Elderberry (Sambucus) 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 more than 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.
At baseline, fever was present in 46.9% of the Elderberry group vs. 28.1% (p value not reported). Mean visual analog scale (VAS) score for self-assessed fever severity were 2.67 vs. 1.11 (p = 0.0256) in the two groups, which showed similar patterns of headache, muscle aches, and nasal congestion.
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% versus16% of patients. 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).
In the Elderberry group, 28% had no symptoms at 48 hours; none of the placebo-treated patients were totally symptom free (no p value reported, Number needed to treat (NNT)=4). Eighty-eight percent of the Elderberry patients reported at least some symptom relief and only 0-2 mild symptoms; 16% of the placebo patients had this degree of symptom resolution (no p value reported, NNT=2). There were no adverse effects reported in either group.
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 (www.newchapterblockade.com). In 2 other randomized trials, an Elderberry extract syrup marketed as Sambucol (http://www.sambucol.com/) 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.
This article was reprinted from the DynaMed Weekly Update – Volume 4 Issue 44, November 4, 2009. DynaMed, published by EBSCO (www.ebscohost.com) is a commercial-free clinical reference tool created by physicians for physicians and other health care professionals for use primarily at the ‘point-of-care’. Offering clinically-organized summaries for more than 3,000 topics, DynaMed is updated daily and monitors the content of over 500 medical journals and systematic evidence review databases directly and indirectly. The new evidence is then integrated with existing content, and overall conclusions are changed as appropriate representing a synthesis of the best available evidence.
For more information on H1N1 flu, see the Influenza in adults topic in DynaMed.
