pharmacokinetics in 15 HIV-infected patients.
Dayquil Severe
Echinacea is reported to have varying effects on a number of Cytochrome P450 metabolizing enzymes in the liver, including CYP1A2 and CYP3A4, which play a role in acetaminophen and dextromethorphan metabolism (both contained in DayQuil Severe), respectively. Studies have reported both enzyme inhibition and induction, making it difficult to predict clinically significant drug interactions with reliability. Specific drug interaction studies reporting definitive results are rare, and potential drug interactions involving echinacea should likely be taken on a case-by-case basis. Based on what we know about how acetaminophen and dextromethorphan are metabolized, the risk of a clinically significant interaction between echinacea and DayQuil Severe is low.
Docetaxel (Taxotere)
Theoretically, echinacea may interfere with the metabolism of docetaxel; however, a small clinical study found no effect.
Docetaxel is metabolized by cytochrome P450 3A4 (CYP3A4). Echinacea has variable effects on CYP3A4, but taking E. purpurea whole plant extract (Echinaforce, A. Vogel Biopharma AG) 20 drops three times daily for 2 weeks did not alter the pharmacokinetics of docetaxel in one clinical study.
Etravirine (Intelence)
Theoretically, echinacea may interfere with the metabolism of etravirine; however, a small clinical study found no effect.
Etravirine is metabolized by cytochrome P450 3A4 (CYP3A4). Echinacea has variable effects on CYP3A4, but taking E. purpurea root extract (Arkocapsulas Echinacea, Arkopharma) 500 mg three times daily for 14 days did not alter the pharmacokinetics of etravirine in HIV-infected patients.
Lopinavir/Ritonavir (Kaletra)
Theoretically, echinacea may interfere with the metabolism of lopinavir; however, a small clinical study found no effect.
Lopinavir is metabolized by cytochrome P450 3A4 (CYP3A4) and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Echinacea has variable effects on CYP3A4, but taking E. purpurea (Echinamide, Natural Factors Nutritional Products, Inc.) 500 mg three times daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in healthy volunteers.
Midazolam (Versed)
Theoretically, echinacea may increase the metabolism of intravenous midazolam.
Echinacea induces hepatic CYP3A4 and might decrease plasma levels of midazolam by about 20%, reducing the effectiveness of intravenous midazolam. Echinacea also appears to inhibit intestinal CYP3A4, which could theoretically increase the bioavailability of oral midazolam. This may cancel out the decrease in availability caused by induction of hepatic CYP3A4, such that overall plasma levels after oral administration of midazolam are not affected by echinacea.
Warfarin (Coumadin)
Echinacea seems to increase the clearance of warfarin, although the effect may not be clinically significant.
Preliminary clinical research in healthy male volunteers suggests that taking echinacea increases the clearance of the active S-isomer of warfarin after a single dose of warfarin, but there was not a clinically significant effect on the INR.
Mullein
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.
Elderberry
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 Elderberry+, from the product label.
Quantum Health
See all Quantum Health products- Name
- Quantum Health
- Street Address
- PO Box 2791
- City
- Eugene
- State
- OR
- ZipCode
- 97402
- Phone Number
- 800-448-1448
- Web Address
- quantumhealth.com
Elderberry+ by Quantum Health: Common Questions
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The Full Monographs Behind Elderberry+’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Echinacea
Interacts with 816 drugsEchinacea is a popular herb taken to help prevent or shorten the common cold, but study results are mixed and the overall benefit appears small at best. It is generally well tolerated for sh...
Read the full Echinacea 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 → Herb & supplement monographMullein
Interacts with 122 drugsMullein 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 →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.
- 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 59 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.
Echinacea 51 references
- Mullins RJ. Echinacea-associated anaphylaxis. Med J Aust 1998;168:170-1. PubMed
- Mullins RJ. Allergic reactions to Echinacea. J Allergy Clin Immunol 2000;104:S340-341 (Abstract 1003).
- Chavez ML, Chavez PI. Echinacea. Hosp Pharm 1998;33:180-8.
- Grimm W, Muller HH. A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections. Am J Med 1999;106:138-43. PubMed
- Taylor JA, Weber W, Standish L, et al. Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial. JAMA 2003;290:2824-30.. PubMed
- Luettig B, Steinmuller C, Gifford GE, et al. Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst 1989;81:669-75. PubMed
- Stimpel M, Proksch A, Wagner H, et al. Macrophage activation and induction of macrophage cytotoxicity by purified polysaccharide fractions from the plant Echinacea purpurea. Infect Immun 1984;46:845-9. PubMed
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- Gallo M, Sarkar M, Au W, et al. Pregnancy outcome following gestational exposure to echinacea: A prospective controlled study. Arch Intern Med 2000;160:3141-3. PubMed
- Soon SL, Crawford RI. Recurrent erythema nodosum associated with echinacea herbal therapy. J Am Acad Dermatol 2001;44:298-9. PubMed
- Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51. PubMed
- Logan JL, Ahmed J. Critical hypokalemic renal tubular acidosis due to Sjogren's syndrome: association with the purported immune stimulant echinacea. Clin Rheumatol 2003;22:158-9.
- Schulten B, Bulitta M, Ballering-Bruhl B, et al. Efficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trial. Arzneimittelforschung 2001;51:563-8.. PubMed
- Yale SH, Glurich I. Analysis of the inhibitory potential of Ginkgo biloba, Echinacea purpurea, and Serenoa repens on the metabolic activity of cytochrome P450 3A4, 2D6, and 2C9. J Altern Complement Med 2005;11:433-9.
- Yale SH, Liu K. Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med 2004;164:1237-41. PubMed
- Gorski JC, Huang S, Zaheer NA, et al. The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo.Clin Pharmacol Ther 2003;73 (Abstract PDII-A-8):P94. PubMed
- Lee AN, Werth VP. Activation of autoimmunity following use of immunostimulatory herbal supplements. Arch Dermatol 2004;140:723-7. PubMed
- Goel V, Lovlin R, Barton R, et al. Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther 2004;29:75-83.
- Barrett B. Medicinal properties of Echinacea: a critical review. Phytomedicine 2003;10:66-86. PubMed
- Huntley AL, Thompson Coon J, Ernst E. The safety of herbal medicinal products derived from Echinacea species: a systematic review. Drug Saf 2005;28:387-400. PubMed
- Turner RB, Bauer R, Woelkart K, et al. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. N Engl J Med 2005;353:341-8.
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-40. .
- Perri D, Dugoua JJ, Mills E, Koren G. Safety and efficacy of echinacea (Echinacea augustafolia, e. purpurea and e. pallida) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e262-7.
- Kocaman O, Hulagu S, Senturk O. Echinacea-induced severe acute hepatitis with features of cholestatic autoimmune hepatitis. Eur J Intern Med 2008;19:148. PubMed
- Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77. PubMed
- Press Release: Echinacea herbal products should not be used in children under 12 years old. Medicines and Healthcare Products Regulatory Agency (UK). August 20, 2012. Available at: www.mhra.gov.uk/NewsCentre/Pressreleases/CON180627. (Accessed 21 October
- Barrett B, Brown R, Rakel D, Rabago D, et al. Placebo effects and the common cold: a randomized controlled trial. Ann.Fam.Med 2011;9:312-22. PubMed
- Haller J, Freund, TF, Pelczer, KG, et al. The anxiolytic potential and psychotropic side effects of an echinacea preparation in laboratory animals and healthy volunteers. Phytother.Res. 2013;27:54-61.
- Grbic J, Wexler I, Celenti R, et al. A phase II trial of a transmucosal herbal patch for the treatment of gingivitis. J Am Dent.Assoc. 2011;142:1168-75. PubMed
- Schapowal A, Berger D, Klein P, et al. Echinacea/sage or chlorhexidine/lidocaine for treating acute sore throats: a randomized double-blind trial. Eur.J Med Res 9-1-2009;14:406-12. PubMed
- Bossaer JB and Odle BL. Probable etoposide interaction with Echinacea. J.Diet.Suppl 2012;9:90-5.
- Abdul MI, Jiang X, Williams KM, et al. Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects. Br J Clin.Pharmacol. 2010;69:508-15. PubMed
- Kemp, D. E. and Franco, K. N. Possible leukopenia associated with long-term use of echinacea. J Am Board Fam.Pract. 2002;15(5):417-419.
- Liatsos, G., Elefsiniotis, I., Todorova, R., and Moulakakis, A. Severe thrombotic thrombocytopenic purpura (TTP) induced or exacerbated by the immunostimulatory herb Echinacea. Am J Hematol. 2006;81(3):224.
- Penzak, S. R., Robertson, S. M., Hunt, J. D., Chairez, C., Malati, C. Y., Alfaro, R. M., Stevenson, J. M., and Kovacs, J. A. Echinacea purpurea significantly induces cytochrome P450 3A activity but does not alter lopinavir-ritonavir exposure in healthy s
- Maskatia, Z. K. and Baker, K. Hypereosinophilia associated with echinacea use. South.Med J 2010;103(11):1173-1174. PubMed
- Parnham MJ. Benefit-risk assessment of the squeezed sap of the purple coneflower (Echinacea purpurea) for long-term oral immunostimulation. Phytomed 1996;3:95-102. PubMed
- Schroder-Aasen T, Molden G, Nilsen OG. In vitro inhibition of CYP3A4 by the multiherbal commercial product Sambucus Force and its main constituents Echinacea purpurea and Sambucus nigra. Phytother Res 2012;26(11):1606-13.
- Moltó J, Valle M, Miranda C, et al. Herb-drug interaction between Echinacea purpurea and darunavir-ritonavir in HIV-infected patients. Antimicrob Agents Chemother 2011;55(1):326-30.
- Goey AK, Meijerman I, Rosing H, et al. The effect of Echinacea purpurea on the pharmacokinetics of docetaxel. Br J Clin Pharmacol 2013;76(3):467-74.
- Moltó J, Valle M, Miranda C, et al. Herb-drug interaction between Echinacea purpurea and etravirine in HIV-infected patients. Antimicrob Agents Chemother 2012;56(10):5328-31. PubMed
- Lawrenson JA, Walls T, Day AS. Echinacea-induced acute liver failure in a child. J Paediatr Child Health 2014;50(10):841.
- Hansen TS, Nilsen OG. In vitro CYP3A4 metabolism: inhibition by Echinacea purpurea and choice of substrate for the evaluation of herbal inhibition. Basic Clin Pharmacol Toxicol 2008;103:445-9.
- Gabranis I, Koufakis T1, Papakrivos I, Batala S. Echinacea-associated acute cholestatic hepatitis. J Postgrad Med. 2015;61(3):211-2. 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
- Karsch-Völk M, Barrett B, Kiefer D, Bauer R, Ardjomand-Woelkart K, Linde K. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev.2014;(2):CD000530. doi: 10.1002/14651858.CD000530.pub3. PubMed
- Hoban CL, Byard RW, Musgrave IF. Analysis of spontaneous adverse drug reactions to echinacea, valerian, black cohosh and ginkgo in Australia from 2000 to 2015. J Integr Med. 2019;17(5):338-343. PubMed
- Ogal M, Johnston SL, Klein P, Schoop R. Echinacea reduces antibiotic usage in children through respiratory tract infection prevention: a randomized, blinded, controlled clinical trial. Eur J Med Res. 2021 Apr 8;26(1):33. PubMed
- Lopresti AL, Smith SJ. An investigation into the anxiety-relieving and mood-enhancing effects of Echinacea angustifolia (EP107 ™): A randomised, double-blind, placebo-controlled study. J Affect Disord 2021;293:229-237.
- Weishaupt R, Buchkov A, Kolev E, Klein P, Schoop R. Reduction of viral load in patients with acute sore throats: Results from an observational clinical trial with Echinacea / Salvia lozenges [published online ahead of print, 2023 Mar 8]. Complement Med Re
- Sumer J, Keckeis K, Scanferla G, et al. Novel Echinacea formulations for the treatment of acute respiratory tract infections in adults-A randomized blinded controlled trial. Front Med (Lausanne) 2023;10:948787. 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
Mullein 2 references
- Castro AI, Carmona JB, Gonzales FG, Nestar OB. Occupational airborne dermatitis from gordolobo (Verbascum densiflorum). Contact Dermatitis 2006;55(5):301.
- 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.
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