Taking Sambucol Elderberry With Tamiflu

In our latest question and answer, the pharmacist discusses the use of elderberry products with Tamiflu.

Question

Is it okay to take Sambucol Black Elderberry with Tamiflu?

Asked by Izzy On Apr 05, 2019

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Apr 05, 2019
Elderberry Closeup With Text

Overview

There are no known interactions between Sambucol black elderberry products and Tamiflu. They should be safe to take together.

In fact, taking products that contain elderberry may help to provide additional immune support against the flu based on studies that show that elderberry can stimulate the immune system and shorten the duration of infection.[1]

Does Tamiflu Have Drug Interactions?

Tamiflu (Oseltamivir) has very few drug interactions. The prescribing information for the drug only lists one that is clinically significant, the live flu vaccine, simply because Tamiflu may decrease our immune response to it.

The prescribing information states the following regarding drug interactions in general:[2]

Information derived from pharmacology and pharmacokinetic studies of oseltamivir [Tamiflu] suggests that clinically significant drug interactions are unlikely.

There is no information that would suggest that Tamiflu has any sort of interaction with elderberry products.

Elderberry For The Flu

Elderberry extracts have been studied fairly extensively for their safety and efficacy in treating certain types of infection, like the cold and flu.

Research shows that not only does elderberry have few (if any) side effects, it may reduce the symptoms and duration of influenza infection.

One study, which studied a Sambucol elderberry extract product specifically, reported that if given within 48 hours of initial symptoms, significant improvement in flu symptoms were seen within 2 to 4 days and the duration of symptoms was lessened by over 50%.[3]

Does Elderberry Interact With Any Drugs?

Evidence suggests that elderberry has a low potential for interactions and should be safe to take with most other drugs.

One study reported that one product that contained multiple ingredients, including elderberry and echinacea could potentially inhibit a metabolizing enzyme known as CYP3A4, which could lead to drug interactions. Nevertheless, other research strongly points to elderberry alone not having an effect on CYP3A4 activity, so interactions seem unlikely.[4]

The biggest concern would be if you are taking immunosuppressants. Since Elderberry can stimulate the immune system, it may decrease the effectiveness of immunosuppressant drugs so be sure to talk with your doctor first if you are taking them.[5]

Summary

There is no known drug interaction between elderberry products and Tamiflu.

References
  1. ^ Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. PubMed
  2. ^ Tamiflu Prescribing Information Tamiflu Manufacturer Website
  3. ^ Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. PubMed
  4. ^ In vitro inhibition of CYP3A4 by the multiherbal commercial product Sambucus Force and its main constituents Echinacea purpurea and Sambucus nigra.PubMed
  5. ^ The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: Inflammatory cytokines.PubMed

About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Brian.Staiger@PharmacistAnswers.com Office: 716-389-3076

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