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Dietary supplement

Sambucus Traditional Elderberry Immune Syrup Zero Sugar Ingredients & Drug Interactions

by Nature's Way

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

Sambucus Traditional Elderberry Immune Syrup Zero Sugar 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 Traditional Elderberry Immune Syrup Zero Sugar 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 (50 mg) without saying how much of each component you get.

This syrup contains one active ingredient: elderberry. The product is sweetened with sorbitol instead of sugar.

The remaining ingredients — water, glycerin, natural flavors, citric acid, and potassium sorbate — are inactive components that give the syrup its texture, taste, and shelf stability.

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: Upper respiratory tract infection (URTI), Respiratory tract infections, Lower respiratory tract infections, Rhinosinusitis, Colds, Influenza — and 1 related terms.
  • 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, Upper respiratory tract infection (URTI), Lower respiratory tract infections.

The evidence for elderberry in the areas most people ask about — respiratory tract infections, hay fever, fatigue, heart health, breathing problems, and thinking and memory — is rated insufficient. That means the research we have isn't reliable enough to say whether it works.

That doesn't mean it doesn't work; it means we just don't have solid proof yet.

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 like this one are generally well tolerated. However, raw or unripe elderberries, seeds, leaves, and bark contain compounds that can cause nausea, vomiting, diarrhea, dizziness, and other symptoms — but cooking eliminates this risk, and commercial products like this syrup are safe in that regard.

One rare case report links elderberry use over several years to autoimmune liver inflammation in someone with an existing autoimmune condition, though this is uncommon. You should avoid this product during pregnancy and breastfeeding — there isn't enough safety data to know either way, so talk with your doctor or pharmacist for personalized advice if you're pregnant, planning to become pregnant, or nursing.

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.

Double-check this product before taking it if you're on immunosuppressant medications (used after transplant or for autoimmune disease) or pazopanib (Votrient) for cancer — both interact at Moderate severity. Use the checker below to verify your full medication list.

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.

This product is generally well tolerated if you don't take immunosuppressants or pazopanib. If you do take either of those medications, check with your pharmacist before starting.

The evidence for what elderberry actually does for common concerns like colds and allergies isn't established, so manage your expectations about what it can deliver.

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 Mar 25, 2025.

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 Traditional Elderberry Immune Syrup Zero Sugar, 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 Mar 25, 2025
DSLD ID 328051
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 Traditional Elderberry Immune Syrup Zero Sugar 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
Calories10 Calorie(s), 25 Calorie(s)--
Total Carbohydrates4 Gram(s), 8 Gram(s)1%, 3%
Added Sugars0 Gram(s), 0 Gram(s)--
Total Sugars0 Gram(s), 0 Gram(s)--
Sugar Alcohol4 Gram(s), 8 Gram(s)--
Elderberry3200 mg, 6400 mg--
Black Elderberry Extract50 mg, 100 mg--

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

Tap any ingredient to jump to its full detail below.

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

Servings per container 24 12

Suggested/Recommended/Usage/Directions

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

Precautions

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

Keep out of reach of children.

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

Not a low calorie food

Storage

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

Formulation

Gluten free. No peanut, dairy, or artificial colors.

Bottled and tested in the USA

Vegan Gelatin Free

Vegan Gelatin Free

Zero sugar

Brand IP Statement(s)

Copyright 2024 Nature's Way Brands, LLC

Seals/Symbols

Vegan Gelatin Free

Formula

Highly concentrated elderberry extract

FDA Statement of Identity

Dietary Supplement

See for yourself

Sambucus Traditional Elderberry Immune Syrup Zero Sugar 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 Traditional Elderberry Immune Syrup Zero Sugar 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: 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: Sorbitol, Water, Purified, Glycerin, Natural Flavors, Citric Acid, Potassium Sorbate. These complete the product’s ingredient list but are not active constituents.

Interaction report

Sambucus Traditional Elderberry Immune Syrup Zero Sugar by Nature's Way Drug Interactions

Want to check YOUR meds against Sambucus Traditional Elderberry Immune Syrup Zero Sugar?

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 Traditional Elderberry Immune Syrup Zero Sugar 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 Traditional Elderberry Immune Syrup Zero Sugar, 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 Traditional Elderberry Immune Syrup Zero Sugar by Nature's Way: Common Questions

Does Sambucus Traditional Elderberry Immune Syrup Zero Sugar by Nature's Way interact with any medications?
Yes. Based on its ingredients, Sambucus Traditional Elderberry Immune Syrup Zero Sugar 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 Traditional Elderberry Immune Syrup Zero Sugar contains a single active ingredient, and that one ingredient can interact with many different medications on its own. We check it against each medication and show the mechanism responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Is this safe to take while pregnant or breastfeeding?
There isn't enough reliable safety data either way. The facts advise against it during pregnancy and breastfeeding. Talk with your doctor or pharmacist — they can help you decide whether the benefit outweighs the uncertainty in your situation.
Can elderberry help me get over a cold or respiratory infection?
The evidence for elderberry in respiratory infections isn't established in the data we hold. That means we don't have solid research to say whether it works — so don't count on it as your main treatment.
What if I take an immunosuppressant medication?
Elderberry stimulates your immune system, which might interfere with medications meant to suppress it. Check with your pharmacist before starting — this is a Moderate-severity interaction that needs a professional look at your specific drugs.
Are there any common side effects from this syrup?
Properly prepared elderberry products like this one are generally well tolerated. Side effects are rare and usually only happen if someone ingests raw or unripe berries, which this product isn't.
Can I take this with cancer medication?
If you take pazopanib (Votrient), one case report shows a patient developed severe nausea and liver injury after taking elderberry, though we can't say for certain the supplement caused it. Check with your pharmacist before adding this.
Does this syrup contain sugar?
No — it's zero sugar and sweetened with sorbitol instead.

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

Not sure if Sambucus Traditional Elderberry Immune Syrup Zero Sugar 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 Traditional Elderberry Immune Syrup Zero Sugar label
Go deeper

The Full Monographs Behind Sambucus Traditional Elderberry Immune Syrup Zero Sugar’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 Traditional Elderberry Immune Syrup Zero Sugar'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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