Interactions on record — worth a quick check against your medications. Check your meds →
Dietary supplement

Sambucus Traditional Immune Syrup Elderberry Ingredients & Drug Interactions

by Nature's Way

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

Sambucus Traditional Immune Syrup Elderberry 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 Immune Syrup Elderberry 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.

This syrup contains one active ingredient: elderberry. Black elderberry extract provides the immune-support compounds.

The product also includes inactive ingredients — fructose, purified water, glycerin, natural flavor, malic acid, and potassium sorbate — to make the syrup palatable and shelf-stable.

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: Respiratory tract infections, Upper respiratory tract infection (URTI), Lower respiratory tract infections, Rhinosinusitis, Influenza, Common cold — 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 on elderberry for colds, flu, hay fever, heart health, chronic fatigue, COPD, and cognitive function is insufficient to rate it reliably. We hold no data showing whether this product works for these conditions.

If immune support is your goal, talk with us about what the science actually supports for your situation.

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 (cooked) elderberry products are generally well tolerated. Raw or unripe berries, leaves, bark, and seeds contain a toxin that can cause nausea, vomiting, severe diarrhea, weakness, dizziness, numbness, and even confusion — but cooking eliminates it, and this syrup should be prepared correctly.

The safety data isn't complete enough to recommend elderberry supplements during pregnancy or while breastfeeding, so it's best to avoid them at those times. There is also one case report of a patient with an underlying autoimmune condition who developed liver inflammation after taking elderberry for years and recovered after stopping it.

If you have an autoimmune disease, mention this product to your doctor.

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 if you take immunosuppressants (such as those used after organ transplant or for severe autoimmune disease) or pazopanib (Votrient) for cancer. Elderberry may interfere with both.

If you take any other prescription medication, use the search tool below to be sure.

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 syrup is generally well tolerated if you're not on an immunosuppressant or pazopanib. But we don't have solid evidence that it works for colds, flu, or the other conditions it's marketed for.

Before you start it, check your medications with the tool on this page — especially if you take drugs that weaken your immune system or any cancer medication.

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 Sep 25, 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 Traditional Immune Syrup Elderberry, 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 Sep 25, 2024
DSLD ID 317117
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 Immune Syrup Elderberry 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
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%
Elderberry6400 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.

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

Formulation

Gluten free No peanut, dairy, or artificial colors.

Bottled and tested in the USA

Vegan Gelatin free

Vegan Gelatin free

Highly concentrated elderberry extract

Brand IP Statement(s)

Copyright 2023 Nature's Way Brands, LLC

Seals/Symbols

Vegan Gelatin free

FDA Statement of Identity

Dietary Supplement

Storage

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

General Statements

Servings per container 48, 24

See for yourself

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

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

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

Does Sambucus Traditional Immune Syrup Elderberry by Nature's Way interact with any medications?
Yes. Based on its ingredients, Sambucus Traditional Immune Syrup Elderberry 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 Immune Syrup Elderberry 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 breastfeeding?
The safety data isn't complete enough to recommend it at those times. It's best to avoid elderberry supplements during pregnancy and while breastfeeding. Talk with your doctor or pharmacist if you're thinking about using it at either stage.
What's actually in this syrup besides the elderberry?
The active ingredient is elderberry. Inactive ingredients include fructose, purified water, glycerin, natural flavor, malic acid, and potassium sorbate — these are fillers and preservatives that make the syrup taste good and stay fresh.
What if I eat raw elderberries instead of taking the syrup?
Raw or unripe berries, seeds, leaves, and bark can contain a toxin that causes nausea, vomiting, severe diarrhea, weakness, dizziness, numbness, and confusion. This syrup is properly prepared and cooked, so that risk is eliminated. Raw berries are not a safe substitute.
Can elderberry actually prevent colds or flu?
The evidence we hold isn't strong enough to rate it reliably for colds, flu, or respiratory infections. If you're looking for cold or immune support, we can talk about what the science actually backs.
I take an immunosuppressant after my transplant. Can I use this?
Elderberry stimulates immune activity, which may interfere with what your immunosuppressant is supposed to do. You should not take this without checking with your transplant team or pharmacist first — this is a serious interaction.

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

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

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

Keep exploring