Elderberry extract has long been used as a folk remedy for cold and influenza symptoms. A recent randomized trial provides evidence for its efficacy (level 2 [mid-level] evidence). During the spring 2009 influenza season in China, 64 patients with ≥ 3 influenza-like symptoms (fever, headache, myalgias, coughing, nasal mucus discharge, nasal congestion) were randomized within 24 hours of symptom onset to elderberry extract lozenge (175 mg) vs. placebo orally 4 times daily for 2 days. After 48 hours, the rate of complete symptom relief was higher in the elderberry group (28% vs. 0%, no p value reported), with at least some symptom relief (only 0-2 mild symptoms remaining) reported in 88% vs. 16% for placebo (no p value reported). Elderberry extract was associated with significantly improved symptom severity scores for headache, nasal congestion, muscle aches, and fever at 24 hours (p < 0.001) and for all symptoms at 48 hours (p < 0.001). The elderberry group had higher symptom scores at baseline, however, suggesting that the groups may have been at different stages in their overall illness course despite randomization within 24 hours (Online J Pharmacol Pharmacokin 2009;5:32).

The elderberry extract in this new study is a proprietary product marketed as ViraBLOC. In 2 other randomized trials, an elderberry extract syrup preparation marketed as Sambucol was associated with higher rates of symptom resolution in fewer days. It is important to note that these products may shorten the duration of symptoms but are not substitutes for standard preventive measures, such as immunization, handwashing, and avoiding close contact when sick.