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Dietary supplement

Elderberry Syrup Ingredients & Drug Interactions

by Planetary Herbals

Liquid Category: Botanical
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Elderberry Syrup is a dietary supplement by Planetary Herbals with 1 active ingredient. Its ingredients are commonly taken for colds, flu (influenza), other respiratory infections.Based on those ingredients, 121 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Elderberry Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Elderberry Syrup by Planetary Herbals

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

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 1 of its 1 active ingredient.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains one active ingredient: elderberry extract. Elderberry is the ripe fruit of the elder tree, used traditionally for immune and respiratory support.

The syrup also includes honey, grain alcohol, and purified water as inactive ingredients.

Does it work?

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

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use — see Elderberry's own graded uses on its monograph.

Why this rating?
  • The label markets this product for: European classic for natural defenses.
  • We looked for evidence on: Respiratory tract infections, Upper respiratory tract infection (URTI), Lower respiratory tract infections, Influenza, Common cold.
  • The closest evidence on file: Elderberry is rated "Insufficient Reliable Evidence To Rate" for Respiratory tract infections (Natural Medicines).
  • Also on file: Elderberry is rated "Insufficient Reliable Evidence To Rate" for Upper respiratory tract infection (URTI), Lower respiratory tract infections.

The evidence for elderberry in hay fever, heart disease, chronic fatigue, lung disease, memory and thinking, and respiratory infections is insufficient — we don't have reliable data showing it works for any of these uses. If you're considering it for one of these purposes, talk with your doctor or pharmacist about what the evidence actually supports.

The evidence, ingredient by ingredient Elderberry

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 1 of the 1 matched ingredient.
  • Pregnancy & breastfeeding safety ratings cover 1 of 1.
  • General safety write-ups exist for 1 of 1.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Properly cooked elderberry syrup is generally well tolerated. Adverse effects come mostly from raw or unripe berries, seeds, leaves, and bark, which contain a compound (cyanogenic glycosides) that cooking destroys; raw forms can cause nausea, vomiting, diarrhea, weakness, dizziness, and numbness.

One case reported autoimmune hepatitis after years of elderberry use in someone with an underlying autoimmune disease. During pregnancy and breastfeeding, there isn't enough safety information, so the data advises against use.

If you're pregnant or nursing and interested in elderberry, talk with your doctor or pharmacist for personalized guidance.

Side effects, ingredient by ingredient Elderberry

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?
  • 1 of the 1 matched ingredient can interact with medications — Elderberry.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: immunosuppressants / transplant drugs.
  • For scale: 121 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.

Check with your doctor or pharmacist before taking this product if you're on immunosuppressants (drugs that dampen your immune system) or pazopanib (Votrient). Both carry Moderate interaction risks with elderberry's immune-stimulating effects.

Check your own medication Run your meds through the checker above

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.

Elderberry syrup is a single-ingredient product well tolerated when properly prepared from ripe fruit. If you take immunosuppressants (like those after transplant) or pazopanib for cancer, check with your doctor or pharmacist before starting — the documented interactions are moderate-level concerns.

Anyone with an underlying autoimmune disease should be cautious and discuss this with their healthcare provider.

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

Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated Aug 22, 2017.

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 Syrup, straight from the product label.

Brand Planetary Herbals
Barcode (UPC) 021078102915
Net contents 8 fl. Oz.; 236.56 mL
Market status On market
Date entered into DSLD Aug 22, 2017
DSLD ID 75903
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Children 4 or More Years of Age, Adult (18 - 50 Years), Children more than 1 but less than 4
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Elderberry Syrup by Planetary Herbals, 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 tsp
Maximum serving Sizes:
1 tsp
Servings per container
47
UPC/BARCODE
021078102915
IngredientAmount% DV
Calories35 Calorie(s)--
Total Carbohydrates4 Gram(s)1%
Elderberry Extract5 mL--

Other ingredients: Honey, Grain Alcohol, purified Water

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.
Formula

Sambucus nigra

General Statements

European classic for natural defenses

Approved by Michael Tierra L.Ac, O.M.D

In the herbal traditions of Europe, elderberry has been used since antiquity as a wine, a syrup, and a warming winter cordial. The berries are rich in bioflavonoids and anthocyanins, a unique class of constitutes known for their beneficial effect on cellular function, and particularly for their role in maintaining the integrity of capillary walls. Planetary Herbals delicious Elderberry Syrup captures these unique compounds, uniting age-old tradition with modern science to support natural defenses. Created for Planetary Herbals by licensed acupuncturist and clinical herbalist Michael Tierra. A clinician since 1972, Michael is an authority on the world's herbal traditions, and has authored several respected herb books.

FDA Statement of Identity

Herbal Supplement

Suggested/Recommended/Usage/Directions

Suggested Use: 1 teaspoon 1 to 2 times daily.

Precautions

Note: If you are pregnant, may become pregnant, or breastfeeding, consult your health care professional before using this product.

Not for use by children under 2 years of age.

Do not use if tamper-evident seal is broken or missing.

Keep out of the reach of children

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.

General

PF029 REV K151

See for yourself

Elderberry Syrup by Planetary Herbals label

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

What’s inside

The Ingredients in Elderberry Syrup by Planetary Herbals

This is the 1 active ingredient this product is made of. Select it to open its full monograph.

Serving size1 tsp Dosage formLiquid Servings per container47 Amounts shown are per serving.

Elderberry Extract

Interacts with
121 drugs
5 mL per serving

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 Extract monograph & interactions

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

Interaction report

Elderberry Syrup by Planetary Herbals Drug Interactions

Want to check YOUR meds against Elderberry Syrup?

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
121Drugs
121 Moderate

Ingredients driving the most interactions

Each ingredient & the kinds of drugs it affects

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

Elderberry Extract2 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 Syrup, from the product label.

Planetary Herbals

See all Planetary Herbals products
Name
Planetary Herbals, LLC
Street Address
P.O. Box 1760
City
Soquel
State
CA
ZipCode
95073
Web Address
www.planetaryherbals.com
Pharmacist Counseling Corner

Elderberry Syrup by Planetary Herbals: Common Questions

Does Elderberry Syrup by Planetary Herbals interact with any medications?
Yes. Based on its ingredients, Elderberry Syrup has a known interaction with 121 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Elderberry Syrup contains a single active ingredient, and that one ingredient can interact with many different medications on its own. We check it against each medication and show the mechanism 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 safety data we have isn't enough to say it's safe during pregnancy or breastfeeding. The recommendation is to avoid it in both cases. Talk with your doctor or pharmacist about whether it's right for you.
What happens if I take raw elderberry instead of this syrup?
Raw or unripe elderberries, plus the seeds, leaves, and bark of the elder tree, contain a toxic compound that cooking destroys. Raw forms can cause nausea, vomiting, severe diarrhea, weakness, dizziness, and numbness. This syrup is properly prepared, so that's not a concern here — but don't make your own from raw berries.
Does elderberry actually help with colds or the flu?
The evidence for elderberry in respiratory tract infections is insufficient — we don't have reliable data showing it works. If preventing or treating respiratory illness is why you're considering it, talk with your doctor about what actually does have solid evidence.
What are the inactive ingredients in this syrup?
The inactive ingredients are honey, grain alcohol, and purified water. These are fillers and preservatives that make up the syrup base.
Can this cause liver problems?
Most people tolerate cooked elderberry well, but one case reported autoimmune hepatitis (liver inflammation) after years of use in someone who already had an autoimmune disease. If you have an autoimmune condition, discuss this product with your doctor or pharmacist first.

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 Syrup label
Sources

Sources & How We Checked

Elderberry Syrup'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 6 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 →

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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