Interactions on record — worth a quick check against your medications. Based on 1 of 2 ingredients. Check your meds →
Dietary supplement

Organic Fermented Elderberry Ingredients & Drug Interactions

by Dr. Mercola

Organic Fermented Elderberry label
See full label image
Capsule Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

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

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

The interaction bottom line Most serious interaction: Moderate

Organic Fermented Elderberry is a dietary supplement by Dr. Mercola with 2 active ingredients. 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 Fruit Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Organic Fermented Elderberry by Dr. Mercola

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

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HelloPharmacist Scorecard of Organic Fermented Elderberry by Dr. Mercola

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

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Aug 27, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 3 of its 3 active ingredients.
  • “Elderberry Fruit Extract” is listed as a grouped ingredient — the label gives one combined amount (250 mg) without saying how much of each component you get.

This product contains 3 active ingredients: elderberry powder (fermented), anthocyanins, and polyphenols. Elderberry is a traditional plant extract used to support immune and respiratory health, and it's been fermented to aid digestion and absorption.

The anthocyanins and polyphenols are compounds naturally present in the berries that may contribute to its activity. The capsules also contain pullulan and rice 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: immune support.
  • We looked for evidence on: Upper respiratory tract infection (URTI), Lower respiratory tract infections, Respiratory tract infections, common cold, influenza, sinus infections.
  • The closest evidence on file: Elderberry is rated "Insufficient Reliable Evidence To Rate" for Lower respiratory tract infections (Natural Medicines).

The evidence for elderberry isn't well established in the data we hold. The product has been studied for allergic rhinitis (hay fever), cardiovascular disease, chronic fatigue syndrome, chronic obstructive pulmonary disease, cognitive function, and respiratory tract infections — but all of those have insufficient reliable evidence to rate its effectiveness.

If you're considering this for a specific condition, talk it over with your doctor or pharmacist about what the current research actually shows.

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 prepared, cooked elderberry is generally well tolerated. However, raw or unripe berries, seeds, leaves, and bark contain toxic compounds that can cause nausea, vomiting, severe diarrhea, weakness, dizziness, numbness, and confusion — cooking eliminates this risk, and this product is fermented (heat-processed), so that's not a concern here.

There's not enough safety data to recommend elderberry during pregnancy or while breastfeeding, so if you're pregnant or nursing, check with your doctor or pharmacist before taking it. In rare cases, people with underlying autoimmune disease have developed autoimmune hepatitis (liver inflammation) after long-term elderberry use; if you have an autoimmune condition, that's worth discussing with your healthcare provider.

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.

Before taking this product, check with your doctor or pharmacist if you take immunosuppressants (medications that weaken your immune system intentionally) or pazopanib (Votrient), a cancer drug — both carry moderate interaction concerns with elderberry.

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.

This fermented elderberry supplement is generally well tolerated in properly prepared form, but the evidence for what it actually does is limited. If you take immunosuppressants or pazopanib, don't start this without running it by your doctor or pharmacist first.

Pregnant or breastfeeding? Same conversation needed.

For everyone else, the main question is whether the research supports what you're hoping it'll do for you.

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

Assessment coverage: 1 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Mar 22, 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 Organic Fermented Elderberry, straight from the product label.

Brand Dr. Mercola
Barcode (UPC) 810487032254
Net contents 60 Capsule(s)
Market status On market
Date entered into DSLD Mar 22, 2024
DSLD ID 308706
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other
Intended target group(s) Adult (18 - 50 Years), Organic
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 Organic Fermented Elderberry by Dr. Mercola, 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
810487032254
IngredientAmount% DV
Anthocyanins30 mg--
Polyphenols40 mg--
Elderberry Fruit Extract250 mg--
Elderberry, Powder, Fermented500 mg--

Other ingredients: Pullulan, Rice

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions

Suggested Use: Adults, as a dietary supplement, take two (2) capsules daily with water.

Precautions

Keep out of reach of children.

Do not use if safety seal is broken.

If you are nursing, pregnant, taking medication or have a medical condition, consult your physician before taking this product.

Seals/Symbols

USDA Organic

FDA Statement of Identity

Dietary Supplement

Formulation

Certified Organic By: Quality Assurance International.

Brand IP Statement(s)

Dr. Mercola Providing quality products since 2001.

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

See for yourself

Organic Fermented Elderberry by Dr. Mercola label

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

Organic Fermented Elderberry label

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

View the full label (PDF)
What’s inside

The Ingredients in Organic Fermented Elderberry by Dr. Mercola

These are the 2 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.

Elderberry Fruit Extract

Interacts with
121 drugs
250 mg per serving Form: Sambucus nigra Fruit Extract

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 Fruit Extract monograph & interactions
  • › Anthocyanins
  • › Polyphenols

Elderberry, Powder, Fermented

Interacts with
121 drugs
500 mg per serving Form: Sambucus nigra, Powder, Fermented

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, Powder, Fermented monograph & interactions

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

Interaction report

Organic Fermented Elderberry by Dr. Mercola Drug Interactions

Want to check YOUR meds against Organic Fermented Elderberry?

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

 Go to the checker
121Drugs
121 Moderate

Ingredients driving the most interactions

Elderberry Fruit Extract 121

Individual Drug Interactions

The ingredients in Organic Fermented Elderberry interact with 121 drugs. Click any drug to see the details.

1 of the 2 ingredients in Organic Fermented Elderberry interact with drugs. Each result below shows which ingredient is responsible. Elderberry Fruit Extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Organic Fermented Elderberry 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 Fruit 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
Elderberry Fruit Extract full monograph & interactions
The maker

Brand information

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

Dr. Mercola

See all Dr. Mercola products
Name
NHP
Street Address
125 SW 3rd Place
City
Cape Coral
State
FL
ZipCode
33991
Phone Number
(877) 985-2696
Pharmacist Counseling Corner

Organic Fermented Elderberry by Dr. Mercola: Common Questions

Does Organic Fermented Elderberry by Dr. Mercola interact with any medications?
Yes. Based on its ingredients, Organic Fermented Elderberry 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?
Organic Fermented Elderberry contains 2 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 if I'm pregnant or breastfeeding?
There isn't enough safety data to know either way, so the facts advise against it. Talk with your doctor or pharmacist about whether it's right for you.
Does elderberry actually work for colds or the flu?
The evidence for respiratory tract infections isn't well established in our data. We can't say whether it's effective for that.
Are there any side effects from this product?
Properly prepared elderberry (like this fermented version) is generally well tolerated. The toxic effects — nausea, vomiting, severe diarrhea — come from raw berries, seeds, and leaves, which are not in this product.
What are anthocyanins and polyphenols?
They're compounds naturally found in elderberries. Anthocyanins give berries their color, and polyphenols are antioxidants. We don't have interaction data available for either one.
Is fermented elderberry better than regular?
Fermentation is meant to make the ingredients easier for your body to absorb and digest. The effectiveness data we hold doesn't compare fermented to non-fermented forms, so we can't say one is definitively better.
What's pullulan and rice doing in the capsule?
Those are inactive ingredients — fillers and binders that help make the capsule. They're not the active part of the product.

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

Not sure if Organic Fermented Elderberry is safe with your meds?

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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.

Organic Fermented Elderberry label
Go deeper

The Full Monographs Behind Organic Fermented Elderberry’s Ingredients

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

Herb & supplement monograph

Elderberry

Interacts with 121 drugs

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

Read the full Elderberry monograph →
Sources

Sources & How We Checked

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

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

The 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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