Interactions on record — worth a quick check against your medications. Based on 4 of 6 ingredients. Check your meds →
Dietary supplement

Sambucus Kids Ingredients & Drug Interactions

by Nature's Answer

Sambucus Kids label
See full label image
Liquid Category: Botanical
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 Kids 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 Kids is a dietary supplement by Nature's Answer with 6 active ingredients. Its ingredients are commonly taken for common cold, flu and respiratory infections, immune support.Based on those ingredients, 974 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Echinacea angustifolia root extract, Astragalus mongholicus root extract, Red Raspberry juice concentrate. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Sambucus Kids by Nature's Answer

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

Pharmacist-reviewed data Checks every ingredient Answer in seconds
Prefer a human? Send your question to our licensed pharmacists — free, answered by email within 24 hours.

HelloPharmacist Scorecard of Sambucus Kids by Nature's Answer

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

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 2 of its 5 active ingredients.
  • “Proprietary Herbal Blend” is a proprietary blend — the label gives one combined amount (65 mg) without saying how much of each component you get.

Sambucus Kids contains five active ingredients: red raspberry juice concentrate, echinacea (as both angustifolia root extract and purpurea aerial parts extract), black elderberry juice concentrate, and astragalus mongholicus root extract, plus a proprietary herbal blend whose individual components are listed separately. The product also contains inactive ingredients—agave syrup, vegetable glycerin, purified water, and citric acid—to deliver the formula as a liquid.

Each of these herbal extracts and concentrates is included for its traditional supportive role in children's wellness products, though the strength of evidence for any particular use varies.

Does it work?

Couldn't assess
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 assessable

The label doesn't state a purpose we can grade — see each ingredient's own graded uses on its monograph instead.

Why this rating?
  • We looked at the product name, claims, and label statements and couldn't find a stated purpose to grade.

The evidence for what red raspberry, echinacea, elderberry, and astragalus can do is not well established in our data. Red raspberry has insufficient reliable evidence for aging skin, cardiovascular disease, respiratory tract infections, congestive heart failure, and diabetes.

Echinacea's effectiveness for anxiety, athletic performance, attention deficit-hyperactivity disorder, burns, chronic fatigue syndrome, and migraine headache is also insufficient. Elderberry shows insufficient evidence for allergic rhinitis, cardiovascular disease, chronic fatigue syndrome, chronic obstructive pulmonary disease, cognitive function, and lower respiratory tract infections.

Astragalus similarly lacks sufficient evidence for allergic rhinitis, amenorrhea, aplastic anemia, angina, asthma, and beta-thalassemia. In short, we do not hold established effectiveness ratings for the uses these ingredients are traditionally associated with in children's products.

The evidence, ingredient by ingredient Echinacea Astragalus Red Raspberry 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 4 of the 4 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 4 of 4.
  • General safety write-ups exist for 4 of 4.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Red raspberry fruit is generally well tolerated, though safety evidence is limited. The most common side effects are diarrhea, stomach upset, and upper abdominal pain, though these don't typically occur at standard doses.

Echinacea is well tolerated short-term but may trigger allergic reactions, especially in people sensitive to ragweed or related plants (ragweed, chrysanthemums, marigolds, daisies). Rare but serious cases of echinacea-induced liver inflammation (hepatitis) have been reported.

Black elderberry from ripe, properly prepared fruit is generally well tolerated; however, raw or unripe berries and other plant parts contain toxins that can cause nausea, vomiting, severe diarrhea, weakness, dizziness, and numbness—cooking eliminates these toxins. Rare cases of liver inflammation after long-term elderberry use have also been reported.

Astragalus is generally well tolerated short-term in healthy adults, though quality human safety data is limited. One trial reported lacunar angina (chest pain), and dizziness and palpitations have been associated with it in some studies, though causation was unclear.

For pregnancy: red raspberry is rated likely safe to possibly safe (mixed evidence), but you should use it only with your provider's guidance because safety in pregnancy is not well established. Echinacea is possibly safe in pregnancy, but safety data is limited.

Elderberry is rated likely safe in pregnancy and lactation. Astragalus should be avoided in pregnancy and lactation because there isn't enough safety data.

For breastfeeding: there isn't enough data on red raspberry to know either way, so talk with your doctor or pharmacist. Echinacea safety while breastfeeding is not on file.

Astragalus should be avoided. Always discuss use during pregnancy or while breastfeeding with your own healthcare provider.

Side effects, ingredient by ingredient Echinacea Astragalus Red Raspberry 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?
  • 4 of the 4 matched ingredients can interact with medications — Red Raspberry, Elderberry, Astragalus, Echinacea.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; lithium.
  • For scale: 975 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 giving Sambucus Kids, double-check with your doctor or pharmacist if your child takes blood thinners or antiplatelet drugs (echinacea and red raspberry), drugs that are metabolized by liver enzymes CYP1A2 or CYP3A4 (echinacea), immunosuppressants (echinacea, elderberry, astragalus), diabetes medications or insulin (red raspberry, astragalus), lithium (astragalus), or cancer drugs like etoposide, pazopanib, or cyclophosphamide (echinacea, elderberry, astragalus). These carry Moderate-severity interaction potential, and a few carry Minor-severity risks with warfarin, HIV medications, and sedatives.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with no assessable stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

Sambucus Kids is a liquid herbal blend designed for children's wellness support. Because it contains echinacea, elderberry, astragalus, and red raspberry—all of which interact with medications including blood thinners, diabetes drugs, immunosuppressants, and liver-metabolized medications—you'll want to check your child's exact prescriptions with a pharmacist or doctor before starting.

If your child is on any medication, especially for chronic conditions, talk it over with your healthcare provider or pharmacist first.

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

Assessment coverage: 5 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 11, 2022.

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 Kids, straight from the product label.

Brand Nature's Answer
Barcode (UPC) 083000260445
Net contents 4 fl. Oz.; 120 mL
Market status On market
Date entered into DSLD Apr 11, 2022
DSLD ID 264109
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Children 4 or More Years of Age, Vegan, Vegetarian, Kosher, Gluten 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 Kids by Nature's Answer, 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:
10 mL
Maximum serving Sizes:
10 mL
Servings per container
12
UPC/BARCODE
083000260445
IngredientAmount% DV
Calories40 Calorie(s)--
Total Carbohydrates10 Gram(s)3%
Sugar7 Gram(s)--
added Sugars7 Gram(s)14%
Proprietary Herbal Blend65 mg--
Red Raspberry juice concentrate19 mg--
Echinacea angustifolia root extract0 NP--
Black Elderberry juice concentrate1 Gram(s)--
Echinacea purpurea aerial parts extract0 NP--
Astragalus mongholicus root extract0 NP--

Other ingredients: Agave Syrup, Vegetable Glycerin, Water, Purified, Citric Acid

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.
Brand IP Statement(s)

Discover Nature's Answer and trust the Difference... The True Nature of Our Standards go way beyond the herb...

Nature's Answer Since 1972

Discover Nature's Answer

Copyright 2018 Nature's Answer

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.

Precautions

Warning: Keep out of reach of children.

Do not use if safety seal is damaged or missing.

If you are pregnant, nursing, taking any medications, planning any medical procedure or have a medical condition, consult with your healthcare practitioner before use.

Storage

Store in a cool, dry place.

Formulation

Non GMO Project Verified nongmoproject.org

Gluten-Free

Supports a Healthy Immune System

Vegan

Absolutely No Preservatives

Seals/Symbols

Non GMO Project Verified nongmoproject.org

K Parve (Kosher)

Formula

K Parve (Kosher)

Kid's Formula

Made From 4,000 mg Black Elderberries per serving

FDA Statement of Identity

Herbal Supplement

Suggested/Recommended/Usage/Directions

Suggested Use: For daily maintenance, as a dietary supplement, children 4-12 years of age, take two (2) teaspoons daily. Shake well before use. Mix in a small amount of water.

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

See for yourself

Sambucus Kids by Nature's Answer label

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

Sambucus Kids 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 Kids by Nature's Answer

These are the 6 active ingredients this product is made of. Select any to open its full monograph.

Serving size10 mL Dosage formLiquid Servings per container12 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.

Sugar

7 Gram(s) per serving

Red Raspberry juice concentrate

Interacts with
135 drugs
19 mg per serving

Red raspberry leaf is a traditional herbal remedy most often used as a tea in late pregnancy and for menstrual discomfort, but solid scientific eviden...

Red Raspberry juice concentrate monograph & interactions

Black Elderberry juice concentrate

Interacts with
121 drugs
1 Gram(s) 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...

Black Elderberry juice concentrate monograph & interactions

Other (inactive) ingredients: Agave Syrup, Vegetable Glycerin, Water, Purified, Citric Acid. These complete the product’s ingredient list but are not active constituents.

Interaction report

Sambucus Kids by Nature's Answer Drug Interactions

Want to check YOUR meds against Sambucus Kids?

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
974Drugs
973 Moderate 1 Minor

Ingredients driving the most interactions

Echinacea angustifolia root extract 816
Astragalus mongholicus root extract 208
Red Raspberry juice concentrate 135
Black Elderberry juice concentrate 121

Individual Drug Interactions

The ingredients in Sambucus Kids interact with 974 drugs. Click any drug to see the details.

4 of the 6 ingredients in Sambucus Kids interact with drugs. Each result below shows which ingredient is responsible. Echinacea angustifolia root extract Astragalus mongholicus root extract Red Raspberry juice concentrate Black Elderberry juice concentrate

Each ingredient & the kinds of drugs it affects

For each ingredient in Sambucus Kids 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.

Echinacea angustifolia root extract12 drug types · 816 drugs

Caffeine

Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Echinacea seems to increase plasma concentrations of caffeine by around 30%. This is likely due to inhibition of cytochrome P450 1A2 (CYP1A2) by echinacea.

Likelihood Probable Evidence B
Cytochrome P450 1A2 (Cyp1A2) Substrates

Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Echinacea appears to inhibit CYP1A2 enzymes in humans. Additionally, echinacea seems to increase plasma concentrations of caffeine, a CYP1A2 substrate, by around 30%. Theoretically, echinacea might increase levels of other drugs metabolized by CYP1A2.

Likelihood Possible Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4. This may increase or decrease levels of drugs metabolized by CYP3A4.
Several clinical trials have shown that taking echinacea for up to one month does not significantly affect the metabolism of various CYP3A4 substrates, including midazolam, docetaxel, etravirine, lopinavir-ritonavir, and darunavir-ritonavir. However, other clinical research shows that echinacea may increase the clearance of midazolam, suggesting that echinacea might induce CYP3A4. The discrepancy is thought to be due to differing effects of echinacea on intestinal versus hepatic CYP3A4 enzymes. Echinacea appears to induce hepatic CYP3A4 but inhibit intestinal CYP3A4. In some cases, these effects might cancel each other out, but in others, drug levels may be increased or decreased depending on the level of effect at hepatic and intestinal sites. The effect of echinacea on CYP3A4 activity may differ depending on the CYP3A4 substrate.

Likelihood Possible Evidence B
Etoposide (Vepesid)

Echinacea may increase levels of etoposide.
In one report, concomitant use of etoposide and echinacea was associated with more severe thrombocytopenia than the use of etoposide alone, suggesting inhibition of etoposide metabolism. Etoposide is a cytochrome P450 3A4 (CYP3A4) substrate. Echinacea has variable effects on CYP3A4, but some studies have reported inhibition of the enzyme.

Likelihood Possible Evidence D
Immunosuppressants

Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Theoretically, echinacea may interfere with immunosuppressant therapy because of its immunostimulant activity.

Likelihood Possible Evidence B
Darunavir (Prezista)

Theoretically, echinacea may interfere with the metabolism of darunavir; however, a small clinical study found no effect.
Darunavir is metabolized by cytochrome P450 3A4 (CYP3A4) and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Echinacea has variable effects on CYP3A4, but administration of an E. purpurea root extract (Arkocapsulas Echinacea, Arkopharma) 500 mg four times daily for 14 days did not affect darunavir/ritonavir pharmacokinetics in 15 HIV-infected patients.

Likelihood Unlikely Evidence B
Dayquil Severe

Echinacea is reported to have varying effects on a number of Cytochrome P450 metabolizing enzymes in the liver, including CYP1A2 and CYP3A4, which play a role in acetaminophen and dextromethorphan metabolism (both contained in DayQuil Severe), respectively. Studies have reported both enzyme inhibition and induction, making it difficult to predict clinically significant drug interactions with reliability. Specific drug interaction studies reporting definitive results are rare, and potential drug interactions involving echinacea should likely be taken on a case-by-case basis. Based on what we know about how acetaminophen and dextromethorphan are metabolized, the risk of a clinically significant interaction between echinacea and DayQuil Severe is low.

Likelihood Unlikely Evidence A
Docetaxel (Taxotere)

Theoretically, echinacea may interfere with the metabolism of docetaxel; however, a small clinical study found no effect.
Docetaxel is metabolized by cytochrome P450 3A4 (CYP3A4). Echinacea has variable effects on CYP3A4, but taking E. purpurea whole plant extract (Echinaforce, A. Vogel Biopharma AG) 20 drops three times daily for 2 weeks did not alter the pharmacokinetics of docetaxel in one clinical study.

Likelihood Unlikely Evidence B
Etravirine (Intelence)

Theoretically, echinacea may interfere with the metabolism of etravirine; however, a small clinical study found no effect.
Etravirine is metabolized by cytochrome P450 3A4 (CYP3A4). Echinacea has variable effects on CYP3A4, but taking E. purpurea root extract (Arkocapsulas Echinacea, Arkopharma) 500 mg three times daily for 14 days did not alter the pharmacokinetics of etravirine in HIV-infected patients.

Likelihood Unlikely Evidence B
Lopinavir/Ritonavir (Kaletra)

Theoretically, echinacea may interfere with the metabolism of lopinavir; however, a small clinical study found no effect.
Lopinavir is metabolized by cytochrome P450 3A4 (CYP3A4) and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Echinacea has variable effects on CYP3A4, but taking E. purpurea (Echinamide, Natural Factors Nutritional Products, Inc.) 500 mg three times daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in healthy volunteers.

Likelihood Unlikely Evidence B
Midazolam (Versed)

Theoretically, echinacea may increase the metabolism of intravenous midazolam.
Echinacea induces hepatic CYP3A4 and might decrease plasma levels of midazolam by about 20%, reducing the effectiveness of intravenous midazolam. Echinacea also appears to inhibit intestinal CYP3A4, which could theoretically increase the bioavailability of oral midazolam. This may cancel out the decrease in availability caused by induction of hepatic CYP3A4, such that overall plasma levels after oral administration of midazolam are not affected by echinacea.

Likelihood Possible Evidence B
Warfarin (Coumadin)

Echinacea seems to increase the clearance of warfarin, although the effect may not be clinically significant.
Preliminary clinical research in healthy male volunteers suggests that taking echinacea increases the clearance of the active S-isomer of warfarin after a single dose of warfarin, but there was not a clinically significant effect on the INR.

Likelihood Possible Evidence B
Echinacea angustifolia root extract full monograph & interactions

Astragalus mongholicus root extract4 drug types · 208 drugs

Antidiabetes Drugs

Theoretically, taking astragalus with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research in humans shows that astragalus might have hypoglycemic effects. Theoretically, taking astragalus, especially in combination with other hypoglycemic agents, might increase the risk of hypoglycemia.

Likelihood Probable Evidence A
Cyclophosphamide

Theoretically, astragalus might interfere with cyclophosphamide therapy.
Evidence regarding the effect of astragalus on immunosuppression caused by cyclophosphamide is conflicting. Some animal research suggests that astragalus reverses cyclophosphamide-induced immunosuppression. However, other animal research shows no effect.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, astragalus might interfere with immunosuppressive therapy.
Astragalus seems to stimulate immune function. Theoretically, taking astragalus might decrease the effects of immunosuppressive therapy.

Likelihood Possible Evidence D
Lithium

Theoretically, astragalus might increase levels and adverse effects of lithium.
Animal research suggests that astragalus has diuretic properties. Theoretically, due to this diuretic effect, astragalus might reduce excretion and increase levels of lithium.

Likelihood Probable Evidence D
Astragalus mongholicus root extract full monograph & interactions

Red Raspberry juice concentrate2 drug types · 135 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, taking red raspberry leaf with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
In vitro research suggests that red raspberry leaf extract has antiplatelet activity and enhances the in vitro effects of the antiplatelet medication cangrelor. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Insulin

Red raspberry leaf might reduce glucose levels in patients being treated with insulin.
In one case report, a 38-year-old patient with gestational diabetes, whose blood glucose was being controlled with medical nutrition therapy and insulin, developed hypoglycemia after consuming two servings of raspberry leaf tea daily for 3 days beginning at 32 weeks' gestation. The patient required an insulin dose reduction. The hypoglycemia was considered to be probably related to use of red raspberry leaf tea.

Likelihood Possible Evidence D
Red Raspberry juice concentrate full monograph & interactions

Black Elderberry juice concentrate2 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 juice concentrate full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Sambucus Kids, from the product label.

Nature's Answer

See all Nature's Answer products
Name
Nature's Answer
Street Address
85 Commerce Drive
City
Hauppauge
State
NY
ZipCode
11788
Phone Number
(800) 439-2324
Web Address
www.naturesanswer.com
Pharmacist Counseling Corner

Sambucus Kids by Nature's Answer: Common Questions

Does Sambucus Kids by Nature's Answer interact with any medications?
Yes. Based on its ingredients, Sambucus Kids has a known interaction with 974 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Sambucus Kids contains 6 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 Sambucus Kids safe for my child during pregnancy or breastfeeding?
Safety during pregnancy and breastfeeding varies by ingredient. Red raspberry and echinacea have conflicting or limited pregnancy data and should only be used with your provider's approval. Elderberry is rated likely safe for both pregnancy and lactation. Astragalus should be avoided during both. Because this product contains multiple ingredients, talk with your own doctor or pharmacist before use in pregnancy or while nursing.
What are the side effects I should watch for?
Most common side effects are mild: diarrhea, stomach upset, and abdominal pain from red raspberry or echinacea, and nausea or vomiting. Allergic reactions to echinacea are possible, especially if your child is sensitive to ragweed or related plants. Rare but serious cases of liver inflammation have been reported with echinacea and elderberry. If your child develops rash, severe abdominal pain, yellowing of skin or eyes, or breathing difficulty, contact your doctor right away.
Does this product actually work?
The evidence for what these herbs do isn't well established in our data. All five active ingredients—red raspberry, echinacea, elderberry, and astragalus—are rated as having insufficient reliable evidence for their traditional uses. This doesn't mean they don't work; it means the science we hold doesn't confirm their effectiveness.
Can I give this to my child if they take insulin or diabetes medication?
Red raspberry and astragalus both may lower blood sugar (glucose) levels. If your child takes insulin or diabetes medication, talk with your doctor or pharmacist before starting this product—they'll want to monitor blood sugar or adjust doses if needed.
What's in this liquid besides the herbs?
The inactive ingredients are agave syrup, vegetable glycerin, purified water, and citric acid. These are excipients that create the liquid formulation. The product also includes a proprietary herbal blend whose specific plant components are listed separately.
My child is on an immunosuppressant medication. Can we use Sambucus Kids?
No, not without checking first. Three of the five active ingredients—echinacea, elderberry, and astragalus—may interfere with immunosuppressant therapy because they stimulate immune function. Talk with your child's doctor or pharmacist before use.

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

Not sure if Sambucus Kids is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Sambucus Kids label
Go deeper

The Full Monographs Behind Sambucus Kids’s Ingredients

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

Herb & supplement monograph

Echinacea

Interacts with 816 drugs

Echinacea is a popular herb taken to help prevent or shorten the common cold, but study results are mixed and the overall benefit appears small at best. It is generally well tolerated for sh...

Read the full Echinacea monograph → Herb & supplement monograph

Astragalus

Interacts with 208 drugs

Astragalus is a root used for centuries in traditional Chinese medicine, mainly to support the immune system and help the body cope with stress. While early studies are interesting, strong h...

Read the full Astragalus monograph → Herb & supplement monograph

Red Raspberry

Interacts with 135 drugs

Red raspberry leaf is a traditional herbal remedy most often used as a tea in late pregnancy and for menstrual discomfort, but solid scientific evidence for these uses is limited. It is gene...

Read the full Red Raspberry 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 Kids'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 78 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.

Red Raspberry 8 references
  1. Eagon PK, Elm MS, Hunter DS, et al. Medicinal herbs: modulation of estrogen action. Era of Hope Mtg, Dept Defense; Breast Cancer Res Prog, Atlanta, GA 2000;Jun 8-11.
  2. Parsons M, Simpson M, Ponton T. Raspberry leaf and its effects on labour: safety and efficacy. Aust Coll Midwives Inc J 1999;12:20-5.
  3. Simpson M, Parsons M, Greenwood J, Wade K. Raspberry leaf in pregnancy: its safety and efficacy in labor. J Midwifery Womens Health 2001;46:51-9.. PubMed
  4. Mullen W, McGinn J, Lean ME, et al. Ellagitannins, flavonoids, and other phenolics in red raspberries and their contribution to antioxidant capacity and vasorelaxation properties. J Agric Food Chem 2002;50:5191-6.. PubMed
  5. Sherson, D., Andersen, B., Hansen, I., and Kjoller, H. Occupational asthma due to freeze-dried raspberry. Ann Allergy Asthma Immunol. 2003;90(6):660-663. PubMed
  6. Cheang KI, Nguyen TT, Karjane NW, Salley KE. Raspberry Leaf and Hypoglycemia in Gestational Diabetes Mellitus. Obstet Gynecol. 2016;128(6):1421-4. PubMed
  7. Dudzinska D, Bednarska K, Boncler M, Luzak B, Watala C. The influence of Rubus idaeus and Rubus caesius leaf extracts on platelet aggregation in whole blood. Cross-talk of platelets and neutrophils. Platelets. 2016;27(5):433-9.
  8. Henrotin Y, Cozannet RL, Fança-Berthon P, et al. Rubus idaeus extract improves symptoms in knee osteoarthritis patients: results from a phase II double-blind randomized controlled trial. BMC Musculoskelet Disord 2022;23(1):650. PubMed

See these in context on the Red Raspberry monograph →

Echinacea 51 references
  1. Mullins RJ. Echinacea-associated anaphylaxis. Med J Aust 1998;168:170-1. PubMed
  2. Mullins RJ. Allergic reactions to Echinacea. J Allergy Clin Immunol 2000;104:S340-341 (Abstract 1003).
  3. Chavez ML, Chavez PI. Echinacea. Hosp Pharm 1998;33:180-8.
  4. Grimm W, Muller HH. A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections. Am J Med 1999;106:138-43. PubMed
  5. Taylor JA, Weber W, Standish L, et al. Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial. JAMA 2003;290:2824-30.. PubMed
  6. Luettig B, Steinmuller C, Gifford GE, et al. Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst 1989;81:669-75. PubMed
  7. Stimpel M, Proksch A, Wagner H, et al. Macrophage activation and induction of macrophage cytotoxicity by purified polysaccharide fractions from the plant Echinacea purpurea. Infect Immun 1984;46:845-9. PubMed
  8. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  9. Gallo M, Sarkar M, Au W, et al. Pregnancy outcome following gestational exposure to echinacea: A prospective controlled study. Arch Intern Med 2000;160:3141-3. PubMed
  10. Soon SL, Crawford RI. Recurrent erythema nodosum associated with echinacea herbal therapy. J Am Acad Dermatol 2001;44:298-9. PubMed
  11. Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51. PubMed
  12. Logan JL, Ahmed J. Critical hypokalemic renal tubular acidosis due to Sjogren's syndrome: association with the purported immune stimulant echinacea. Clin Rheumatol 2003;22:158-9.
  13. Schulten B, Bulitta M, Ballering-Bruhl B, et al. Efficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trial. Arzneimittelforschung 2001;51:563-8.. PubMed
  14. Yale SH, Glurich I. Analysis of the inhibitory potential of Ginkgo biloba, Echinacea purpurea, and Serenoa repens on the metabolic activity of cytochrome P450 3A4, 2D6, and 2C9. J Altern Complement Med 2005;11:433-9.
  15. Yale SH, Liu K. Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med 2004;164:1237-41. PubMed
  16. Gorski JC, Huang S, Zaheer NA, et al. The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo.Clin Pharmacol Ther 2003;73 (Abstract PDII-A-8):P94. PubMed
  17. Lee AN, Werth VP. Activation of autoimmunity following use of immunostimulatory herbal supplements. Arch Dermatol 2004;140:723-7. PubMed
  18. Goel V, Lovlin R, Barton R, et al. Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther 2004;29:75-83.
  19. Barrett B. Medicinal properties of Echinacea: a critical review. Phytomedicine 2003;10:66-86. PubMed
  20. Huntley AL, Thompson Coon J, Ernst E. The safety of herbal medicinal products derived from Echinacea species: a systematic review. Drug Saf 2005;28:387-400. PubMed
  21. Turner RB, Bauer R, Woelkart K, et al. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. N Engl J Med 2005;353:341-8.
  22. Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-40. .
  23. Perri D, Dugoua JJ, Mills E, Koren G. Safety and efficacy of echinacea (Echinacea augustafolia, e. purpurea and e. pallida) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e262-7.
  24. Kocaman O, Hulagu S, Senturk O. Echinacea-induced severe acute hepatitis with features of cholestatic autoimmune hepatitis. Eur J Intern Med 2008;19:148. PubMed
  25. Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77. PubMed
  26. Press Release: Echinacea herbal products should not be used in children under 12 years old. Medicines and Healthcare Products Regulatory Agency (UK). August 20, 2012. Available at: www.mhra.gov.uk/NewsCentre/Pressreleases/CON180627. (Accessed 21 October
  27. Barrett B, Brown R, Rakel D, Rabago D, et al. Placebo effects and the common cold: a randomized controlled trial. Ann.Fam.Med 2011;9:312-22. PubMed
  28. Haller J, Freund, TF, Pelczer, KG, et al. The anxiolytic potential and psychotropic side effects of an echinacea preparation in laboratory animals and healthy volunteers. Phytother.Res. 2013;27:54-61.
  29. Grbic J, Wexler I, Celenti R, et al. A phase II trial of a transmucosal herbal patch for the treatment of gingivitis. J Am Dent.Assoc. 2011;142:1168-75. PubMed
  30. Schapowal A, Berger D, Klein P, et al. Echinacea/sage or chlorhexidine/lidocaine for treating acute sore throats: a randomized double-blind trial. Eur.J Med Res 9-1-2009;14:406-12. PubMed
  31. Bossaer JB and Odle BL. Probable etoposide interaction with Echinacea. J.Diet.Suppl 2012;9:90-5.
  32. Abdul MI, Jiang X, Williams KM, et al. Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects. Br J Clin.Pharmacol. 2010;69:508-15. PubMed
  33. Kemp, D. E. and Franco, K. N. Possible leukopenia associated with long-term use of echinacea. J Am Board Fam.Pract. 2002;15(5):417-419.
  34. Liatsos, G., Elefsiniotis, I., Todorova, R., and Moulakakis, A. Severe thrombotic thrombocytopenic purpura (TTP) induced or exacerbated by the immunostimulatory herb Echinacea. Am J Hematol. 2006;81(3):224.
  35. Penzak, S. R., Robertson, S. M., Hunt, J. D., Chairez, C., Malati, C. Y., Alfaro, R. M., Stevenson, J. M., and Kovacs, J. A. Echinacea purpurea significantly induces cytochrome P450 3A activity but does not alter lopinavir-ritonavir exposure in healthy s
  36. Maskatia, Z. K. and Baker, K. Hypereosinophilia associated with echinacea use. South.Med J 2010;103(11):1173-1174. PubMed
  37. Parnham MJ. Benefit-risk assessment of the squeezed sap of the purple coneflower (Echinacea purpurea) for long-term oral immunostimulation. Phytomed 1996;3:95-102. PubMed
  38. Schroder-Aasen T, Molden G, Nilsen OG. In vitro inhibition of CYP3A4 by the multiherbal commercial product Sambucus Force and its main constituents Echinacea purpurea and Sambucus nigra. Phytother Res 2012;26(11):1606-13.
  39. Moltó J, Valle M, Miranda C, et al. Herb-drug interaction between Echinacea purpurea and darunavir-ritonavir in HIV-infected patients. Antimicrob Agents Chemother 2011;55(1):326-30.
  40. Goey AK, Meijerman I, Rosing H, et al. The effect of Echinacea purpurea on the pharmacokinetics of docetaxel. Br J Clin Pharmacol 2013;76(3):467-74.
  41. Moltó J, Valle M, Miranda C, et al. Herb-drug interaction between Echinacea purpurea and etravirine in HIV-infected patients. Antimicrob Agents Chemother 2012;56(10):5328-31. PubMed
  42. Lawrenson JA, Walls T, Day AS. Echinacea-induced acute liver failure in a child. J Paediatr Child Health 2014;50(10):841.
  43. Hansen TS, Nilsen OG. In vitro CYP3A4 metabolism: inhibition by Echinacea purpurea and choice of substrate for the evaluation of herbal inhibition. Basic Clin Pharmacol Toxicol 2008;103:445-9.
  44. Gabranis I, Koufakis T1, Papakrivos I, Batala S. Echinacea-associated acute cholestatic hepatitis. J Postgrad Med. 2015;61(3):211-2. PubMed
  45. Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
  46. Karsch-Völk M, Barrett B, Kiefer D, Bauer R, Ardjomand-Woelkart K, Linde K. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev.2014;(2):CD000530. doi: 10.1002/14651858.CD000530.pub3. PubMed
  47. Hoban CL, Byard RW, Musgrave IF. Analysis of spontaneous adverse drug reactions to echinacea, valerian, black cohosh and ginkgo in Australia from 2000 to 2015. J Integr Med. 2019;17(5):338-343. PubMed
  48. Ogal M, Johnston SL, Klein P, Schoop R. Echinacea reduces antibiotic usage in children through respiratory tract infection prevention: a randomized, blinded, controlled clinical trial. Eur J Med Res. 2021 Apr 8;26(1):33. PubMed
  49. Lopresti AL, Smith SJ. An investigation into the anxiety-relieving and mood-enhancing effects of Echinacea angustifolia (EP107 ™): A randomised, double-blind, placebo-controlled study. J Affect Disord 2021;293:229-237.
  50. Weishaupt R, Buchkov A, Kolev E, Klein P, Schoop R. Reduction of viral load in patients with acute sore throats: Results from an observational clinical trial with Echinacea / Salvia lozenges [published online ahead of print, 2023 Mar 8]. Complement Med Re
  51. Sumer J, Keckeis K, Scanferla G, et al. Novel Echinacea formulations for the treatment of acute respiratory tract infections in adults-A randomized blinded controlled trial. Front Med (Lausanne) 2023;10:948787. PubMed

See these in context on the Echinacea monograph →

Elderberry 6 references
  1. Barak V, Halperin T, Kalickman I. The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw 2001;12:290-6..
  2. Elderberry (Sambucus species). The Poison Plant Patch, Novia Scotia Museum, 2007. Available at: http://museum.gov.ns.ca/poison/?section=species&id=117 (Accessed 16 October 2009).
  3. European elder. Canadian Poisonous Plants Information System. Available at: http://www.cbif.gc.ca/pls/pp/ppack.jump?p_null=all&p_psn=121&p_type=all&p_sci=comm&p_x=px (Accessed 16 October 2009).
  4. Raus K, Pleschka S, Klein P, Schoop R, Fisher P. Effect of an echinacea-based hot drink versus oseltamivir in Influenza treatment: a randomized, double-blind, double-dummy, multicenter, noninferiority clinical trial. . Curr Ther Res Clin Exp. 2015;20;77:6 PubMed
  5. Ramachandran A, Antala D, Pudasainee P, Panginikkod S, Gupta H. A Plausible Association Between the Use of Elderberry and Autoimmune Hepatitis. Cureus 2022;14(4):e24250. PubMed
  6. Agarwal N, Mangla A. Elderberry interaction with pazopanib in a patient with soft-tissue sarcoma: A case report and literature review. Mol Clin Oncol 2024;20(5):36. PubMed

See these in context on the Elderberry monograph →

Astragalus 13 references
  1. Upton R, ed. Astragalus Root: Analytical, quality control, and therapeutic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia. 1999:1-25.
  2. Khoo KS, Ang PT. Extract of astragalus membranaceus and ligustrum lucidum does not prevent cyclophosphamide-induced myelosuppression. Singapore Med J 1995;36:387-90.
  3. Chu DT, Wong WL, Mavligit GM. Immunotherapy with Chinese medicinal herbs. II. Reversal of cyclophosphamide-induced immune suppression by administration of fractionated Astragalus membranaceus in vivo. J Clin Lab Immunol 1988;25:125-9.
  4. Sun Y, Hersh EM, Lee SL, et al. Preliminary observations on the effects of the Chinese medicinal herbs Astragalus membranaceus and Ligustrum lucidum on lymphocyte blastogenic responses. J Biol Response Mod 1983;2:227-37..
  5. Ma J, Peng A, Lin S. Mechanisms of the therapeutic effect of astragalus membranaceus on sodium and water retention in experimental heart failure. Chin Med J (Engl) 1998;111:17-23.
  6. Matkovic Z, Zivkovic V, Korica M, et al. Efficacy and safety of Astragalus membranaceus in the treatment of patients with seasonal allergic rhinitis. Phytother Res 2010;24:175-81.
  7. Zhang, J. G., Yang, N., He, H., Wei, G. H., Gao, D. S., Wang, X. L., Wang, X. Z., and Song, G. Y. [Effect of Astragalus injection on plasma levels of apoptosis-related factors in aged patients with chronic heart failure.]. Chin J Integr.Med 2005;11(3):18 PubMed
  8. Chen, H. W., Lin, I. H., Chen, Y. J., Chang, K. H., Wu, M. H., Su, W. H., Huang, G. C., and Lai, Y. L. A novel infusible botanically-derived drug, PG2, for cancer-related fatigue: a phase II double-blind, randomized placebo-controlled study. Clin Invest PubMed
  9. Tian H, Lu J, He H, et al.The effect of Astragalus as an adjuvant treatment in type 2 diabetes mellitus: A (preliminary) meta-analysis. J Ethnopharmacol. 2016;191:206-215. doi: 10.1016/j.jep.2016.05.062. PubMed
  10. Hong KF, Liu PY, Zhang W, Gui DK, Xu YH. The Efficacy and Safety of Astragalus as an Adjuvant Treatment for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. J Integr Complement Med 2023. PubMed
  11. Chan KW, Kwong ASK, Tsui PN, et al. Add-on astragalus in type 2 diabetes and chronic kidney disease: A multi-center, assessor-blind, randomized controlled trial. Phytomedicine 2024;130:155457. PubMed
  12. Han X, Yu T, Chen X, Du Z, Yu M, Xiong J. Effect of Astragalus membranaceus on left ventricular remodeling in HFrEF: a systematic review and meta-analysis. Front Pharmacol 2024;15:1345797. PubMed
  13. Jing P, Hongzheng H, Zhenqi WU, Meijuan Z, Zuojing LI, Gang C. Long-term efficacy and safety of Huangqi ()-based Traditional Chinese Medicine in diabetic peripheral neuropathy: a Meta-analysis of randomized controlled trials. J Tradit Chin Med 2024;44(2):

See these in context on the Astragalus 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

Keep exploring
Supplement interaction checker › Check any supplement or product against your medications Drug–drug interactions › Check two or more of your medications against each other Browse medications A–Z › Every drug we've checked against herbs & supplements NDC & pricing lookup › Find a drug’s NDCs, packaging and costs Ask a pharmacist › Free, personal answer from our licensed team