Elder is a small tree native throughout Europe, western and central Asia, and North Africa, naturalized in the United States (Leung and Foster, 1996; Wichtl and Bisset, 1994). Elder is one of Germany's more important medicinal plant crops (Lange and Schippmann, 1997). The material of commerce, however, is mostly collected from the wild, mainly from the former U.S.S.R., former Yugoslavia, Bulgaria, Hungary, Romania, and the United Kingdom (BHP, 1996; Wichtl and Bisset, 1994). The Roman naturalist Pliny the Elder (ca. 23-79 b.c.) wrote of its uses, as did the Swiss alchemist and physician Paracelsus (1493-1541) (Grieve, 1979; Nadkarni, 1976). Its current therapeutic use as a diaphoretic in Germany and the United States stems from traditional Greek medicine. Its same indications for use in traditional Greek medicine have spread to India where it has been introduced into Ayurvedic medicine (Karnick, 1994; Nadkarni, 1976). It is used in Belgium and France as a diuretic (Bradley, 1992; Bruneton, 1995).
Well-designed human clinical studies have not been conducted on elder flower (Newall et al., 1996). The approved modern therapeutic applications for elder flower are supportable based on a combination of factors, including its long history of use in well established systems of traditional medicine, in vitro and in vivo studies in animals, and phytochemical investigations.
In Germany, elder flower is a standard medicinal tea used as a diaphoretic for feverish common colds. In both the United States and Germany it is also used as a component of compounds for cold and flu in dosage forms, including teas, alcoholic fluidextract or tincture, and native extract in solid dosage forms such as drages (coated tablets) (Bradley, 1992; Leung and Foster, 1996; Wichtl and Bisset, 1994). In the United States and Canada it is often combined with yarrow flower and peppermint leaf in formulas intended to relieve fevers associated with colds.
Pharmacopeial grade dried elder flower must contain not less than 0.8% total flavonoids, calculated as isoquercitrin (DAB 1997; Ph.Eur.3, 1998). The Pharmacopoeia of Switzerland requires not less than 0.7% flavonoids (Ph.Helv.VII, 1987). The dried flower should also contain not less than 25% water-soluble extract (Bradley, 1992).
Elder flower consists of the dried, sifted inflorescence of Sambucus nigra L. [Fam. Caprifoliaceae] as well as its preparations in effective dosage.
Chemistry and Pharmacology
Elder flower contains flavonoids (up to 3%) composed mainly of flavonol glycosides (astragalin, hyperoside, isoquercitrin, and rutin up to 1.9%) and free aglycones (quercetin and kaempferol); minerals (89%), mainly potassium; phenolic compounds (approx. 3% chlorogenic acid); triterpenes (approx. 1%) including α- and β-amyrin; triterpene acids (approximately 0.85% ursolic and oleanolic acids); sterols (approx. 0.11%); volatile oils (0.030.3%) composed of approx. 66% free fatty acids (linoleic, linolenic, and palmitic acids) and approximately 7% alkanes; mucilage; pectin; plastocynin (protein); sugar; tannins (Bradley, 1992; Leung and Foster, 1996; List and Hörhammer, 1973-1979; Newall et al., 1996; Wichtl and Bisset, 1994).
The Commission E reported diaphoretic and increased bronchial secretion activity.
The British Herbal Compendium reported diaphoretic and diuretic actions (Bradley, 1992). The mechanism of action is not fully understood. Its flavonoids and phenolic acids may contribute to the diaphoretic effect (Bradley, 1992). It has demonstrated anti-inflammatory, antiviral, and diuretic actions in in vitro studies. The flavonoids and triterpenes appear to be the main biologically active constituents (Newall et al., 1996).
The Commission E approved the internal use of elder flower for colds. The British Herbal Compendium lists its uses for common cold, feverish conditions, and as a diuretic (Bradley, 1992). The German Standard License for elder flower tea calls it a diaphoretic medicine for the treatment of feverish common colds or catarrhal complaints (Braun et al., 1997).
Use During Pregnancy and Lactation
No restrictions known.
Interactions with Other Drugs
Dosage and Administration
Unless otherwise prescribed: 10-15 g whole flower per day (3-5 g, three times daily).
Infusion: 3-4 g in 150 ml water, 1-2 cups sipped several times daily, as hot as may be taken safely.
Fluidextract 1:1 (g/ml): 1.5-3 ml (Erg.B.6).
Tincture 1:5 (g/ml): 2.5-7.5 ml (Erg.B.6).
Native soft extract 4.0-5.0:1 (w/w): 2-3.75 g (0.7-1.25 g three times daily).
Bradley, P.R. (ed.). 1992. British Herbal Compendium, Vol. 1. Bournemouth: British Herbal Medicine Association.
Braun, R. et al. 1997. Standardzulassungen für Fertigarzneimittel—Text and Kommentar. Stuttgart: Deutscher Apotheker Verlag.
British Herbal Pharmacopoeia (BHP). 1996. Exeter, U.K.: British Herbal Medicine Association.
Bruneton, J. 1995. Pharmacognosy, Phytochemistry, Medicinal Plants. Paris: Lavoisier Publishing.
Deutsches Arzneibuch (DAB 1997). 1997. Stuttgart: Deutscher Apotheker Verlag.
Ergänzungsbuch zum Deutschen Arzneibuch, 6th ed. (Erg.B.6). 1953. Stuttgart: Deutscher Apotheker Verlag.
Grieve, M. 1979. A Modern Herbal. New York: Dover Publications, Inc.
Lange D. and U. Schippmann. 1997. Trade Survey of Medicinal Plants in Germany—A Contribution to International Plant Species Conservation. Bonn: Bundesamt für Naturschutz. 32-33.
Leung, A.Y. and S. Foster. 1996. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2nd ed. New York: John Wiley & Sons, Inc.
List, P.H. and L. Hörhammer (eds.). 1973-1979. Hagers Handbuch der Pharmazeutischen Praxis, Vols. 1-7. New York: Springer Verlag.
Nadkarni, K.M. 1976. Indian Materia Medica. Bombay: Popular Prakashan. 1097.
Newall, C.A., L.A. Anderson, J.D. Phillipson. 1996. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press.
Pharmacopoeia Helvetica, 7th ed. Vol. 1-4.(Ph.Helv.VII). 1987. Bern: Office Central Fédéral des Imprimés et du Matériel.
Ph.Eur.3. See Europäisches Arzneibuch.
Wichtl, M. and N.G. Bisset (eds.). 1994. Herbal Drugs and Phytopharmaceuticals. Stuttgart: Medpharm Scientific Publishers.
British Herbal Pharmacopoeia (BHP). 1990. Bournemouth, U.K.: British Herbal Medicine Association.
British Pharmaceutical Codex (BPC). 1949. London: The Pharmaceutical Press.
Davidek, J. 1961. Isolation of Chromatographically Pure Rutin from Flowers of Elder. Nature 189:487-488.
Deutscher Arzneimittel-Codex (DAC). 1986-1991. Stuttgart: Deutscher Apotheker Verlag.
Hajkova, I.I. and V. Brazdova. 1963. [The content of some principals in Sambucus nigra flowers and fruits in the course of vegetation] [In Czech]. Farm Obzor 32:343-347.
Hänsel, R. and M. Kussmaul. 1975. Zwei Triterpene aus den Holunderblüten [Two triterpenes from the flowers of the elder]. Arch Pharm (Weinheim) 308(10):790-792.
Karnick, C.R. 1994. Pharmacopoeial Standards of Herbal Plants, Vol. 2. Delhi: Sri Satguru Publications. 49.
Kolodynska, M. and W. Pasieczna. 1967. Oznaczanie rutyny i kwercetyny w wybranych preparatach galenowych z kwiatow bzu czarnego (Sambucus nigra) [The determination of rutin and quercetin in selected galenic preparations of Sambucus nigra flowers] [In Polish]. Ann Univ Mariae Curie Sklodowska [Med] 22:127-130.
Lamaison J.L., C. Petitjean-Freytet, A. Carnat. 1991. Presence de 3-glucoside et de 3-rutinoside d'isorhamnetine dans les fleurs de Sambucus nigra L. [Presence of isorhamnetin 3-glucoside and 3-rutinoside in Sambucus nigra L. flowers]. Ann Pharm Fr 49(5):258-262.
Liefertova, I., J. Kudrnacova, V. Brazdova. 1971. [Substances contained in flowers and fruit of Sambucus during the growth period] [In Russian]. Acta Fac Pharm Univ Comeniana 20:57-82.
Lukash, L.L. et al. 1997. Vliianie lektina sotsvetii Sambucus nigra na spontannyi i indutisrovannyi alkiliruiushchim agentom mutagenez v somaticheskikh kletkakh mlekopitaiushchikh [The effect of the lectin from Sambucus nigra inflorescences on spontaneous and alkylating agent-induced mutagenesis in mammalian somatic cells]. Tsitol Genet 31(5):52-60.
McGuffin, M., C. Hobbs, R. Upton, A. Goldberg. 1997. American Herbal Product Association's Botanical Safety Handbook. Boca Raton: CRC Press.
Pietta, P., A. Bruno, P. Mauri, A. Rava. 1992. Separation of flavonol-2-O-glycosides from Calendula officinalis and Sambucus nigra by high-performance liquid and micellar electrokinetic capillary chromatography. J Chromatogr 593(12):165-170.
Radu, A., M. Tamas, A. Otlacan. 1976. [Comparative study of flavones in indigenous Elder flowers (Sambucus nigra L., S. ebulus L., S. racemosa L.)] [In Romanian]. Farmacia (Bucharest) 24:9-15.
Reynolds, J.E.F. (ed.). 1993. Martindale: The Extra Pharmacopoeia, 30th ed. London: The Pharmaceutical Press.
Richter, W. and G. Willuhn. 1977. Zur Kenntnis der Inhaltsstoffe von Sambucus nigra L.III. Bestimmung des Ursol- und Oleanolsure-, des Amyrin- und Steringehaltes der Flores Sambuci DAB 7. Pharm Ztg 122:1567-1570.
Schmersahl, K.J. 1964. Über die Wirkstoffe der diaphoretischen Drogen des DAB 6. Naturwissenschaften 51:361.
Serkedjieva, J. et al. 1990. Antiviral activity of the infusion (SHS-174) from flowers of Sambucus nigra L., aerial parts of Hypericum perforatum L., and roots of Saponaria officinalis L. against influenza and herpes simplex viruses. Phytotherapy Res 4:97.
Steinegger, E. and R. Hänsel. 1988. Lehrbuch der Pharmakognosie und Phytopharmazie. Berlin-Heidelberg; New York: Springer Verlag.
Taylor, M. 1998. Elderflower. Canadian Journal of Herbalism 6-7.
Toulemonde, B. and H.M.J. Richard. 1983. Volatile constituents of dry elder (Sambucus nigra L.) flowers. J Agric Food Chem 31:365-370.
This material was adapted from The Complete German Commission E Monographs—Therapeutic Guide to Herbal Medicines. M. Blumenthal, W.R. Busse, A. Goldberg, J. Gruenwald, T. Hall, C.W. Riggins, R.S. Rister (eds.) S. Klein and R.S. Rister (trans.). 1998. Austin: American Botanical Council; Boston: Integrative Medicine Communications.
1) The Overview section is new information.
2) Description, Chemistry and Pharmacology, Uses, Contraindications, Side Effects, Interactions with Other Drugs, and Dosage sections have been drawn from the original work. Additional information has been added in some or all of these sections, as noted with references.
3) The dosage for equivalent preparations (tea infusion, fluidextract, and tincture) have been provided based on the following example:
Unless otherwise prescribed: 2 g per day of [powdered, crushed, cut or whole] [plant part]
Infusion: 2 g in 150 ml of water
Fluidextract 1:1 (g/ml): 2 ml
Tincture 1:5 (g/ml): 10 ml
4) The References and Additional Resources sections are new sections. Additional Resources are not cited in the monograph but are included for research purposes.
This monograph, published by the Commission E in 1994, was modified based on new scientific research. It contains more extensive pharmacological and therapeutic information taken directly from the Commission E.
Excerpt from Herbal Medicine: Expanded Commission E Monographs Copyright 2000 American Botanical Council Published by Integrative Medicine Communications Available from the American Botanical Council.