Elderberry (Sambucus nigra) is the dark purple berry from the European elder tree. It has a long history of use for cold and flu.

Elderberry is a popular ingredient in supplements. It might affect the immune system, and also seems to have activity against viruses, including the flu.

Elderberry is commonly used for the common cold, flu, high cholesterol, and many other conditions, but there is no good scientific evidence to support most of these uses, with the possible exception of the flu. There is also no good evidence to support using elderberry for COVID-19.

Don't confuse elderberry with American Elder, Elderflower, or Dwarf Elder. These aren't the same and have different effects.
When taken by mouth: Elderberry is commonly consumed in foods. Elderberry extract is possibly safe when taken for up to 12 weeks. There isn't enough reliable information to know if it is safe to use for longer than 12 weeks.

It is possibly unsafe to consume elder leaves or stems, or unripe or uncooked elderberries. Cooked elderberry seems to be safe, but raw and unripe fruit might cause nausea, vomiting, or severe diarrhea.

Special Precautions & Warnings:

Children: Elderberry extract is possibly safe in children 5 years of age or older when taken by mouth for up to 3 days. There isn't enough reliable information to know if it is safe for children younger than 5 years of age to take elderberry. Unripe or uncooked elderberries are possibly unsafe. Don't give them to children.

Pregnancy and breast-feeding: There isn't enough reliable information to know if elderberry extract is safe to use when pregnant or breast-feeding. Stay on the safe side and stick to food amounts.

"Autoimmune diseases" such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), or other conditions: Elderberry might cause the immune system to become more active. This could increase the symptoms of autoimmune diseases. If you have one of these conditions, it's best to avoid using elderberry.


NatMed Pro rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
Likely effective Effectiveness definitions
Possibly effective Effectiveness definitions
  • Flu (influenza). Taking a specific elderberry extract syrup (Sambucol, Nature's Way) seems to reduce flu symptoms when taken within 48 hours of the first symptoms. But it might not be helpful in some people, including those with lung conditions or children under 12 years of age.
There is interest in using elderberry for a number of other purposes, but there isn't enough reliable information to say whether it might be helpful.
Likely ineffective Effectiveness definitions
Possibly ineffective Effectiveness definitions
Insufficient evidence Effectiveness definitions

Dosing & administration

Elderberry fruit extracts have most often been used by adults in doses up to 1200 mg by mouth daily for 2 weeks. Elderberry is available in many different types of products, including syrups and mouth rinses. Speak with a healthcare provider to find out what type of product and dose might be best for a specific condition.

Don't consume green, unripe, uncooked elderberries. They contain toxins and can be poisonous.

Interactions with pharmaceuticals

Medications that decrease the immune system (Immunosuppressants)

Interaction Rating=Moderate Be cautious with this combination.

Elderberry can increase the activity of the immune system. Some medications, such as those used after a transplant, decrease the activity of the immune system. Taking elderberry along with these medications might decrease the effects of these medications.

Interactions with herbs & supplements

There are no known interactions with herbs and supplements.

Interactions with foods

There are no known interactions with foods.

MediHerb Elderberry is a practitioner product.

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This monograph was last reviewed on 07/12/2023 11:00:00 and last updated on 05/03/2023 06:16:50. Monographs are reviewed and/or updated multiple times per month and at least once per year.
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