Elder : Safety

by MedlinePlus

(Page 2 of 2)

Allergies

Avoid elder in patients with known allergy to plants in the Caprifoliaceae family (honeysuckle family). There are some reports of allergies in children playing with toys made from fresh elder stems.

Side Effects and Warnings

Elderberry products should be used under the direction of a qualified healthcare provider because of the possible risk of cyanide toxicity, especially from elder bark, root, or leaves.

There are reports of gastrointestinal distress, diarrhea, vomiting, abdominal cramps, and weakness after drinking elderberry juice made from crushed leaves, stems and uncooked elderberries. Notably, the berries must be cooked to prevent nausea or cyanide toxicity.

Allergies are possible from fresh elder stems and may include rash, skin irritation, or difficulty breathing.

In theory, high doses or long-term use of elder flowers may have diuretic (urine-producing) effects. People taking diuretics or drugs that interact with diuretics should use caution when taking products containing elder.

Pregnancy and Breastfeeding

Elder cannot be recommended during pregnancy or breast-feeding based on a theoretical risk of birth defects or spontaneous abortion.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

Elder may possess diuretic (urine producing) effects, and should be used cautiously with drugs that increase urination. Elder may possess laxative effects, and should be used cautiously with other laxatives.

Based on laboratory studies, elder may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. A qualified healthcare provider should monitor patients taking drugs for diabetes by mouth or insulin closely. Medication adjustments may be necessary.

The flavonoid quercitin, which is found in elder, has been reported to inhibit xanthine oxidase, and may affect caffeine and theophylline levels. Patients using theophylline should speak with their healthcare provider before using elder.

Animal studies suggest that elder may increase the effects and possible adverse effects of some cancer chemotherapies.

Based on preliminary research, increased benefits may be seen when elder is used in combination with antibiotics and decongestants, such as oxymetazoline (Afrin®). Animal studies suggest that elder flowers may possess anti-inflammatory properties and may add to the effects of some drugs that also decrease inflammation.

Interactions with Herbs and Dietary Supplements

Elder may possess diuretic (urine producing) effects, and should be used cautiously with herbs that may increase urination, such as artichoke, celery, corn silk, couchgrass, dandelion, horsetail, juniper berry, kava, shepherd's purse, uva ursi, yarrow.

Elder may possess laxative effects, and should be used cautiously with herbs that may also have laxative effects, such as alder buckthorn, aloe dried leaf sap, black root, blue flag rhizome, butternut bark, dong quai, European buckthorn, eyebright, cascara bark, castor oil, chasteberry, colocynth fruit pulp, dandelion, gamboges bark, horsetail, jalap root, manna bark, plantain leaf, podophyllum root, psyllium, rhubarb, senna, wild cucumber fruit, yellow dock root.

Based on laboratory studies, elder may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar such as Aloe vera , American ginseng, bilberry, bitter melon, burdock,fenugreek, fish oil, gymnema, horse chestnut seed extract (HCSE), maitake mushroom, marshmallow, milk thistle, Panax ginseng, rosemary, shark cartilage, Siberian ginseng, stinging nettle and white horehound. Blood glucose levels may require monitoring, and doses may need adjustment.

Increased effects may be seen when elder is used in combination with other antioxidants, such as vitamin C or flavonoids like quercetin.

Taking sucrose and elder together may decrease elimination of the anthocyanin component of elder.

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