Elderberry

Sambucus nigra · Black elderberry

Snapshot

Indications	Contraindications
Cold symptoms¹ Influenza symptoms^1–3 Constipation⁴	Raw or unripe berries⁵ Leaves and stems⁶ Pregnancy or lactation⁶ Known elderberry allergy⁷

Elderberry, the dark purple berry of the European or black elder (Sambucus nigra), is promoted as a dietary supplement for colds, flu, and other conditions⁵. Its use rests on antiviral activity seen in vitro, where it binds viral particles and blocks host cell entry⁶. Adults with early cold or influenza symptoms are the typical users⁸. Other uses are constipation in multi-herb products⁴ and immune support, where firm conclusions are not yet possible⁹.

For respiratory illness, a systematic review found elderberry may not reduce the risk of developing a cold but may shorten and ease colds and influenza, with uncertain evidence¹. A rapid review reported symptom reductions when mono-herbal products were taken within 48 hours of onset⁸. Trials found no change in cardiovascular risk biomarkers, and no good evidence supports use for coronavirus disease 2019 (COVID-19)⁵. In a 2022 in vitro study, a blend of elderberry and aronia extracts inhibited influenza A and a seasonal human betacoronavirus, with no human data on the blend¹⁰. Products listing elderberry are marketed as liquids, gummies, lozenges, and softgels; see Form comparison.

The most consequential caution is toxicity from raw or unripe berries, leaves, and stems, which contain cyanide-producing compounds that cooking eliminates⁵. Health Canada labels ask for a practitioner's advice before use in pregnancy or breastfeeding⁷. Per Memorial Sloan Kettering Cancer Center, patients taking laxatives are asked to talk to their healthcare provider because elderberry can increase their effects⁶.

Last updated October 15, 2026. Read how we make monographs.

In the full monograph

58 sources, 48 studies

When to useThe situations practitioners use it for, each with the reason and the study behind it.
SafetyWho should avoid it, who needs extra care, and the side effects reported in studies.
InteractionsThe medicines and supplements it interacts with, the effect of each, and what labeling says to watch.
Protocol notesThe doses used in studies, how and when they were taken, and how the forms on the market compare.
How it worksWhat it is and how it works in the body, in plain terms.
Published studiesThe studies behind each use, popular claims checked against them, and trials still under way.
Word of mouthWhat patients and practitioners report online, kept separate from the clinical evidence.
Clinical perspectiveA closing read of where the evidence is solid, where it is thin, and what has not been studied.

Snapshot

In the full monograph

Sources