Sambucol.ba - Frequent Asked Questions

Sambucol^® is a unique extract of black elderberry, nature’s richest source of the flavonoids known as anthocyanins. All flavonoids are powerful antioxidants that work to protect the body’s cells against the damaging effects of free radicals. But the flavonoids known as anthocyanins are thought to stimulate the body’s immune system as well, by increasing production of the chemical messenger that helps to activate an immune response. Sambucol^®, with its proprietary manufacturing process, preserves the natural potency of these unique flavonoids to help keep you healthy, especially when winter starts wearing you down.

Yes. Sambucol^® has been used as a daily supplement in countries around the world for more than a decade. The suggested dose for adults is 2 teaspoons of Sambucol® liquid once a day, which may be increased to 1 tablespoon four times a day during winter or whenever an added health boost may be required. The suggested dose for adults taking Sambucol^® lozenges is 1 lozenge twice a day, which may be increased to 2 lozenges three times a day as required.

Unlike other elderberry-based products, Sambucol^® is manufactured using a proprietary process designed to preserve the potency of the flavonoids found concentrated in the black elderberry. The result is a natural supplement that is both great tasting and uniquely rich in immune-supporting antioxidants.

Since its introduction in 1992, there have been no significant side effects reported in connection with the use of Sambucol^®.

Yes, there are such flavors used in the Sambucol Immuno Forte, Immuno Forte Sugar Free and Extra Defence Liquids, as well as Immuno Forte Pastilles, Immuno Forte Hot Drink and Teddies. 

All the Sambucol® Liquid products contain potassium sorbate as the preservative.

Sambucol Immuno Forte Pastilles contain honey.
Sambucol Extra Defence Liquid contains Vitamin D3, derived from sheep’s wool lanolin.

All the products in the Sambucol® product range are considered dairy free.

Yes, the Sambucol® range of products are gluten free.

None of the products from the Sambucol® range contain any artificial colors. The product gets its color from the elderberry extract.

Sambucol Immuno Forte Sugar Free Liquid, Sambucol Immuno Forte Pastilles, Sambucol Immuno Forte Effervescent Tablets and Sambucol Immuno Forte Capsules are all sugar-free. The remaining products either contain Glucose syrup or Sucrose.

None of the Sambucol® liquid products contain nuts or any ingredients derived from nuts. The facilities where the Sambucol® liquid products are manufactured do not use nuts or nut products during manufacture. The Sambucol® lozenge products also do not contain nuts or any ingredients derived from nuts. The facilities where the Sambucol® lozenge products are manufactured do not use nuts or nut products during manufacture.

Currently all products from the Sambucol® range are deemed as suitable for a kosher diet.

It is recommended to store the products in a dry and cool place.

The black elderberries used in Sambucol® are obtained from fruit growers in Austria and Eastern Europe.

Sambucol® liquids are produced in France, and other products are produced in Germany, Bulgaria and the UK.

No. Sambucol® is classified as a dietary supplement by the United States Food and Drug Administration.

To preserve quality and freshness, Sambucol^® should be kept tightly sealed and stored in a cool, dry place. As with all medications and dietary supplements, Sambucol^® should be kept out of the reach of children.

Once opened, Sambucol^® will remain effective for up to 27 months, if properly stored.

Sambucol Immuno Forte Pastilles contain honey and Sambucol Extra Defence Liquid contains vitamin D3, so these products are not suitable for vegans although they should still be suitable for vegetarians. All other products are suitable for both vegetarians and vegans.

Details of the uses of elderberry have been recorded since ancient times, as far back as the writings of Hippocrates, Dioscorides and Pliny the Elder. The berries have long been used for making preserves, wines, winter cordials and for adding flavor and color to other wines. These uses are based on the elderberries antioxidant properties. Through these actions, elderberry can help to support the immune system. More recently, elderberry has been used as dietary supplements and used in natural health products containing extracts of the berries.

• a) Stop the virus “Direct Inhibition”

Flavonoids from elderberries bind to haemagglutinin (HA) antigens on the surface of glycoprotein projections which cover the capsule head of the influenza virus. This inhibits the ability of the virus to bind to sialic acids on the extracellular membrane surface of healthy cells. The ability of the virus to then enter healthy cells (via endocytosis) is thereby inhibited.

• b) Cell protection “Indirect Inhibition”

Lectins (specifically S.Nigra Agglutinins SNAs) from elderberries have a high affinity to bind with sialic acids found on the membrane surface of healthy cells, which influenza A also uses to enter the host cell (by triggering endocytosis). Lectins, therefore, compete with the virus in binding to these sialic acids. Sialic acids are found in large concentration on the cell membranes of cells in the upper respiratory system which are targeted especially by Influenza virus.

• c) Immunity “Immuno-stimulation”

Pectic polysaccharides are the principal candidates of many possible components of elderberries that stimulate the body’s natural defense mechanisms. These polysaccharides are linked to an increase in cytokine production. Cytokines play a key role in the immune response to viral invasion.

The black elderberry for dark pigment contains a large concentration of a flavonoid group called anthocyanin. These natural antioxidants are called purple pigments. Studies that investigated the antioxidant activity of various fruits, including black apples, have shown that the antioxidant capacity of black elderberry is much higher than blackcurrant, cranberry and blueberries. Given the amount of stress people are exposed to today, it is very useful to take antioxidant supplements to protect the immune system. Many clinical studies have investigated the influence of black elderberry and Sambucol® activity, and some of them are:

• 1995 (Zakay-Rones)- A double-blind placebo controlled study was conducted during an outbreak of influenza B Panama. 93.3% of the cases treated with black elderberry compound saw a significant improvement in the symptoms. A complete cure was achieved within 2 to 3 days in nearly 90% of those treated with the black elderberry extract within two-three days, three days less than the placebo group.
• 2001 – (Barak, Halperin and Kalickman) 2 in-vitro studies have shown that extracts from black elderberry were beneficial to the stimulation of the immune system.
• 2004 – (Zakay-Rones) In a randomized, double-blind, placebo-controlled study, black elderberry extract was shown to significantly reduce the duration of the flu by around four days. Significantly fewer people who were taking the extract took pain relievers compared to the placebo group.
• 2005 –(Balasingham) During an in-vitro study carried out in London, black elderberry extract was found to be at least 99% effective against the H5N1 strain otherwise known as Avian Bird Flu.

Due to a lack of clinical data available on the use of Sambucol® during pregnancy, it is advisable to avoid taking the product at this time. Consumers are advised to consult their GP before starting to take any new supplement or medication during pregnancy.

There is no evidence to suggest whether Sambucol® should be taken before or after food. Given that Sambucol® is extracted from the berries of the black elder, some people may find it preferable to take after food.

No interactions between black elderberry and other medications were identified from the published worldwide literature. As with all medical conditions, the patient should check with a healthcare professional before using any other supplements or medications.

Due to a lack of clinical data available on the use of Sambucol® during breast feeding, it is advisable to avoid taking the product at this time. Consumers are advised to consult their GP before starting to take any new supplement or medication during breastfeeding.

All the Sambucol® products can be used in children. Please consult the dosage instructions on the individual Sambucol® product packs before use to ensure the correct dose is given for the child’s age.

No special dosage requirements are required for use by the elderly. Follow the recommended dosage on the product packaging.

After a thorough search of published literature, no evidence has been found and no clinical studies have been identified to suggest that black elderberry extracts, which are included in the Sambucol® products, have either a positive or negative effect on patients suffering from asthma. As with any pre-existing medical condition, it is advisable to consult a healthcare professional before starting to take any new supplement or medication.

All the Sambucol® products can be used in children, however the only product recommended for use in children under the age of 3 years is the Sambucol® for Children product.

Sambucol® contains an extract of black elderberries which have powerful antioxidant capabilities. Antioxidants are thought to help boost the immune system. We do not have any information on the use of Sambucol® in patients who are HIV positive. No clinical trials have been conducted in this area and we are unable to comment on the use of Sambucol® in HIV positive patients. As with any pre-existing medical condition the new use of food supplements or medications should be discussed with a healthcare professional.

A literature search was conducted using MEDLINE and PubMed. No records were identified that discussed the effects of blood pressure when taking Sambucol® products (or black elderberry extracts). No warnings or contra-indications regarding use in high blood pressure are included on the proposed SmPC.

Some of the Sambucol® range of products contains zinc and or vitamin C. In large quantities these have been reported to cause heartburn. Sambucol® should not cause heartburn or exacerbate it, provided that the recommended daily dose is adhered to and that any intensive use of the product is only short term. As with any pre-existing medical condition, it is advisable to check with a healthcare professional prior to use of food supplements or medications. If heartburn is experienced the use of the product should be discontinued.

Sambucol® contains an extract of black elderberries which have recognized antioxidant capabilities. Several clinical studies have shown that elderberries have the ability to help boost the immune system. PharmaCare (Europe) Ltd do not have any information on the use of Sambucol® in patients with low white blood cell count and no clinical trials have been conducted in this patient group. As with any pre-existing medical condition it is recommended that a consumer discuss the use of Sambucol® with a Healthcare Professional prior to its use.

Sambucol® contains an extract of black elderberries which have recognized antioxidant capabilities. Several clinical studies have shown that elderberries have the ability to help boost the immune system. PharmaCare (Europe) Ltd do not have any information on the use of Sambucol® in patients with breast cancer and no clinical trials have been conducted in this patient group. As with any pre-existing medical condition it is recommended that a consumer discuss the use of Sambucol® with a Healthcare Professional prior to its use.

Cytokines are produced by the immune system when it is under attack from viruses and pathogens. Cytokines signal immune cells to travel to the site of attack or infection. This is a normal body process that is kept under control by a feedback loop. Sometimes this process can become uncontrolled and too many immune cells are stimulated in a single place. This is often referred to as a cytokine storm. Cytokine storms can cause significant tissue and organ damage. There is no evidence in the literature to indicate that elderberry extract causes cytokine storms. We recommend that Sambucol® products, which contain elderberry extract be used only for the indications on the product labeling.

Information available from the Food Standards Agency and current Government guidelines on healthy eating, indicate that Sambucol® products cannot count as part of the recommended ‘5 a day’ portions of fruit and vegetables. This is based on the fact that only 100% fruit juices are allowed to be classified as a ‘portion of fruit’ and in order to obtain 100% fruit juice from Sambucol®, 150ml of the product would need to be consumed. This amount is not the amount currently recommended on Sambucol® packaging (see individual packs). The Sambucol® range is classed as food supplements and is not intended to replace fruit and vegetables in a diet.