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Dietary supplement

Sambucus Vitamin C Fizzy 1,000 mg Ingredients & Drug Interactions

by Nature's Way

Sambucus Vitamin C Fizzy 1,000 mg label
See full label image
Powder Category: Botanical With Nutrients
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Sambucus Vitamin C Fizzy 1,000 mg 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 Vitamin C Fizzy 1,000 mg is a dietary supplement by Nature's Way with 3 active ingredients. Its ingredients are commonly taken for replacing fluids and electrolytes, preventing dehydration during exercise or illness, treating low blood sodium (under medical care).Based on those ingredients, 515 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Vitamin C, Sodium, organic Black Elder (Sambucus nigra L.) 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 Vitamin C Fizzy 1,000 mg by Nature's Way

Ask about any prescription or over-the-counter medication and we check it for interactions with Sambucus Vitamin C Fizzy 1,000 mg by Nature's Way — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Sambucus Vitamin C Fizzy 1,000 mg 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 Jul 11, 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.
  • “organic Black Elder (Sambucus nigra L.) 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 fizzy powder has 3 active ingredients: sodium, vitamin C, and elderberry extracts (premium cultivar and organic Black Elder extract). The sodium and vitamin C do the bulk of the work here; the elderberries are included for additional support.

You'll also find inactive ingredients like cane sugar, sodium bicarbonate, citric acid, silica, natural flavors, and stevia leaf extract — these are the binders, fillers, and flavoring agents that make the powder work and taste good.

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 support with vitamin C and elderberry.
  • We looked for evidence on: Exercise-induced respiratory infections, Pneumonia, Pharyngitis, Acute bronchitis, Viral infection prevention, Upper respiratory health.
  • The strongest evidence on file: Vitamin C is rated "Possibly Effective" for Exercise-induced respiratory infections (Natural Medicines).
  • Also on file: Vitamin C is rated "Possibly Ineffective" for Acute bronchitis.
  • Also on file: Vitamin C is rated "Insufficient Reliable Evidence To Rate" for Idiopathic interstitial pneumonia, Pneumonia.

Vitamin C in this product is effective for vitamin C deficiency and possibly effective for anemia of chronic disease, atrial fibrillation, cataracts, and exercise-induced respiratory infections, though evidence for those last few isn't conclusive. Sodium's effectiveness is rated for cystic fibrosis (likely effective) and amphotericin B kidney toxicity (possibly effective), but insufficient evidence exists for bipolar disorder and congestive heart failure.

We hold no effectiveness data for the elderberry ingredients in this product.

The evidence, ingredient by ingredient Sodium Vitamin C 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 2 of the 2 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 2 of 2.
  • General safety write-ups exist for 2 of 2.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Vitamin C is generally well tolerated at normal doses, but very high intakes can cause abdominal cramps, heartburn, diarrhea, nausea, and — in people prone to them — kidney stones. Doses above 2 grams daily are more likely to cause these problems.

Sodium is essential in small amounts, but too much is linked to high blood pressure and heart strain. Normal dietary sodium is fine, but avoid sodium supplements or very high intake without medical advice.

In pregnancy and lactation, vitamin C is rated likely safe, though one source flags possibly unsafe — talk with your doctor or pharmacist. Sodium is rated possibly unsafe in pregnancy and lactation.

Side effects, ingredient by ingredient Sodium Vitamin C 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?
  • 2 of the 2 matched ingredients can interact with medications — Vitamin C, Sodium.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; cancer treatments; lithium.
  • For scale: 412 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, double-check with your pharmacist if you use blood pressure drugs (antihypertensives), blood thinners like warfarin, lithium, corticosteroids, or any sodium-containing medications — these are the most serious concerns. Also flag estrogens in birth control or hormone therapy, chemotherapy drugs, and any medication you take with levothyroxine, fluphenazine, indinavir, or didanosine.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This fizzy vitamin C and elderberry powder is worth considering if you need a vitamin C boost and want it in a convenient fizzy form. But if you take blood pressure medications, lithium, blood thinners, corticosteroids, or any other regular prescription, check with your pharmacist first — the sodium and vitamin C here can interfere with how those drugs work.

Same goes if you're pregnant or breastfeeding.

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

Assessment coverage: 2 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 23, 2021.

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 Vitamin C Fizzy 1,000 mg, straight from the product label.

Brand Nature's Way
Barcode (UPC) 033674107614
Net contents 0.27 Oz(s); 7.7 Gram(s)
Market status On market
Date entered into DSLD Jun 23, 2021
DSLD ID 251695
Product type Botanical With Nutrients
Supplement form Powder
Dietary claims / uses Nutrient, All Other, Structure/Function
Intended target group(s) Children 4 or More Years of Age, Adult (18 - 50 Years), Organic, 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 Vitamin C Fizzy 1,000 mg 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:
0.27 Ounce(s)
Maximum serving Sizes:
0.27 Ounce(s)
Servings per container
10
UPC/BARCODE
033674107614
IngredientAmount% DV
Calories25 Calorie(s)--
Total Carbohydrates6 Gram(s)2%
Sodium160 mg7%
Vitamin C1000 mg1111%
Added Sugars5 Gram(s)10%
Total Sugars5 Gram(s)--
premium cultivar Elderberries6.4 Gram(s)--
organic Black Elder (Sambucus nigra L.) extract100 mg--

Other ingredients: Cane Sugar, Sodium Bicarbonate, organic Natural flavors, Citric Acid, Silica, organic Stevia (leaf) extract

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.
General Statements

Since 1969

Not for individual sale LGBN10761.A03 RM22.8918

Formula

Standardized Elderberry

Effervescent drink mix made with organic black elder

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Recommendation: Add contents to 4-6 ounces of water, stir, and drink. Adults and children 9 years of age and older, take contents of one packet daily.

Recommendation: Add contents to 4-6 ounces of water, stir, and drink. Adults and children 9 years of age and older, take one packet daily.

Bold flavor: Mix into 4 oz. of water Light flavor: Mix into 6 oz. of water Cool & refreshing: Mix into cold water and quickly drink Soothing & warm: Mix into hot water and slowly sip.

Precautions

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

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

Keep out of reach of children.

Do not use if packet is open or torn.

Formulation

Gluten free. No yeast-derived ingredients, wheat, soy, dairy, or artificial colors.

Certified Organic by Qualified Assurance International

Easy to make it your way. Whether you want it cool & refreshing to drink, or soothing & warm to sip - this Sambucus drink can be made just right for how you're feeling.

Deliciously powerful. Support your immune system with 1,000 mg Vitamin C and potent, organic black elderberry extract.

About Black Elderberry: For centuries the dark berries of European black elder (Sambucus nigra L.) have been traditionally used as a winter remedy for immune support. 6.4 g Elderberry Equivalence: Each serving provides 100 mg of organic elderberry extract derived from 6.4 g of fresh organic black elderberries Standardized BioActives from select cultivars of organic black elderberries with high levels of naturally-occuring flavonoids Made with Organic Sweeteners

Brand IP Statement(s)

Copyright 2020 Nature’s Way Brands, LLC

FDA Disclaimer Statement

These statements have not been evaluated by the Food & Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

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

See for yourself

Sambucus Vitamin C Fizzy 1,000 mg by Nature's Way label

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

Sambucus Vitamin C Fizzy 1,000 mg 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 Vitamin C Fizzy 1,000 mg by Nature's Way

These are the 3 active ingredients this product is made of. Select any to open its full monograph.

Serving size0.27 Ounce(s) Dosage formPowder Servings per container10 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.

Sodium

Interacts with
205 drugs
160 mg per serving

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...

Sodium monograph & interactions

Vitamin C

Interacts with
207 drugs
1000 mg per serving Form: Ascorbic Acid

Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...

Vitamin C monograph & interactions

Organic Black Elder (Sambucus nigra L.) extract

Interacts with
121 drugs
100 mg per serving Form: BioActives

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...

Organic Black Elder (Sambucus nigra L.) extract monograph & interactions
  • › Premium cultivar Elderberries

Other (inactive) ingredients: Cane Sugar, Sodium Bicarbonate, Organic Natural flavors, Citric Acid, Silica, Organic Stevia (leaf) extract. These complete the product’s ingredient list but are not active constituents.

Interaction report

Sambucus Vitamin C Fizzy 1,000 mg by Nature's Way Drug Interactions

Want to check YOUR meds against Sambucus Vitamin C Fizzy 1,000 mg?

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
515Drugs
409 Moderate 106 Minor

Ingredients driving the most interactions

Vitamin C 207
Sodium 205
organic Black Elder (Sambucus nigra L.) extract 121

Individual Drug Interactions

The ingredients in Sambucus Vitamin C Fizzy 1,000 mg interact with 515 drugs. Click any drug to see the details.

3 of the 3 ingredients in Sambucus Vitamin C Fizzy 1,000 mg interact with drugs. Each result below shows which ingredient is responsible. Vitamin C Sodium organic Black Elder (Sambucus nigra L.) extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Sambucus Vitamin C Fizzy 1,000 mg 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.

Vitamin C13 drug types · 207 drugs

Alkylating Agents

Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.

Likelihood Possible Evidence D
Aluminum

Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.

Likelihood Probable Evidence B
Antitumor Antibiotics

Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.

Likelihood Possible Evidence D
Estrogens

Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.

Likelihood Probable Evidence B
Fluphenazine (Prolixin)

Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.

Likelihood Possible Evidence D
Indinavir (Crixivan)

Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.

Likelihood Probable Evidence B
Levothyroxine (Synthroid, Others)

Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.

Likelihood Probable Evidence B
Warfarin (Coumadin)

High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.

Likelihood Possible Evidence D
Acetaminophen (Tylenol, Others)

High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.

Likelihood Probable Evidence B
Aspirin

Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.

Likelihood Possible Evidence B
Choline Magnesium Trisalicylate (Trilisate)

Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.

Likelihood Possible Evidence B
Niacin

Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.

Likelihood Possible Evidence A
Salsalate (Disalcid)

Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.

Likelihood Possible Evidence B
Vitamin C full monograph & interactions

Sodium7 drug types · 205 drugs

Antihypertensive Drugs

Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.

Likelihood Probable Evidence A
Corticosteroids

Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.

Likelihood Possible Evidence D
Didanosine (Videx)

Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.

Likelihood Probable Evidence C
Lithium

Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.

Likelihood Probable Evidence B
Sodium Phosphates

Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Sodium-Containing Drugs

Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Tolvaptan (Samsca)

Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.

Likelihood Probable Evidence C
Sodium full monograph & interactions

organic Black Elder (Sambucus nigra L.) 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
organic Black Elder (Sambucus nigra L.) extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Sambucus Vitamin C Fizzy 1,000 mg, 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 Vitamin C Fizzy 1,000 mg by Nature's Way: Common Questions

Does Sambucus Vitamin C Fizzy 1,000 mg by Nature's Way interact with any medications?
Yes. Based on its ingredients, Sambucus Vitamin C Fizzy 1,000 mg has a known interaction with 515 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Sambucus Vitamin C Fizzy 1,000 mg contains 3 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.
Is this safe if I'm pregnant or breastfeeding?
The vitamin C in here is rated likely safe during pregnancy and lactation at normal doses, but one source flags it as possibly unsafe — there isn't enough clarity to say it's completely risk-free. Sodium is rated possibly unsafe in pregnancy and lactation. Talk with your doctor or pharmacist before taking it to decide what's right for you.
Can high doses of vitamin C in this powder cause side effects?
Yes. Doses above 2 grams daily are more likely to cause trouble. You might experience stomach cramps, heartburn, diarrhea, nausea, or — if you're prone to them — kidney stones. The fizzy powder makes it easy to take, but don't assume more is better.
What does the sodium do in this product?
Sodium is listed as an active ingredient. It's effective for cystic fibrosis and possibly effective for kidney damage from amphotericin B. But the main concern here is that extra sodium can interfere with blood pressure medications and lithium, and it can raise sodium levels dangerously if you're on certain other drugs.
Does vitamin C really work for colds and flu?
Vitamin C is possibly effective for exercise-induced respiratory infections — infections that happen after intense exercise. The evidence for colds and flu isn't strong enough to rate, so we can't say this will prevent or shorten a typical cold.
What are the elderberries for?
The product includes elderberry extracts, but we don't hold interaction or effectiveness data on those ingredients. They're included for additional immune support, but I can't tell you exactly what the evidence says about them from the data we have.
Is there a lot of sodium in one serving of this fizzy powder?
The product facts don't specify how much sodium is in each serving, so I can't tell you the exact amount. If you're watching your sodium intake or taking medications affected by sodium, ask your pharmacist to check the label with you.

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.

Sambucus Vitamin C Fizzy 1,000 mg label
Go deeper

The Full Monographs Behind Sambucus Vitamin C Fizzy 1,000 mg’s Ingredients

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

Herb & supplement monograph

Sodium

Interacts with 205 drugs

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from...

Read the full Sodium monograph → Herb & supplement monograph

Vitamin C

Interacts with 207 drugs

Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...

Read the full Vitamin C monograph → 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 Vitamin C Fizzy 1,000 mg'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 95 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.

Sodium 38 references
  1. Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
  2. Food and Drug Administration Science Background: Safety of Sodium Phosphates Oral Solution. September 17, 2001. Available at: http://www.fda.gov/cder/drug/safety/sodiumphospate.htm
  3. Coton T, Mallaret C, Coilliot C, Carre D, Guisset M. Severe acute ulcerated gastritis induced by salt. Presse Med 2009;38(3):499-500. PubMed
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Vitamin C 51 references
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Elderberry 6 references
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See these in context on the Elderberry monograph →

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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.

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