Interactions on record — worth a quick check against your medications. Based on 2 of 5 ingredients. Check your meds →
Dietary supplement

Standardized Sambucus Sambucus nigra + Probiotic Ingredients & Drug Interactions

by Nature's Answer

Capsule Category: Other Combinations
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Standardized Sambucus Sambucus nigra + Probiotic is a dietary supplement by Nature's Answer with 5 active ingredients. Its ingredients are commonly taken for colds, flu (influenza), other respiratory infections.Based on those ingredients, 302 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Lactobacillus acidophilus, Black Elderberry (Sambucus nigra) concentrated fruit extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Standardized Sambucus Sambucus nigra + Probiotic 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

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 1 of its 5 active ingredients.
  • “Immunity Probiotic Blend containing” is a proprietary blend — the label doesn't break down how much of each component you get.

This formula contains 5 active ingredients: three Lactobacillus strains (acidophilus, paracasei, and rhamnosus GG), Bifidobacterium animalis lactis, and a standardized Black Elderberry fruit extract. The probiotics are live beneficial bacteria intended to support digestive and immune health, while the elderberry is a concentrated plant extract.

The capsules also contain three inactive ingredients — glycerin, hypromellose, and water — which serve as a base and binding agent.

Does it work?

Moderate 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
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: Immune support with elderberry and probiotic.
  • We looked for evidence on: Upper respiratory tract infection (URTI), Lower respiratory tract infections, Respiratory tract infections, Antibiotic-associated diarrhea, Lactose intolerance, Bacterial vaginosis — and 4 related terms.
  • The strongest evidence on file: Lactobacillus Acidophilus is rated "Possibly Effective" for Antibiotic-associated diarrhea (Natural Medicines).
  • Also on file: Lactobacillus Acidophilus is rated "Possibly Effective" for Bacterial vaginosis.
  • Also on file: Elderberry is rated "Insufficient Reliable Evidence To Rate" for Respiratory tract infections, Lower respiratory tract infections.

For Lactobacillus acidophilus, the evidence shows it's possibly effective for irritable bowel syndrome, Helicobacter pylori infection, antibiotic-associated diarrhea, and bacterial vaginosis. It's rated possibly ineffective for atopic disease, and we don't have enough reliable evidence to rate it for acute respiratory distress syndrome.

For Black Elderberry, the data we hold does not establish effectiveness for any of the conditions tested — allergic rhinitis, cardiovascular disease, chronic fatigue syndrome, COPD, cognitive function, or respiratory tract infections are all rated insufficient evidence. The effectiveness of the specific probiotic blends isn't established in our data.

The evidence, ingredient by ingredient Elderberry Lactobacillus Acidophilus

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 2 of the 2 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 2 of 2.
  • General safety write-ups exist for 2 of 2.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Lactobacillus acidophilus is generally well tolerated in healthy adults and children. It can rarely cause gastrointestinal side effects like bloating, gas, abdominal pain, or diarrhea, though these are uncommon.

In very rare cases, the live bacteria have been reported in serious infections like sepsis or bloodstream infection, mostly in patients with compromised immune systems or underlying conditions. Black Elderberry prepared from ripe fruit is generally well tolerated when properly cooked, but raw or unripe berries, seeds, and leaves contain toxins that can cause nausea, vomiting, severe diarrhea, weakness, and dizziness — cooking eliminates this risk.

Safety data for elderberry in pregnancy and breastfeeding are not sufficient, so the recommendation is to avoid it during those periods. Talk with your doctor or pharmacist about whether this product is right for you.

Side effects, ingredient by ingredient Elderberry Lactobacillus Acidophilus

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?
  • 2 of the 2 matched ingredients can interact with medications — Elderberry, Lactobacillus Acidophilus.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: immunosuppressants / transplant drugs.
  • For scale: 302 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 take immunosuppressants (used after organ transplant or for autoimmune conditions) — elderberry may reduce their effect. If you're on antibiotic therapy, time your doses several hours apart from the probiotic so the antibiotics don't kill the beneficial bacteria.

If you take pazopanib (Votrient) for cancer, do not combine it with this product without your oncologist's approval — there's a documented case of severe liver injury. Use the medication checker below for your complete medication list.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This combination may appeal to you if you're interested in supporting digestive health with probiotics and immune function with elderberry, but check with your doctor first if you take immunosuppressants, antibiotics, or cancer medications like pazopanib. The probiotics are generally well tolerated, though the live organisms mean antibiotics can interfere with them.

Avoid this product during pregnancy and breastfeeding. Talk it over with your doctor or pharmacist to make sure it fits your situation.

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

Assessment coverage: 2 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jul 24, 2019.

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 Standardized Sambucus Sambucus nigra + Probiotic, straight from the product label.

Brand Nature's Answer
Barcode (UPC) 083000262654
Net contents 60 Vegan DuoCap Capsules
Market status On market
Date entered into DSLD Jul 24, 2019
DSLD ID 204353
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), 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 Standardized Sambucus Sambucus nigra + Probiotic 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:
2 VCaps Plus Capsule(s)
Maximum serving Sizes:
2 VCaps Plus Capsule(s)
Servings per container
30
UPC/BARCODE
083000262654
IngredientAmount% DV
Lactobacillus paracasei0 NP--
Bifidobacterium animalis lactis0 NP--
Lactobacillus acidophilus0 NP--
Lactobacillus rhamnosus GG0 NP--
Black Elderberry (Sambucus nigra) concentrated fruit extract100 mg--
Immunity Probiotic Blend containing0 NP--

Other ingredients: Glycerin, Hypromellose, Water

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

2 in 1 DuoCap technology

Moisture defense maintains the integrity of the Immune Probiotic

Internal + external barrier for enhanced probiotic stability Immune probiotic protected inside inner capsule

New Since 1972

Formula

Elderberry extract + Immune Probiotic

Liquid Elderberry extract in outer capsule

Per serving 32,000 mg (32 g) fresh Elderberry 10 billion CFU Probiotic

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.

Seals/Symbols

Holistically Balanced

Cruelty Free Not Tested On Animals

Non GMO

Gluten Free

Formulation

Non GMO Gluten Free

Absolutely no preservatives

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Suggested use: As a dietary supplement, take 2 capsules per day with food or water.

Brand IP Statement(s)

VCaps and DuoCap are trademarks of Lonza or its affiliates.

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.

See for yourself

Standardized Sambucus Sambucus nigra + Probiotic by Nature's Answer label

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

What’s inside

The Ingredients in Standardized Sambucus Sambucus nigra + Probiotic by Nature's Answer

These are the 5 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 VCaps Plus Capsule(s) Dosage formCapsule Servings per container30 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.

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 (Sambucus nigra) concentrated fruit extract monograph & interactions

Immunity Probiotic Blend containing

0 NP per serving
  • › Lactobacillus paracasei
  • › Bifidobacterium animalis lactis
  • › Lactobacillus acidophilus
  • › Lactobacillus rhamnosus GG

Other (inactive) ingredients: Glycerin, Hypromellose, Water. These complete the product’s ingredient list but are not active constituents.

Interaction report

Standardized Sambucus Sambucus nigra + Probiotic by Nature's Answer Drug Interactions

Want to check YOUR meds against Standardized Sambucus Sambucus nigra + Probiotic?

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
302Drugs
302 Moderate

Each ingredient & the kinds of drugs it affects

For each ingredient in Standardized Sambucus Sambucus nigra + Probiotic 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.

Lactobacillus acidophilus1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Lactobacillus acidophilus with antibiotic drugs might decrease the effectiveness of L. acidophilus.
L. acidophilus preparations usually contain live and active organisms. Therefore, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and L. acidophilus preparations by at least two hours.

Likelihood Probable Evidence D

Black Elderberry (Sambucus nigra) concentrated fruit 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 Standardized Sambucus Sambucus nigra + Probiotic, 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

Standardized Sambucus Sambucus nigra + Probiotic by Nature's Answer: Common Questions

Does Standardized Sambucus Sambucus nigra + Probiotic by Nature's Answer interact with any medications?
Yes. Based on its ingredients, Standardized Sambucus Sambucus nigra + Probiotic has a known interaction with 302 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Standardized Sambucus Sambucus nigra + Probiotic contains 5 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.
Can I take this if I'm pregnant or breastfeeding?
The safety data for Black Elderberry are not sufficient in pregnancy or breastfeeding, so the recommendation is to avoid it during those periods. The probiotics don't have enough data either way. Talk with your doctor or pharmacist about your individual situation before taking this product while pregnant or nursing.
What are the probiotics in this formula supposed to do?
This product contains three strains of beneficial bacteria — Lactobacillus acidophilus, L. paracasei, and L. rhamnosus GG — plus Bifidobacterium animalis lactis. These live organisms are intended to support digestive and immune health. The acidophilus strain has evidence suggesting it may help with irritable bowel syndrome, antibiotic-associated diarrhea, and bacterial vaginosis.
I just started antibiotics. Should I take this probiotic at the same time?
No — taking antibiotics and Lactobacillus acidophilus together may kill many of the beneficial bacteria in the probiotic, making it less effective. Ask your pharmacist to help you time the doses several hours apart, so the antibiotic and probiotic don't work against each other.
Is the elderberry in this product raw or cooked?
This product contains a concentrated fruit extract from ripe elderberries, which should be properly prepared. Raw or unripe berries, seeds, and leaves can cause nausea, vomiting, and severe diarrhea because they contain toxins — but those are eliminated by cooking. As a standardized extract, this preparation should be safe on that front.
What adverse effects might I experience?
The probiotics and elderberry extract are generally well tolerated. Some people report mild gastrointestinal side effects from probiotics like bloating, gas, or mild abdominal discomfort, though these are uncommon. Rarely, serious infections from live bacteria have been reported, mainly in people with weakened immune systems.
Does this product work for colds or the flu?
The data we hold on Black Elderberry does not establish that it works for respiratory tract infections, colds, or the flu. The evidence is rated insufficient, so we can't say whether it's effective for these conditions.

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

Not sure if Standardized Sambucus Sambucus nigra + Probiotic 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.

Standardized Sambucus Sambucus nigra + Probiotic label
Sources

Sources & How We Checked

Standardized Sambucus Sambucus nigra + Probiotic'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 21 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.

Lactobacillus Acidophilus 15 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Begtrup LM, de Muckadell OB, Kjeldsen J, Christensen RD, Jarbøl DE. Long-term treatment with probiotics in primary care patients with irritable bowel syndrome--a randomised, double-blind, placebo controlled trial. Scand J Gastroenterol 2013;48(10):1127-35 PubMed
  3. Chatterjee S, Kar P, Das T, Ray S, Gangulyt S, Rajendiran C, Mitra M. Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12 for prevention of antibiotic-associated
  4. Shavakhi A, Tabesh E, Yaghoutkar A, Hashemi H, Tabesh F, Khodadoostan M,Minakari M, Shavakhi S, Gholamrezaei A. The effects of multistrain probiotic compound on bismuth-containing quadruple therapy for Helicobacter pylori infection: a randomized placebo-c
  5. Karamali M, Dadkhah F, Sadrkhanlou M, et al. Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Metab 2016;42(4):234-41. PubMed
  6. Badehnoosh B, Karamali M, Zarrati M, et al. The effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. J Matern Fetal Neonatal Med. 2018 May;31(9):1128-1136.
  7. Kumar S, Kumar R, Rohilla L, Jacob N, Yadav J, Sachdeva N. A high potency multi-strain probiotic improves glycemic control in children with new-onset type 1 diabetes mellitus: A randomized, double-blind, and placebo-controlled pilot study. Pediatr Diabete
  8. Shahriari A, Karimi E, Shahriari M, Aslani N, Khooshideh M, Arab A. The effect of probiotic supplementation on the risk of gestational diabetes mellitus among high-risk pregnant women: A parallel double-blind, randomized, placebo-controlled clinical trial PubMed
  9. Xiao SD, Zhang DZ, Lu H, et al. Multicenter, randomized, controlled trial of heat-killed Lactobacillus acidophilus LB in patients with chronic diarrhea. Adv Ther. 2003;20(5):253-60.
  10. Rossi F, Amadoro C, Gasperi M, Colavita G. Lactobacilli infection case reports in the last three years and safety implications. Nutrients. 2022;14(6):1178. PubMed
  11. Ozer M, Goksu SY, Shahverdiani A, Mustafa M. Lactobacillus acidophilus-induced endocarditis and associated splenic abscess. Case Rep Infect Dis 2020;2020:1382709.
  12. Sadrin S, Sennoune S, Gout B, et al. A 2-strain mixture of Lactobacillus acidophilus in the treatment of irritable bowel syndrome: A placebo-controlled randomized clinical trial. Dig Liver Dis 2020;52(5):534-540. PubMed
  13. Stoffer JN, Slingsby TJ, Giuliari GP. Lactobacillus acidophilus endophthalmitis after intravitreal bevacizumab injection requiring intraocular lens explantation. Can J Ophthalmol 2022;57(1):e21-e22. PubMed
  14. Cukovic-Cavka S, Likic R, Francetic I, Rustemovic N, Opacic M, Vucelic B. Lactobacillus acidophilus as a cause of liver abscess in a NOD2/CARD15-positive patient with Crohn's disease. Digestion 2006;73(2-3):107-10.
  15. Hui J, Ren Y, Wang Y, Han Q. Lactobacillus acidophilus endophthalmitis postcataract operation: A case report with a literature review. Ocul Immunol Inflamm 2023.

See these in context on the Lactobacillus Acidophilus 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 →

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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