Overview

Elderberry is the fruit of the European elder plant. It is made into dietary supplements, as well as teas, syrups, and juices. Elderberry is commonly used to treat or prevent infections of the nose or throat, but its benefits are not well defined. Although ripe or cooked elderberries seem to be well tolerated, there is not enough research on what side effects they may cause. Unripe or uncooked elderberries can be toxic and should be avoided. Before taking elderberry, make sure to tell your health care provider about any health conditions you have or medicines you are taking.

Uses

What is elderberry used for?

Elderberry (Sambucus nigra) is often used to treat or prevent the common cold, flu, and other infections in the nose or throat. But its benefits are not well defined.

Note: The FDA has not reviewed elderberry for safety and effectiveness. Learn more about dietary supplements here.

How does elderberry work (mechanism of action)?

Elderberry is the berry (fruit) of a plant called European elder (Sambucus nigra). These berries are used to make tea, juice, syrup, and dietary supplements.

Elderberry is commonly taken to treat or prevent infections in the nose and throat, such as the common cold or flu. But research on elderberry has been unclear, and its benefits for these uses are not well defined. It is not clear if or how elderberry may work for any use.

Herbal products such as elderberry naturally contain many chemicals, including flavonoids and anthocyanins. The amounts of each chemical in a specific elderberry product may vary. Some, none, or all of these chemicals may have effects on the body. These effects may change depending on how much of each chemical is found in the product you are using.

How should I store elderberry?

You should store elderberry according to the product label. Most dietary supplements should be kept in a cool, dry location that is out of the reach of children and pets and not in direct sunlight.

Side Effects

What are the most common side effects of elderberry?

Elderberry seems to be well tolerated. But there is not enough research to know what the common side effects may be. Tell your health care provider if you have any side effects that bother you.

There may be side effects of elderberry that are not listed here. Contact your health care provider if you think you are having a side effect of a supplement. In the U.S., you can report side effects to the FDA at www.safetyreporting.hhs.gov or by calling 888-SAFEFOOD (888-723-3366). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of elderberry?

While less common, the most serious side effects of elderberry are described below, along with what to do if they happen.

Severe Allergic Reactions. Elderberry may cause allergic reactions, which can be serious. Stop taking elderberry and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching or skin rash
• Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Precautions

Who should not use elderberry?

Allergies to Ingredients. People who are allergic to any of the following should not take elderberry.

• Elderberry
• European elder
• Sambucus nigra
• Any of the ingredients in the specific product

Your pharmacist can tell you all of the ingredients in the specific elderberry products they stock.

What should I know about elderberry before using it?

Elderberry cannot be marketed to treat or cure a disease.

Read and follow the directions on the specific product you are taking, or take it as recommended by your health care provider.

Keep elderberry out of the reach of children.

Products that contain elderberry should only contain cooked or fully ripe berries. The unripe, uncooked fruit contains chemicals that can be toxic. The other parts of the European elder plant, such as the leaves, bark, and seeds, can also be toxic. It is important not to use products that contain other parts of the plant.

Herbal products, such as elderberry, naturally contain many chemicals. The amount of each chemical in a specific elderberry product can change for many reasons, including the area where the plant was grown, the weather during growth, the time of year when it was harvested, and the way that the fruit was processed after it was harvested. If you switch to a new bottle or a different brand, you may not have the same effects or side effects because of this variability. Talk to your health care provider if you have questions or concerns.

Elderberry is available in many different forms, including as a tea, juice, syrup, liquid extract, tablet, capsule, or gummy. Each of these forms may contain different amounts of the chemicals that are naturally found in the plant.

Elderberry products may also contain other ingredients, such as vitamin C, zinc, and other herbs. These other ingredients may have different effects and side effects on the body. Read the product label closely to check which ingredients it contains.

If you are taking elderberry syrup, use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist which measuring device to use.

The FDA has not tested elderberry products to confirm that they contain the ingredients stated on their labels. Some dietary supplements have been tested by third-party organizations to confirm that they contain the ingredients listed on their labels and do not contain any harmful chemicals. Learn more about how to choose a safe dietary supplement product here.

What should I tell my health care provider before using elderberry?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if elderberry is right for you.

In particular, make sure that you discuss any of the following.

Pregnancy. It is not known if or how elderberry could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if elderberry passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does elderberry interact with foods or drinks?

There are no known interactions between elderberry and foods or drinks.

It is unknown if drinking alcohol will affect elderberry.

Does elderberry interact with medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

The interactions between elderberry and medicines are not fully understood. As with most dietary supplements, the research on drug interactions with elderberry is incomplete. Always check with your health care provider before taking elderberry with any medicines.

Dosing

What should I do if I accidentally use too much elderberry?

If you or someone else has used too much elderberry, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

Elderberry is available in many different doses and forms, depending on your reasons for using it. Read the product label closely and speak with a health care provider about how to take elderberry safely. Do not take double or extra doses, even if you miss a dose.