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Dietary supplement

Sambucus Organic Elderberry Syrup Ingredients & Drug Interactions

by Nature's Way

Sambucus Organic Elderberry Syrup 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 Organic Elderberry 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 Organic Elderberry 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 Organic Elderberry Syrup by Nature's Way

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

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HelloPharmacist Scorecard of Sambucus Organic Elderberry 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 (50 mg) without saying how much of each component you get.

This syrup contains one active ingredient: elderberry, a fruit extract traditionally used for respiratory and immune support. The product also contains inactive ingredients—organic agave syrup, purified water, citric acid, and natural flavors—that sweeten and flavor the liquid.

Does it work?

Insufficient 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
Insufficient

There isn't enough reliable clinical evidence to rate this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: immune support and respiratory health.
  • We looked for evidence on: Lower respiratory tract infections, Rhinosinusitis, upper respiratory infections, colds, influenza.
  • 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 strong enough to confirm it works for the conditions it's commonly marketed for. The data we hold rates it as having insufficient reliable evidence for allergic rhinitis (hay fever), cardiovascular disease, chronic fatigue syndrome, COPD, cognitive function, and lower respiratory tract infections.

That doesn't mean it doesn't help—it means large, well-designed trials haven't yet proven the benefit clearly enough.

The evidence, ingredient by ingredient Elderberry

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 1 of the 1 matched ingredient.
  • Pregnancy & breastfeeding safety ratings cover 1 of 1.
  • General safety write-ups exist for 1 of 1.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Properly prepared elderberry syrup like this one—made from cooked, ripe fruit—is generally well tolerated. However, raw or unripe berries, seeds, leaves, and bark contain toxins that can cause nausea, vomiting, severe diarrhea, weakness, dizziness, numbness, and even stupor; cooking eliminates these.

Rarely, even cooked elderberry has been linked to liver inflammation in someone with an underlying autoimmune disease. Pregnancy and breastfeeding safety data isn't reliable enough to recommend this supplement during either.

Talk with your doctor or pharmacist about whether it's right for your situation.

Side effects, ingredient by ingredient Elderberry

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 1 of the 1 matched ingredient can interact with medications — Elderberry.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: immunosuppressants / transplant drugs.
  • For scale: 121 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking this product, check with your doctor or pharmacist if you're on immunosuppressants (medications that calm your immune system after transplant or for autoimmune conditions) or pazopanib for cancer. Both carry a Moderate risk of interaction with elderberry.

Check your own medication Run your meds through the checker above

The bottom line

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

Elderberry syrup is generally well tolerated when made from properly cooked fruit, but the evidence that it works for common conditions like hay fever or colds isn't yet solid. The main concern is if you take immunosuppressants or pazopanib—those need a conversation with your doctor or pharmacist before you start.

If neither applies to you and you want to try it, check your complete medication list with the tool on this page first.

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 Jan 23, 2023.

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 Organic Elderberry Syrup, straight from the product label.

Brand Nature's Way
Net contents 4 Fluid Ounce(s); 120 mL
Market status On market
Date entered into DSLD Jan 23, 2023
DSLD ID 273466
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, Adult (18 - 50 Years), Organic, 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 Organic Elderberry 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, 10 mL
Maximum serving Sizes:
5 mL, 10 mL
Servings per container
12
IngredientAmount% DV
Calories20 Calorie(s), 35 Calorie(s)--
Total Carbohydrates5 Gram(s), 9 Gram(s)2%, 3%
Added Sugars4 Gram(s), 9 Gram(s)8%, 18%
Total Sugars4 Gram(s), 9 Gram(s)--
Elderberry3200 mg--
Black Elderberry Extract50 mg, 100 mg--

Other ingredients: organic Agave syrup, Water, Purified, Citric Acid, Natural Flavors

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 Ages 7 and older: Take 1 teaspoon (5 mL) daily. For Intensive Use: Adults: Take 2 teaspoons (10 mL) four times daily. Children Ages 7 and older: Take 1 teaspoon (5 mL) three times daily.

Precautions

Do not exceed recommended dose.

Not formulated for children under 7 years of age.

If you are pregnant, nursing, or taking an 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.

Formulation

Vegan

Organic certified

Gluten free Contains no: Gluten, dairy, soy, peanuts, or artificial colors

Traditional immune support

USDA Organic Certified organic by Quality Assurance International

Seals/Symbols

Quality Global Sourcing Bottled & Tested in the USA

USDA Organic

Quality Assurance International Certified Organic

FDA Disclaimer Statement

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

Formula

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

FDA Statement of Identity

Dietary Supplement

General Statements

Servings per container 24, 12

Questions? 1-800-9NATURE/naturesway.com

Storage

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

Brand IP Statement(s)

Copyright 2021 Nature's Way Brands, LLC

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

See for yourself

Sambucus Organic Elderberry Syrup by Nature's Way label

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

Sambucus Organic Elderberry 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 Organic Elderberry 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 container12 Amounts shown are per serving.

Black Elderberry Extract

Interacts with
121 drugs
50 mg per serving Form: Anthocyanins, Sambucus nigra Berry Extract

Elderberry is a popular herbal supplement, mainly taken to help with colds and flu. Some small studies suggest it may modestly shorten cold or flu sym...

Black Elderberry Extract monograph & interactions

Other (inactive) ingredients: Organic Agave syrup, Water, Purified, Citric Acid, Natural Flavors. These complete the product’s ingredient list but are not active constituents.

Interaction report

Sambucus Organic Elderberry Syrup by Nature's Way Drug Interactions

Want to check YOUR meds against Sambucus Organic Elderberry Syrup?

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

 Go to the checker
121Drugs
121 Moderate

Ingredients driving the most interactions

Black Elderberry Extract 121

Individual Drug Interactions

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

1 of the 1 ingredient in Sambucus Organic Elderberry 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 Organic Elderberry Syrup with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.

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 Organic Elderberry 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 Organic Elderberry Syrup by Nature's Way: Common Questions

Does Sambucus Organic Elderberry Syrup by Nature's Way interact with any medications?
Yes. Based on its ingredients, Sambucus Organic Elderberry Syrup has a known interaction with 121 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Sambucus Organic Elderberry Syrup contains a single active ingredient, and that one ingredient can interact with many different medications on its own. We check it against each medication and show the mechanism responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Is elderberry safe during pregnancy or while breastfeeding?
The safety data isn't reliable enough to recommend it during either. Talk with your doctor or pharmacist about your specific situation before using it.
What are the side effects of this elderberry syrup?
When made from ripe, cooked fruit, it's generally well tolerated and most people don't have problems. The risks come from raw or unripe berries or other plant parts, which can cause nausea, vomiting, diarrhea, weakness, dizziness, and numbness—but cooking (as this product does) eliminates that toxin.
Does elderberry actually work for colds or hay fever?
The evidence isn't strong enough yet to say yes. We rate elderberry as having insufficient reliable evidence for colds, hay fever, and other common uses. That means studies haven't proven it clearly works—not that it definitely doesn't.
What is elderberry used for?
Elderberry is traditionally used to support respiratory health and immune function. The most common reasons people take it are for colds, flu, hay fever, and general immune support, though the evidence for these uses isn't yet conclusive.
Can I take this if I've had a liver problem?
There's a rare case report of someone with underlying autoimmune disease who developed liver inflammation after taking elderberry for years. If you have a history of liver disease or autoimmune hepatitis, talk with your doctor or pharmacist before starting.

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

Not sure if Sambucus Organic Elderberry 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 Organic Elderberry Syrup label
Go deeper

The Full Monographs Behind Sambucus Organic Elderberry 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 Organic Elderberry Syrup's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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

The 6 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

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

See these in context on the Elderberry monograph →

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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