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Dietary supplement

Sambucus Original Syrup Ingredients & Drug Interactions

by Nature's Way

Liquid Category: Botanical
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Sambucus Original 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.

HelloPharmacist Scorecard of Sambucus Original 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

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 1 of its 1 active ingredient.
  • “Black Elderberry Extract” is listed as a grouped ingredient — the label gives one combined amount (100 mg) without saying how much of each component you get.

Sambucus Original Syrup contains one active ingredient: elderberry (in extract form). Black elderberry extract is the component that carries the immune-supporting activity in this product.

The rest is inactive ingredients — fructose, purified water, glycerin, natural flavor, malic acid, and potassium sorbate — which are the sweeteners, preservatives, and binders that make it a liquid you can drink.

Does it work?

Not established
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use — see Elderberry's own graded uses on its monograph.

Why this rating?
  • The label markets this product for: immune support and cold/flu symptoms.
  • We looked for evidence on: Lower respiratory tract infections, Upper respiratory tract infections, Influenza, Common cold.
  • 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 Lower respiratory tract infections.

The effectiveness evidence for elderberry is limited. The data we hold shows insufficient reliable evidence to rate elderberry for hay fever, cardiovascular disease, chronic fatigue, COPD, cognitive function, and respiratory infections.

If you're considering this syrup for any of those purposes, that means the research isn't solid enough yet to back up a claim that it works.

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 products (cooked ripe fruit) are generally well tolerated. The main safety note is to avoid raw, unripe berries, seeds, leaves, and bark — those can contain toxins that cause nausea, vomiting, severe diarrhea, weakness, dizziness, and other problems.

Since this is a prepared syrup, that risk is much lower. Nausea and vomiting have been reported in a few cases, though it's unclear whether that was from the elderberry itself or another ingredient in the product.

There's also one case report of a patient with an underlying autoimmune condition who developed autoimmune hepatitis (liver inflammation) after taking elderberry for several years. Because there isn't enough reliable safety information, the data advises against elderberry supplements during pregnancy and while breastfeeding.

If you're pregnant or nursing, talk with your doctor or pharmacist before taking this.

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 you start this syrup, double-check with your own doctor or pharmacist if you take immunosuppressants (drugs that calm your immune system, often used after transplant or for severe autoimmune conditions) — elderberry's immune-boosting activity may interfere with them. Also check if you take pazopanib (Votrient), a cancer medication.

Both carry Moderate interaction risk.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.

Sambucus Original Syrup is a single-ingredient elderberry product that's generally well tolerated when properly prepared. The biggest concern is if you take immunosuppressants or the cancer drug pazopanib — both carry documented interaction risks.

If you don't take those drugs and you're not pregnant or breastfeeding, talk with your doctor or pharmacist about whether this makes sense for you and your medications.

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

Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated Apr 23, 2024.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Sambucus Original Syrup, straight from the product label.

Brand Nature's Way
Net contents 8 Fluid Ounce(s); 240 Milliliter(s)
Market status On market
Date entered into DSLD Apr 23, 2024
DSLD ID 304691
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), 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 Original Syrup by Nature's Way, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
5 mL
Maximum serving Sizes:
10 mL
Servings per container
24
IngredientAmount% DV
Calories30 Calorie(s), 15 Calorie(s)--
Added Sugars6 Gram(s), 3 Gram(s)12%, 6%
Total Sugars6 Gram(s), 3 Gram(s)--
Total Carbohydrate7 Gram(s), 4 Gram(s)3%, 1%
Elderberry3200 mg--
Black Elderberry Extract100 mg, 50 mg--

Other ingredients: Fructose, Water, Purified, Glycerin, Natural flavor, Malic Acid, Potassium Sorbate

Tap any ingredient to jump to its full detail below.

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

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

Precautions

Not formulated for children under 7 years of age.

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 safety seal is broken or missing.

Formulation

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

Vegan

Traditional immune support

Brand IP Statement(s)

Copyright 2023 Nature's Way Brands, LLC

General Statements

Questions? 1-800-962-8873 / naturesway.com

Seals/Symbols

Quality global sourcing Bottled & tested in the USA

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.

Formula

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

FDA Statement of Identity

Dietary Supplement

Storage

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

See for yourself

Sambucus Original Syrup by Nature's Way label

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

What’s inside

The Ingredients in Sambucus Original Syrup by Nature's Way

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

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

Black Elderberry Extract

Interacts with
121 drugs
100 mg per serving Form: Anthocyanins

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

Black Elderberry Extract monograph & interactions

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

Interaction report

Sambucus Original Syrup by Nature's Way Drug Interactions

Want to check YOUR meds against Sambucus Original 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

Each ingredient & the kinds of drugs it affects

For each ingredient in Sambucus Original 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
The maker

Brand information

Manufacturer and brand details for Sambucus Original 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 Original Syrup by Nature's Way: Common Questions

Does Sambucus Original Syrup by Nature's Way interact with any medications?
Yes. Based on its ingredients, Sambucus Original 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 Original 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 it safe to take this while I'm pregnant or breastfeeding?
There isn't enough reliable safety information to know for sure, so the data advises against elderberry supplements during pregnancy and while breastfeeding. Talk with your doctor or pharmacist about your specific situation — they can help you decide what's best for you and your baby.
Does this syrup actually work for colds or the flu?
The evidence we have doesn't establish that elderberry works for those purposes yet — the data shows insufficient reliable evidence to rate it. That doesn't mean it doesn't help, just that the research isn't solid enough to make a confident claim.
What are the common side effects?
When properly prepared (cooked) ripe fruit is used, adverse effects are uncommon. A small number of reports mention nausea and vomiting, though it's unclear whether that came from the elderberry or another ingredient. Raw, unripe berries can cause nausea, vomiting, and severe diarrhea — but this syrup is prepared, so that risk is low.
What does the Black Elderberry Extract do?
Black elderberry is the active ingredient in this syrup. It's thought to support immune function by boosting cytokine production — that's why it's also the reason it can interact with immunosuppressants and pazopanib.
Is this product just elderberry, or does it have other stuff in it?
It's one active ingredient (elderberry extract) plus inactive ingredients — fructose, water, glycerin, natural flavor, malic acid, and potassium sorbate, which sweeten and preserve the syrup.
Can I take this if I have an autoimmune disease?
Because elderberry stimulates the immune system, you should talk with your doctor or pharmacist first, especially if you take immunosuppressants or have a history of autoimmune hepatitis. There's one case report of liver inflammation in someone with underlying autoimmune disease who took elderberry for years.

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

Not sure if Sambucus Original Syrup is safe with your meds?

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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 Original Syrup label
Go deeper

The Full Monographs Behind Sambucus Original Syrup’s Ingredients

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

Sources

Sources & How We Checked

Sambucus Original 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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