What is it used for?
Adults 18 years and older
Flower
(Traditionally) used in Herbal Medicine (as a diaphoretic) to promote sweating to help relieve fever (in cases of common colds, flus) (Godfrey and Saunders 2010; Bone 2003; Hoffman 2003; WHO 2002; BHC 1992; BHP 1983; Grieve 1931; Sayre 1917; Felter and Lloyd 1898).
(Traditionally) used in Herbal Medicine to help relieve symptoms of colds and flus (such as coughs, sore throat and mucus buildup (catarrh) of the (upper) respiratory tract) [Source note 2].
Used in Herbal Medicine to help relieve nasal congestion and discharge associated with sinusitis, hay fever/allergic rhinitis [Source note 3].
(Traditionally) used in Herbal Medicine as a diuretic [Source note 4].
(Traditionally) used in Herbal Medicine (as an alterative) to help remove accumulated waste products via the kidneys, skin and mucus membranes (Williamson 2003; Tilgner 1999; Felter 1922; Culbreth 1921; Fyfe 1903; Felter and Lloyd 1898).
Fruit
(Traditionally) used in Herbal Medicine (as a diaphoretic) to promote sweating to help relieve fever (in cases of common colds, flus) [Source note 5].
(Traditionally) used in Herbal Medicine to help relieve symptoms of colds and flus (such as coughs, sore throat and mucus buildup (catarrh) of the (upper) respiratory tract) [Source note 6].
(Traditionally) used in Herbal Medicine to help relieve joint pain associated with conditions such as arthritis [Source note 7].
(Traditionally) used in Herbal Medicine as a diuretic [Source note 8].
(Traditionally) used in Herbal Medicine (as an alterative) to help remove accumulated waste products via the kidneys, skin and mucus membranes [Source note 9].
Source of antioxidants/Provides antioxidants [Source note 10].
Source of antioxidants/Provides antioxidants that help fight/protect (cell) against/reduce (the oxidative effect of/the oxidative damage caused by/cell damage caused by) free radicals [Source note 11].
Children 2-11 years and Adolescents 12-17 years
Flower and/or Fruit
(Traditionally) used in Herbal Medicine (as a diaphoretic) to promote sweating to help relieve fever (in cases of common colds, flus) (Godfrey and Saunders 2010; Winston and Kuhn 2008; Bone 2003; Hoffman 2003; WHO 2002; Shook 1992; BHC 1992; BHP 1983; Grieve 1931; Remington et al. 1918; Sayre 1917; Felter et Lloyd 1898).
(Traditionally) used in Herbal Medicine to help relieve symptoms of colds and flus (such as coughs, sore throat and mucus buildup (catarrh) of the (upper) respiratory tract) [Source note 12].
Flower
Used in Herbal Medicine to help relieve nasal congestion and discharge associated with sinusitis, hay fever/allergic rhinitis [Source note 13].
The above uses can be combined on the product label if from the same traditional or non-traditional system of medicine (e.g., Used in Herbal Medicine to help relieve symptoms of colds and flus and to help relieve nasal congestion and discharge associated with sinusitis, hay fever).
For multi-ingredient products:
To prevent the product from being represented as a “traditional medicine”, any indicated traditional use claim must refer to the specific active ingredient(s) and recognized traditional system of medicine from which the claim originates when 1) both traditional and modern claims are present or 2) when claims originate from multiple systems of traditional medicine (e.g., Black elder is traditionally used in Herbal Medicine as a diuretic).
When ALL of the active ingredients (MIs) in the product are used within the SAME identified system of traditional medicine AND the product makes ONLY traditional claims, listing of MIs in the traditional claim(s) is not required.
Who does this guide cover?
As specified below.
How is it taken?
Oral
Which forms are covered?
this reference excludes foods or food-like dosage forms as indicated in the Compendium of references Guidance Document.
Acceptable dosage forms by age group:
Children 2 years: The acceptable dosage forms are limited to emulsion/suspension and solution/ liquid preparations (Giacoia et al. 2008; EMA/CHMP 2006). Children 3-5 years: The acceptable dosage forms are limited to chewables, emulsion/suspension, powders and solution/liquid preparations (Giacoia et al. 2008; EMA/CHMP 2006). Children 6-11 years, Adolescents 12-17 years, and Adults 18 years and older:
Quantities
Flower
Methods of preparation: Dry, Powdered, Non-Standardized Ethanolic Extracts (Dry extract, Tincture, Fluid extract)
| Use(s) or purpose(s) | Subpopulation(s)¹,² | Subpopulation(s)¹,² | Dried flower (g/day) / Minimum | Dried flower (g/day) / Maximum |
|---|---|---|---|---|
| Children | 2-4 years | 0.25 g | 2.5 g |
| Children | 5-9 years | 0.375 g | 3.75 g |
| Children | 10-11 years | 0.75 g | 7.5 g |
| Adolescents | 12-13 years | 0.75 g | 7.5 g |
| Adolescents | 14-17 years | 1.5 g | 15 g |
| Adults | 18 years and older | 1.5 g | 15 g |
¹Children and adolescent doses were calculated as a proportion of the adult dose [Source note 14]. The use of Elder spp. in children and adolescents is supported by the following references: McIntyre 2005; Bove 2001; Gladstar 1999. ²Adult dose supported by the following references: Winston and Kuhn 2008; Bone 2003; WHO 2002; BHC 1992; Fyfe 1903.
Method of preparation: Infusion
| Use(s) or purpose(s) | Subpopulation(s)¹,² | Subpopulation(s)¹,² | Dried flower (g/day) / Minimum | Dried flower (g/day) / Maximum |
|---|---|---|---|---|
| Children | 2-4 years | 1 g | 2.5 g |
| Children | 5-9 years | 1.5 g | 3.75 g |
| Children | 10-11 years | 3 g | 7.5 g |
| Adolescents | 12-13 years | 3 g | 7.5 g |
| Adolescents | 14-17 years | 6 g | 15 g |
| Adults | 18 years and older | 6 g | 15 g |
¹Children and adolescent doses were calculated as a proportion of the adult dose [Source note 15]. The use of Elder spp. in children and adolescents is supported by the following references: McIntyre 2005; Bove 2001; Gladstar 1999. ²Adult dose supported by the following references: Hoffman 2003 Williamson 2003; WHO 2002; BHC 1992.
Fruit
Methods of preparation: Dry, Powdered, Non-Standardized Extracts (Dry extract*, Tincture, Fluid extract, Decoction, Decoction concentrate, Infusion, Infusion concentrate)
| Use(s) or purpose(s) | Subpopulation(s)¹,² | Subpopulation(s)¹,² | Dried fruit(g/day) / Minimum | Dried fruit(g/day) / Maximum |
|---|---|---|---|---|
| Children | 2-4 years | 0.217 g | 3 g |
| Children | 5-9 years | 0.325 g | 4.5 g |
| Children | 10-11 years | 0.65 g | 9 g |
| Adolescents | 12-13 years | 0.65 g | 9 g |
| Adolescents | 14-17 years | 1.3 g | 18 g |
| Adults | 18 years and older | 1.5 g | 15 g |
| Antioxidants | Adults | 18 years and Older | - | 18 g |
¹Children and adolescent doses were calculated as a proportion of the adult dose [Source note 16]. The use of Sambucus spp. in children and adolescents is supported by the following references: McIntyre 2005; Bove 2001; Gladstar 1999. ²Adult dose supported by the following references: Winston and Kuhn 2008; Tillotson 2001; Fyfe 1903.
*Note: Solvents allowed for the method of preparation “Non-standardized extracts (Dry extract)” as part of this reference are ethanol and/or water only.
How is it used?
The reference does not require an additional label statement in this section. This does not establish an absence of risk.
How long is it used?
Diuretic
For occasional use only [Source note 17].
All other products
The reference does not require an additional label statement in this section. This does not establish an absence of risk.
Warnings and precautions
All products
Ask a healthcare professional before use if you are pregnant or breastfeeding.
Diaphoretic; Symptoms of colds, flus; Sinusitis, hay-fever; Joint pain
Ask a healthcare professional if symptoms persist or worsen.
When should it be avoided?
The reference does not require an additional label statement in this section. This does not establish an absence of risk.
Possible side effects
All products
Stop use if hypersensitivity/allergy occur [Source note 18].
All products except those making a diuretic claim
When using this product diuretic effect may occur [Source note 19].
Storage
Must be established in accordance with the requirements described in the applicable product regulations.
Preparation details
Ingredient identity, preparation requirements, and other details that define the scope of this guide.
Ingredients and preparations
| Proper name(s) | Common name(s) | Source information / Source material(s) | Source information / Part(s) | Source information / Preparation(s) |
|---|---|---|---|---|
| Sambucus nigra subsp. nigra |
| Sambucus nigra subsp. nigra |
| Dry |
| Sambucus nigra subsp. canadensis |
| Sambucus nigra subsp. canadensis |
| Dry |
References: Proper names: USDA 2024; Gardner and McGuffin 2013; Common names: source ingredient database 2024; Source information: EMA 2018; Godfrey and Saunders 2010; Hoffman 2003.
Other ingredients
Must be chosen from the current source ingredient database and must meet the limitations outlined in the database.
Preparation and quality requirements
The finished product specifications must be established in accordance with the requirements described in the source authority source’s product quality guidance.
The active ingredient must comply with the requirements outlined in the source ingredient database.
Guide change history
Updates to this SupplementSafety.org guide.
Minor updates
Updated guide wording, organization, and source presentation. Added our editorial change history.
Initial release
Initial SupplementSafety.org guide prepared from source reference material.
Validation: Not yet completed. Editorial updates do not constitute clinical validation.
Sources
Source information
This guide organizes source material about uses, preparations, amounts, and precautions. Read the conditions alongside each statement; the information may apply only to particular preparations or populations.
The source document includes supporting references. We have not independently summarized or assessed every cited study for this guide.
- Source document version
- December 19, 2025
- Source captured
- Aug 15, 2026
- Editorial work
- Editorial preparation. Independent clinical review has not been recorded for this guide.
Full citations are available through the link above. Verification is required to open them; reading this guide does not require verification.
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Explore our supplement–medication interaction checker. Its coverage and review status are shown with the results; a missing finding does not establish that a combination is safe.