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Dietary supplement

Sambucus Elderberry Sugar Free Syrup Ingredients & Drug Interactions

by Nature's Way

Sambucus Elderberry Sugar Free Syrup label
See full label image
Liquid Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 23, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Sambucus Elderberry Sugar Free Syrup 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

Sambucus Elderberry Sugar Free Syrup is a dietary supplement by Nature's Way 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 Black Elderberry Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Sambucus Elderberry Sugar Free Syrup by Nature's Way

Ask about any prescription or over-the-counter medication and we check it for interactions with Sambucus Elderberry Sugar Free Syrup by Nature's Way — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Sambucus Elderberry Sugar Free Syrup by Nature's Way

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 Sep 10, 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 1 of its 1 active ingredient.
  • “Black Elderberry Extract” is listed as a grouped ingredient — the label gives one combined amount (100 mg) without saying how much of each component you get.

This product contains one active ingredient: elderberry, which comes as a black elderberry extract in a sugar-free liquid form. The syrup also contains several inactive ingredients for texture and preservation — sorbitol (a sugar substitute), glycerin, purified water, natural flavors, citric acid, and potassium sorbate.

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 and cold and flu relief.
  • We looked for evidence on: Lower respiratory tract infections, Rhinosinusitis, upper respiratory infection, influenza, common cold, sinus infection.
  • 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 Rhinosinusitis, Lower respiratory tract infections.

The evidence for elderberry isn't established in the data we hold. The product facts list six conditions it's sometimes used for — hay fever, cardiovascular disease, chronic fatigue, COPD, cognitive function, and lower respiratory infections — but all are rated as having insufficient reliable evidence to rate its effectiveness.

That doesn't mean it doesn't work; it means the science isn't solid enough yet to say for certain either way.

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 products like this syrup are generally well tolerated. The main risk is with raw or unripe berries, leaves, bark, and seeds, which contain toxins that can cause nausea, vomiting, severe diarrhea, weakness, dizziness, numbness, and in extreme cases stupor — but cooking eliminates that risk.

Nausea and vomiting have occasionally been reported after taking elderberry products, though it's not always clear what caused them. There's one case report of a woman with an autoimmune condition who developed liver inflammation after taking elderberry for several years; her liver recovered after she stopped and started treatment.

There isn't enough reliable safety data for pregnancy or breastfeeding, so it's best to avoid elderberry supplements in those situations.

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 using this product if you take immunosuppressants (drugs that control your immune system after a transplant or for autoimmune conditions) or pazopanib (Votrient) for cancer. Elderberry might interfere with how these medications work.

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 may be worth considering if you're looking for immune support, but it's not your first reach if you take immunosuppressants, pazopanib, or other medications — the interaction risk is real. Cooked elderberry products are generally tolerated well, and this one is sugar-free.

Talk with your doctor or pharmacist before starting, especially if you're pregnant, breastfeeding, or on any prescription medications.

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 Apr 23, 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 Sambucus Elderberry Sugar Free Syrup, straight from the product label.

Brand Nature's Way
Net contents 8 Fluid Ounce(s); 240 mL
Market status On market
Date entered into DSLD Apr 23, 2024
DSLD ID 304705
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other
Intended target group(s) Children 4 or More Years of Age, Vegan, Vegetarian, Adult (18 - 50 Years), Gluten Free, Dairy Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Sambucus Elderberry Sugar Free Syrup by Nature's Way, 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:
5 mL
Maximum serving Sizes:
10 mL
Servings per container
24
IngredientAmount% DV
Calories25 Calorie(s), 10 Calorie(s)--
Total Carbohydrates8 Gram(s), 4 Gram(s)3%, 1%
Added Sugars0 Gram(s), 0 Gram(s)--
Total Sugars0 Gram(s), 0 Gram(s)--
Sugar Alcohol8 Gram(s), 4 Gram(s)--
Elderberry6400 mg--
Black Elderberry Extract100 mg--

Other ingredients: Sorbitol, Water, Purified, Glycerin, Natural Flavors, Citric Acid, Potassium Sorbate

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

Recommendation: Dosage cup included. Shake well before each use. For daily maintenance: Adults: Take 2 teaspoons (tsp) (10 mL) daily. Children 7 years of age and older: Take 1 teaspoon (5 mL) daily. For intensive use: Adults: Take 2 teaspoons (10 mL) four times daily. Children 7 years of age and older: Take 1 teaspoon (5 mL) three times daily.

Precautions

If you are pregnant, nursing, or taking any medications, consult a healthcare professional before use.

Keep out of reach of children.

Safety sealed with inner seal. Do not use if seal is broken or missing.

Not a low-calorie food

Storage

Keep tightly closed. Store at room temperature. Avoid excessive heat and direct sunlight.

Formulation

Gluten free Contains no: Gluten, dairy, peanut, or artificial colors

Vegan

Seals/Symbols

Quality Global Sourcing Bottled & Tested in the USA

Formula

Made from 6,400 mg of elderberries per 2-tsp serving

FDA Statement of Identity

Dietary Supplement

Brand IP Statement(s)

Copyright 2023 Nature's Way Brands, LLC

General Statements

Servings per Container 48, 24

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

See for yourself

Sambucus Elderberry Sugar Free Syrup by Nature's Way label

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

Sambucus Elderberry Sugar Free Syrup 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 Sambucus Elderberry Sugar Free Syrup by Nature's Way

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

Serving size5 mL Dosage formLiquid Servings per container24 Amounts shown are per serving.

Black Elderberry Extract

Interacts with
121 drugs
100 mg per serving Form: Anthocyanins

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...

Black Elderberry Extract monograph & interactions

Other (inactive) ingredients: Sorbitol, Water, Purified, Glycerin, Natural Flavors, Citric Acid, Potassium Sorbate. These complete the product’s ingredient list but are not active constituents.

Interaction report

Sambucus Elderberry Sugar Free Syrup by Nature's Way Drug Interactions

Want to check YOUR meds against Sambucus Elderberry Sugar Free 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

Black Elderberry Extract 121

Individual Drug Interactions

The ingredients in Sambucus Elderberry Sugar Free Syrup interact with 121 drugs. Click any drug to see the details.

1 of the 1 ingredient in Sambucus Elderberry Sugar Free Syrup interact with drugs. Each result below shows which ingredient is responsible. Black Elderberry Extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Sambucus Elderberry Sugar Free 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.

Black 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
Black Elderberry Extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Sambucus Elderberry Sugar Free Syrup, from the product label.

Nature's Way

See all Nature's Way products
Name
Nature's Way Brands, LLC
City
Green Bay
State
WI
ZipCode
54311
Phone Number
1-800-962-8873
Web Address
naturesway.com
Pharmacist Counseling Corner

Sambucus Elderberry Sugar Free Syrup by Nature's Way: Common Questions

Does Sambucus Elderberry Sugar Free Syrup by Nature's Way interact with any medications?
Yes. Based on its ingredients, Sambucus Elderberry Sugar Free 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?
Sambucus Elderberry Sugar Free 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 to use while I'm pregnant or breastfeeding?
There isn't enough reliable safety information about elderberry in pregnancy or breastfeeding, so it's best to avoid it during those times. Talk with your doctor or pharmacist about whether it's right for you and your baby.
What are the side effects?
Properly prepared elderberry like this syrup is generally well tolerated with few side effects. The risks come from raw or unripe berries and other parts of the plant, which can cause nausea, vomiting, and diarrhea — but cooking (which is done here) eliminates those toxins.
Does this actually work for colds or the flu?
The evidence isn't strong enough to say for certain. The product is used for a range of conditions, but we don't have reliable data showing it works for any of them.
What is black elderberry extract?
It's a concentrated form of black elderberries, the active ingredient in this syrup. This product contains one active ingredient, so what you're getting is essentially elderberry in liquid form.
Is there any sugar in this?
No — it's sugar-free. Instead, it uses sorbitol as a sweetener, along with glycerin, natural flavors, and citric acid for taste and preservation.

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

Not sure if Sambucus Elderberry Sugar Free Syrup 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.

Sambucus Elderberry Sugar Free Syrup label
Go deeper

The Full Monographs Behind Sambucus Elderberry Sugar Free Syrup’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

Sambucus Elderberry Sugar Free 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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