Interactions on record — worth a quick check against your medications. Based on 3 of 4 ingredients. Check your meds →
Dietary supplement

Elderberry + Probiotics Ingredients & Drug Interactions

by Ancient Nutrition

Capsule Category: Other Combinations
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Elderberry + Probiotics is a dietary supplement by Ancient Nutrition with 4 active ingredients. Its ingredients are commonly taken for blood sugar support, weight management, digestive upset.Based on those ingredients, 464 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Bacillus subtilis, Apple Cider Vinegar, Elderberry. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Elderberry + Probiotics by Ancient Nutrition

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

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 1 of its 4 active ingredients.
  • “fermented Elderberry blend” is a proprietary blend — the label gives one combined amount (730 mg) without saying how much of each component you get.

This formula contains 4 active ingredients: apple cider vinegar, two forms of elderberry (one fermented), and Bacillus subtilis (a beneficial bacteria). Apple cider vinegar is a sour liquid made from apples.

Elderberry comes from the elder plant's ripe fruit and is fermented in one of the forms here. Bacillus subtilis is a live probiotic organism that's meant to support gut health.

The capsule also holds rice fiber and hypromellose (a plant-based coating material) as inactive ingredients.

Does it work?

Moderate 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
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: immune system and digestive support.
  • We looked for evidence on: Lower respiratory tract infections, Upper respiratory tract infection (URTI), Respiratory tract infections, Diarrhea, Flatulence, Dyspepsia — and 4 related terms.
  • The strongest evidence on file: Bacillus Subtilis is rated "Possibly Effective" for Antibiotic-associated diarrhea (Natural Medicines).
  • Also on file: Elderberry is rated "Insufficient Reliable Evidence To Rate" for Lower respiratory tract infections.
  • Also on file: Apple Cider Vinegar is rated "Insufficient Reliable Evidence To Rate" for Dyspepsia.

For most of the conditions these ingredients are marketed for — hay fever, cold and flu, heart health, focus, and general energy — the evidence we hold rates them as having insufficient reliable evidence. The one exception is Bacillus subtilis for antibiotic-associated diarrhea, which is rated possibly effective, meaning some evidence exists but it's not conclusive.

If you're considering this product for a specific health goal, your doctor or pharmacist can discuss what the current research shows.

The evidence, ingredient by ingredient Apple Cider Vinegar Elderberry Bacillus Subtilis

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 3 of the 3 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 3 of 3.
  • General safety write-ups exist for 3 of 3.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Elderberry extract from ripe, properly cooked fruit is generally well tolerated. Apple cider vinegar in small amounts (like in food) is also usually fine, but large doses taken long-term can cause serious issues — one documented case involved low potassium, bone loss, and kidney effects after someone drank 250 mL daily for 6 years.

Bacillus subtilis is generally well tolerated in healthy people, though quality and safety can vary by product. For pregnancy, elderberry supplements are not recommended because there isn't enough safety data; the same goes for breastfeeding.

Bacillus subtilis also lacks enough pregnancy and breastfeeding data, so it's wise to check with your doctor or pharmacist before using this product if you're pregnant or nursing.

Side effects, ingredient by ingredient Apple Cider Vinegar Elderberry Bacillus Subtilis

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?
  • 3 of the 3 matched ingredients can interact with medications — Elderberry, Apple Cider Vinegar, Bacillus Subtilis.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications.
  • For scale: 464 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, check with your doctor or pharmacist if you take digoxin (Lanoxin) or any heart medication, diuretic drugs (water pills), insulin, diabetes medications, antibiotic drugs, immunosuppressants, or pazopanib (Votrient). The severity ranges from Moderate to Minor, with the most serious being the interaction with digoxin and diuretics.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This combination may be useful if you're looking to support gut health with probiotics and want the benefits of elderberry, but the apple cider vinegar content creates several medication interactions you'll want to rule out first — especially if you take a heart medication, blood pressure pill, diabetes drug, or immune-suppressing medication. Talk with your doctor or pharmacist about your medications before you start.

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

Assessment coverage: 4 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 24, 2024.

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 + Probiotics, straight from the product label.

Brand Ancient Nutrition
Barcode (UPC) 816401025234
Net contents 60 Capsule(s)
Market status On market
Date entered into DSLD Jan 24, 2024
DSLD ID 305765
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
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 + Probiotics by Ancient Nutrition, 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:
2 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
30
UPC/BARCODE
816401025234
IngredientAmount% DV
Apple Cider Vinegar0 NP--
Elderberry0 NP--
fermented Elderberry blend730 mg--
Bacillus subtilis20 mg--
Elderberry, Fermented0 NP--

Other ingredients: Rice Fiber, Hypromellose

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.
Formulation

Formulated for maximum absorption Immune system & digestive support

Color and odor may vary from lot to lot.

FDA Statement of Identity

Whole Food Dietary Supplement

Suggested/Recommended/Usage/Directions

Suggested use: adults take 2 capsules per day.

Precautions

Warning: if you are pregnant, nursing, allergic, have a medical condition, or taking any medications, consult a doctor before using this or any other dietary supplement.

Do not use if inner safety seal is broken or missing.

Keep out of reach of children.

Notice: use this product as a food supplement only. Do not use for weight reduction.

Storage

Store in a cool, dry place.

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.

See for yourself

Elderberry + Probiotics by Ancient Nutrition label

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

What’s inside

The Ingredients in Elderberry + Probiotics by Ancient Nutrition

These are the 4 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Capsule(s) Dosage formCapsule 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.

Fermented Elderberry blend

730 mg per serving

Bacillus subtilis

Interacts with
182 drugs
20 mg per serving

Bacillus subtilis is a spore-forming probiotic bacterium found in soil and some fermented foods, and it is used mainly to support gut health and diges...

Bacillus subtilis monograph & interactions

Other (inactive) ingredients: Rice Fiber, Hypromellose. These complete the product’s ingredient list but are not active constituents.

Interaction report

Elderberry + Probiotics by Ancient Nutrition Drug Interactions

Want to check YOUR meds against Elderberry + Probiotics?

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
464Drugs
391 Moderate 73 Minor

Ingredients driving the most interactions

Each ingredient & the kinds of drugs it affects

For each ingredient in Elderberry + Probiotics 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.

Bacillus subtilis1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Bacillus subtilis with antibiotic drugs might decrease the effectiveness of B. subtilis.
Since B. subtilis preparations usually contain live and active organisms, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and B. subtilis preparations by at least 2 hours.

Likelihood Probable Evidence D

Apple Cider Vinegar4 drug types · 162 drugs

Digoxin (Lanoxin)

Theoretically, concomitant use of apple cider vinegar with digoxin might increase the risk of cardiac toxicity.
A case of hypokalemia related to chronic use of apple cider vinegar has been reported. Theoretically, overuse of apple cider vinegar could decrease potassium levels, increasing the risk of toxicity with digoxin.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, concomitant use of apple cider vinegar with diuretic drugs might increase the risk of hypokalemia.
A case of hypokalemia related to chronic use of apple cider vinegar has been reported. There is some concern that people taking apple cider vinegar along with potassium depleting diuretics might have an increased risk for hypokalemia.

Likelihood Possible Evidence D
Insulin

Theoretically, concomitant use of apple cider vinegar with insulin might increase the risk of hypokalemia.
A case of hypokalemia related to chronic use of apple cider vinegar has been reported. Theoretically, overuse of apple cider vinegar concomitantly with insulin might increase the risk of hypokalemia.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, taking apple cider vinegar with antidiabetes drugs might increase the risk of hypoglycemia.
Apple cider vinegar might reduce fasting and postprandial blood glucose levels and decrease gastric emptying in people with diabetes. However, not all research agrees. Theoretically, it might have additive effects on glucose levels when used with antidiabetes drugs.

Likelihood Possible Evidence B

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
The maker

Brand information

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

Ancient Nutrition

See all Ancient Nutrition products
Name
Ancient Nutrition, LLC
Street Address
3480 Summertown Hwy
City
Summertown
State
TN
ZipCode
38483
Web Address
www.AncientNutrition.com
Pharmacist Counseling Corner

Elderberry + Probiotics by Ancient Nutrition: Common Questions

Does Elderberry + Probiotics by Ancient Nutrition interact with any medications?
Yes. Based on its ingredients, Elderberry + Probiotics has a known interaction with 464 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Elderberry + Probiotics contains 4 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.
Can I take this while I'm pregnant?
The safety data for elderberry in pregnancy is not strong enough to say it's safe, so it's best to avoid elderberry supplements during pregnancy. Bacillus subtilis also lacks pregnancy safety information. Talk with your doctor or pharmacist before taking this product if you're pregnant.
What's the apple cider vinegar in here doing?
Apple cider vinegar is included as one of the active ingredients, though the evidence we hold rates its usefulness for conditions like acne, athletic performance, cognitive function, and dental plaque as insufficient. In food amounts it's generally well tolerated, but supplement doses raise some safety concerns with long-term use.
Does Bacillus subtilis actually work?
The evidence is strongest for antibiotic-associated diarrhea, where it's rated possibly effective — meaning some evidence exists but it's not conclusive. For other uses like athletic performance or constipation, the evidence is insufficient.
What if I'm taking antibiotics at the same time?
Antibiotics can kill the live Bacillus subtilis organisms in this product, making it less effective. It's best to separate your antibiotic doses and this supplement by a few hours — ask your pharmacist for the timing that works best with your specific antibiotic.
Is this safe to use long-term?
Elderberry extract from ripe fruit is generally well tolerated. Bacillus subtilis is generally well tolerated in healthy people. Apple cider vinegar in small amounts is fine, but large or long-term supplement doses haven't been well studied and carry a risk of low potassium and other issues — check with your doctor or pharmacist before using this daily for months.
Can I breastfeed while taking this?
There isn't enough safety data on elderberry supplements for breastfeeding, so it's best to avoid them unless your doctor advises otherwise. The same goes for Bacillus subtilis. Talk with your doctor or pharmacist to make sure it's right for you.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Not sure if Elderberry + Probiotics is safe with your meds?

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Ask a pharmacist

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 + Probiotics label
Sources

Sources & How We Checked

Elderberry + Probiotics'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 27 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.

Apple Cider Vinegar 11 references
  1. Lhotta K, Hofle G, Gasser R, Finkenstedt G. Hypokalemia, hyperreninemia, and osteoporosis in a patient ingesting large amounts of cider vinegar. Nephron 1998;80:242-3. PubMed
  2. Hill LL, Woodruff LH, Foote JC, Barreto-Alcoba M. Esophageal injury by apple cider vinegar tablets and subsequent evaluation of products. J Am Diet Assoc 2005;105:1141-4. PubMed
  3. Hlebowicz J, Darwiche G, Björgell O, Almér LO. Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study. BMC Gastroenterol 2007;7:46. PubMed
  4. Johnston CS, Kim CM, Buller AJ. Vinegar improves insulin sensitivity to a high-carbohydrate meal in subjects with insulin resistance or type 2 diabetes. Diabetes Care 2004;27:281-2. PubMed
  5. Lhotta, K., Hofle, G., Gasser, R., and Finkenstedt, G. Hypokalemia, hyperreninemia and osteoporosis in a patient ingesting large amounts of cider vinegar. Nephron 1998;80(2):242-243. PubMed
  6. Bunick CG, Lott JP, Warren CB, et al. Chemical burn from topical apple cider vinegar. J Am Acad Dermatol 2012;67(4):e143-4. PubMed
  7. Feldstein S, Afshar M, Krakowski AC. Chemical Burn from Vinegar Following an Internet-based Protocol for Self-removal of Nevi. J Clin Aesthet Dermatol. 2015 Jun;8(6):50.
  8. Luu LA, Flowers RH, Kellams AL, et al. Apple cider vinegar soaks [0.5%] as a treatment for atopic dermatitis do not improve skin barrier integrity. Pediatr Dermatol. 2019;36(5):634-639. PubMed
  9. Hadi A, Pourmasoumi M, Najafgholizadeh A, Clark CCT, Esmaillzadeh A. The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trials. BMC Complement Med Ther 2021;21(1):179. PubMed
  10. Feise NK, Johnston CS. Commercial vinegar tablets do not display the same physiological benefits for managing postprandial glucose concentrations as liquid vinegar. J Nutr Metab 2020;2020:9098739. PubMed
  11. Gheflati A, Bashiri R, Ghadiri-Anari A, Reza JZ, Kord MT, Nadjarzadeh A. The effect of apple vinegar consumption on glycemic indices, blood pressure, oxidative stress, and homocysteine in patients with type 2 diabetes and dyslipidemia: A randomized contro

See these in context on the Apple Cider Vinegar monograph →

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 →

Bacillus Subtilis 10 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Lampropoulos PK, Gkentzi D, Tzifas S, Dimitriou G. Neonatal sepsis due to Bacillus subtilis. Cureus 2021;13(9):e17692. PubMed
  3. La Jeon Y, Yang JJ, Kim MJ, et al. Combined Bacillus licheniformis and Bacillus subtilis infection in a patient with oesophageal perforation. J Med Microbiol 2012;61(Pt 12):1766-1769. PubMed
  4. Wallet F, Crunelle V, Roussel-Delvallez M, Fruchart A, Saunier P, Courcol RJ. Bacillus subtilis as a cause of cholangitis in polycystic kidney and liver disease. Am J Gastroenterol 1996;91(7):1477-8.
  5. Velasco E, Martins CA, Tabak D, Bouzas LF. "Bacillus subtilis" infection in a patient submitted to a bone marrow transplantation. Rev Paul Med 1992;110(3):116-7.
  6. Kato A, Yoshifuji A, Komori K, et al. A case of Bacillus subtilis var. natto bacteremia caused by ingestion of natto during COVID-19 treatment in a maintenance hemodialysis patient with multiple myeloma. J Infect Chemother 2022;28(8):1212-1215. PubMed
  7. Freedman KE, Hill JL, Wei Y, et al. Examining the gastrointestinal and immunomodulatory effects of the novel probiotic Bacillus subtilis DE111. Int J Mol Sci 2021;22(5):2453. PubMed
  8. Lefevre M, Racedo SM, Denayrolles M, et al. Safety assessment of Bacillus subtilis CU1 for use as a probiotic in humans. Regul Toxicol Pharmacol 2017;83:54-65. PubMed
  9. Hanifi A, Culpepper T, Mai V, et al. Evaluation of Bacillus subtilis R0179 on gastrointestinal viability and general wellness: a randomised, double-blind, placebo-controlled trial in healthy adults. Benef Microbes 2015;6(1):19-27. PubMed
  10. Tokano M, Tarumoto N, Imai K, et al. A case of bacterial meningitis caused by Bacillus subtilis var. natto. Intern Med. 2022. Epub ahead of print.

See these in context on the Bacillus Subtilis 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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