Ingredients | Amount Per Serving |
---|---|
Proprietary Blend
|
1000 mg |
(bee propolis)
|
|
Dextrose
|
|
Honey Granules
(Not a significant source of added sugars.)
|
|
(fruit)
|
|
Wheat Germ
|
Gelatin, Silica, Magnesium Stearate (Alt. Name: Mg Stearate), Talc, Artificial flavor, Riboflavin
Below is general information about the effectiveness of the known ingredients contained in the product Honeybee Propolis with Elderberry. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
Below is general information about the safety of the known ingredients contained in the product Honeybee Propolis with Elderberry. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
LIKELY SAFE ...when used orally in amounts commonly found in foods. Carob has Generally Recognized as Safe (GRAS) status (4912).
POSSIBLY SAFE ...when used orally in medicinal amounts, short-term. Carob fiber containing 80% polyphenols (Exxenterol, Puleva Biotech SA) has been used with apparent safety in doses of up to 8 grams daily for up to 12 weeks (97846). A beverage made with carob pod extract (Fruit Up, Wild-Valencia SAU) has been used with apparent safety at a dose of 500 mL daily for up to 12 weeks (97849). Carob pod powder has been safely used in doses up to 1500 mg daily for up to 90 days (111127).
CHILDREN: POSSIBLY SAFE
when used in full-term infants.
Carob-based milk thickeners have been used with apparent safety in full-term infants as an additive in infant formula (39972,39991,104239,111128).
CHILDREN: POSSIBLY UNSAFE
when used in preterm infants.
A carob-based milk thickener (Carobel) has been associated with necrotizing enterocolitis leading to death in two low birth-weight infants (39991).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when used orally and appropriately (13161,14306,14307,14308,15655,15752,17187,92271,92274,103247)(103250,108898). However, cocoa naturally contains caffeine, and caffeine may be unsafe when used orally in doses of more than 400 mg daily (11733,98806). While most cocoa products contain only small amounts of caffeine (about 2-35 mg per serving) (2708,3900), one cup of unsweetened, dry cocoa powder can contain up to 198 mg of caffeine (100515). To be on the safe side, cocoa should be used in amounts that provide less than 400 mg of caffeine daily. Keep in mind that only the amount of ADDED caffeine must be stated on product labels. The amount of caffeine naturally found in ingredients such as cocoa does not need to be provided. This can make it difficult to determine the total amount of caffeine in a given product. Cocoa and dark chocolate products worldwide also contain heavy metals such as lead and cadmium. In the US, one ounce (approximately 28 grams) of most commercially available dark chocolate products tested contained levels of lead and/or cadmium above the maximum allowable dose level for California, with cadmium levels generally increasing with the percentage of cocoa (109847,109848,109849). Advise patients to consume cocoa in moderation. ...when used topically. Cocoa butter is used extensively as a base for ointments and suppositories and is generally considered safe (11).
CHILDREN: POSSIBLY UNSAFE
when dark chocolate is used orally.
Cocoa and dark chocolate products worldwide contain heavy metals such as lead and cadmium. In the US, one ounce (approximately 28 grams) of most commercially available dark chocolate products tested contained levels of lead and/or cadmium above the maximum allowable dose level for California, with cadmium levels generally increasing with the percentage of cocoa (109847,109848,109849). Children are at increased risk of adverse effects from intake of lead and/or cadmium. There is insufficient reliable information available about the safety of other chocolate-based products that typically contain smaller quantities of cocoa.
PREGNANCY: POSSIBLY SAFE
when used orally in moderate amounts.
However, due to the caffeine content of cocoa preparations, intake should be closely monitored during pregnancy to ensure moderate consumption. Fetal blood concentrations of caffeine approximate maternal concentrations (4260). Some research has found that intrauterine exposure to even modest amounts of caffeine, based on maternal blood levels during the first trimester, is associated with a shorter stature in children ages 4-8 years (109846). While many cocoa products contain only small amounts of caffeine (about 2-35 mg per serving) (2708,3900), unsweetened, dry cocoa powder can contain up to 198 mg of caffeine per cup (100515). According to a review by Health Canada, and a subsequent large meta-analysis conducted in the US, doses of up to 300 mg daily can be consumed during pregnancy without an increased risk of spontaneous abortion, still birth, preterm birth, fetal growth retardation, or congenital malformations (11733,98806). To be on the safe side, cocoa should be used in amounts that provide less than 300 mg of caffeine daily. Keep in mind that only the amount of ADDED caffeine must be stated on product labels. The amount of caffeine found in ingredients such as cocoa, which naturally contains caffeine, does not need to be provided. This can make it difficult to determine the total amount of caffeine in a given product.
PREGNANCY: POSSIBLY UNSAFE
when used orally in large amounts.
Caffeine found in cocoa crosses the placenta producing fetal blood concentrations similar to maternal levels (4260). Consumption of caffeine in amounts over 300 mg daily is associated with a significantly increased risk of miscarriage in some studies (16014,98806). Additionally, high intake of caffeine during pregnancy have been associated with premature delivery, low birth weight, and loss of the fetus (6). While many cocoa products contain only small amounts of caffeine (about 2-35 mg per serving) (2708,3900), unsweetened, dry cocoa powder can contain up to 198 mg of caffeine per cup (100515). To be on the safe side, cocoa should be used in amounts that provide less than 300 mg of caffeine daily (2708). Keep in mind that only the amount of ADDED caffeine must be stated on product labels. The amount of caffeine found in ingredients such as cocoa, which naturally contains caffeine, does not need to be provided. This can make it difficult to determine the total amount of caffeine in a given product. Cocoa and dark chocolate products worldwide also contain heavy metals such as lead and cadmium. In the US, one ounce (approximately 28 grams) of most commercially available dark chocolate products tested contained levels of lead and/or cadmium above the maximum allowable dose level for California, with cadmium levels generally increasing with the percentage of cocoa (109847,109848,109849). Large doses or excessive intake of cocoa should be avoided during pregnancy.
LACTATION: POSSIBLY SAFE
when used in moderate amounts or in amounts commonly found in foods.
Due to the caffeine content of cocoa preparations, intake should be closely monitored while breastfeeding. During lactation, breast milk concentrations of caffeine are thought to be approximately 50% of serum concentrations. Moderate consumption of cocoa would likely result in very small amounts of caffeine exposure to a nursing infant (6). Keep in mind that only the amount of ADDED caffeine must be stated on product labels. The amount of caffeine found in ingredients such as cocoa, which naturally contains caffeine, does not need to be provided. This can make it difficult to determine the total amount of caffeine in a given product.
LACTATION: POSSIBLY UNSAFE
when used orally in large amounts.
Consumption of excess chocolate (16 oz per day) may cause irritability and increased bowel activity in the infant (6026). Cocoa and dark chocolate products worldwide also contain heavy metals such as lead and cadmium. In the US, one ounce (approximately 28 grams) of most commercially available dark chocolate products tested contained levels of lead and/or cadmium above the maximum allowable dose level for California, with cadmium levels generally increasing with the percentage of cocoa (109847,109848,109849). Large doses or excessive intake of cocoa should be avoided during lactation.
LIKELY SAFE ...when used orally in the amounts typically found in foods. Elderberry has generally recognized as safe (GRAS) status in the US (4912).
POSSIBLY SAFE ...when elderberry fruit extract is used orally, short-term. One specific elderberry fruit extract (Sambucol, Nature's Way) has been used with apparent safety for up to 5 days (5260,12235,103831); another (BerryPharma, Iprona AG) has been used with apparent safety for up to 15 days (91374). A specific elderberry fruit extract lozenge (ViraBLOC, HerbalScience) has been used with apparent safety for 2 days (17022). Other elderberry fruit extracts have been used with apparent safety for up to 12 weeks (21141,21142).
POSSIBLY UNSAFE ...when elder tree leaves and stems, or unripe or uncooked elderberries, are consumed. The unripe green fruit, as well as the leaves and stems of the elder tree, contain a cyanide-producing chemical, which can cause serious toxicity (17020,17021,21143,21144,91374). Cooking eliminates the toxin.
CHILDREN: LIKELY SAFE
when consumed in the amounts typically found in foods.
CHILDREN: POSSIBLY SAFE
when used orally for up to 3 days.
A specific fruit extract (Sambucol, Nature's Way) has been used in doses of 15 mL twice daily for 3 days in children 5 years and older (5260,103831).
CHILDREN: POSSIBLY UNSAFE
when unripe or uncooked elderberries are consumed.
The unripe green fruit, as well as the leaves and stems of the elder tree, contain a cyanide-producing chemical , which can cause serious toxicity (17020,17021,21143,21144,91374). Cooking eliminates the toxin.
PREGNANCY AND LACTATION: LIKELY SAFE
when consumed in the amounts typically found in foods.
There is insufficient reliable information available about the safety of elderberry when used for medicinal purposes; avoid using in amounts greater than those found in foods.
POSSIBLY SAFE ...when used orally and appropriately. Propolis has been used with apparent safety in clinical research at doses of up to 1500 mg daily (95883,99173,102520,102521). ...when used topically. Propolis as a 3% or 10% ointment, 0.5% cream, 30% mouth rinse, or 15% solution has been used with apparent safety in small clinical studies (799,1926,6602,8663,17629,17664,17665,92793,92800,95882)(99171,99173,102519,102521,105785,105786,108516,108523,109985).
PREGNANCY:
Insufficient reliable information available; avoid using.
LACTATION: POSSIBLY SAFE
when used orally and appropriately during lactation.
Propolis 300 mg daily has been used for 4-10 months in one clinical study with no apparent adverse effects to nursing infants (102518).
Below is general information about the interactions of the known ingredients contained in the product Honeybee Propolis with Elderberry. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
Theoretically, carob might also impair the absorption of oral drugs.
Details
|
Theoretically, taking cocoa with ACEIs might increase the risk of adverse effects.
Details
|
Theoretically, cocoa might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Details
Cocoa contains caffeine. Caffeine is a competitive inhibitor of adenosine at the cellular level. However, caffeine does not seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole than adenosine-induced stress testing (11771).
|
Theoretically, concomitant use might increase levels and adverse effects of caffeine.
Details
Cocoa contains caffeine. Alcohol reduces caffeine metabolism. Concomitant use of alcohol can increase caffeine serum concentrations and the risk of caffeine adverse effects (6370).
|
Theoretically, cocoa may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Details
Clinical research shows that intake of cocoa can inhibit platelet adhesion, aggregation, and activity (6085,17076,41928,41948,41957,41958,41995,42014,42070,42145)(111526) and increase aspirin-induced bleeding time (23800). For patients on dual antiplatelet therapy, cocoa may enhance the inhibitory effect of clopidogrel, but not aspirin, on platelet aggregation (111526).
|
Theoretically, taking cocoa with antihypertensive drugs might increase the risk of hypotension.
Details
|
Theoretically, large amounts of cocoa might increase the cardiac inotropic effects of beta-agonists.
Details
Cocoa contains caffeine. Theoretically, large amounts of caffeine might increase cardiac inotropic effects of beta-agonists (15). A case of atrial fibrillation associated with consumption of large quantities of chocolate in a patient with chronic albuterol inhalation abuse has also been reported (42075).
|
Theoretically, concomitant use might increase the effects and adverse effects of caffeine in cocoa.
Details
|
Theoretically, concomitant use might increase the effects and adverse effects of caffeine found in cocoa.
Details
|
Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Details
Cocoa contains caffeine. Caffeine is metabolized by cytochrome P450 1A2 (CYP1A2) (3941,5051,11741,23557,23573,23580,24958,24959,24960,24962), (24964,24965,24967,24968,24969,24971,38081,48603). Theoretically, drugs that inhibit CYP1A2 may decrease the clearance rate of caffeine from cocoa and increase caffeine levels.
|
Theoretically, cocoa might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Details
Cocoa contains caffeine. Caffeine may inhibit dipyridamole-induced vasodilation (11770,11772). It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests (11770). Methylxanthines appear more likely to interfere with dipyridamole than adenosine-induced stress testing (11771).
|
Theoretically, disulfiram might increase the risk of adverse effects from caffeine.
Details
Cocoa contains caffeine. In human research, disulfiram decreases the rate of caffeine clearance (11840).
|
Theoretically, using cocoa with diuretic drugs might increase the risk of hypokalemia.
Details
|
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Details
|
Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Details
Cocoa contains caffeine. Estrogen inhibits caffeine metabolism (2714).
|
Theoretically, fluconazole might increase the levels and adverse effects of caffeine.
Details
Cocoa contains caffeine. Fluconazole decreases caffeine clearance by approximately 25% (11022).
|
Theoretically, cocoa might increase the levels and adverse effects of flutamide.
Details
Cocoa contains caffeine. In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide (23553).
|
Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Details
Cocoa contains caffeine. Fluvoxamine reduces caffeine metabolism (6370).
|
Theoretically, abrupt cocoa withdrawal might increase the levels and adverse effects of lithium.
Details
|
Theoretically, methoxsalen might increase the levels and adverse effects of caffeine.
Details
Cocoa contains caffeine. Methoxsalen can reduce caffeine metabolism (23572).
|
Theoretically, metformin might increase the levels and adverse effects of caffeine.
Details
Cocoa contains caffeine. Animal research suggests that metformin can reduce caffeine metabolism (23571).
|
Theoretically, mexiletine might increase the levels and adverse effects of caffeine.
Details
|
Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Details
Cocoa contains caffeine. Large amounts of caffeine with MAOIs might precipitate a hypertensive crisis (15).
|
Theoretically, concomitant use might increase the risk of hypertension.
Details
Cocoa contains caffeine. Concomitant use of caffeine and nicotine has been shown to have additive cardiovascular effects, including increased heart rate and blood pressure. Blood pressure was increased by 10.8/12.4 mmHg when the agents were used concomitantly (36549).
|
Theoretically, cocoa might decrease the effects of pentobarbital.
Details
Cocoa contains caffeine. Caffeine might negate the hypnotic effects of pentobarbital (13742).
|
Theoretically, cocoa might reduce the effects of phenobarbital and increase the risk for convulsions.
Details
|
Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Details
|
Theoretically, phenylpropanolamine might increase the risk of hypertension, as well as the levels and adverse effects of caffeine.
Details
|
Theoretically, cocoa might reduce the effects of phenytoin and increase the risk for convulsions.
Details
|
Theoretically, quinolone antibiotics might increase the levels and adverse effects of caffeine.
Details
|
Theoretically, concomitant use might increase the levels and adverse effects of both caffeine and riluzole.
Details
Cocoa contains caffeine. Caffeine and riluzole are both metabolized by cytochrome P450 1A2, and concomitant use might reduce metabolism of one or both agents (11739).
|
Theoretically, concomitant use might increase stimulant adverse effects.
Details
Cocoa contains caffeine. Concomitant use might increase the risk of stimulant adverse effects (11832).
|
Theoretically, terbinafine might increase the levels and adverse effects of caffeine.
Details
Cocoa contains caffeine. Terbinafine decreases the rate of caffeine clearance (11740).
|
Theoretically, cocoa might increase the levels and adverse effects of theophylline.
Details
|
Theoretically, cocoa tea might increase the levels and adverse effects of tiagabine.
Details
Cocoa contains caffeine. Animal research suggests that chronic caffeine administration can increase the serum concentrations of tiagabine. However, concomitant use does not seem to reduce the antiepileptic effects of tiagabine (23561).
|
Theoretically, ticlopidine might increase the levels and adverse effects of caffeine.
Details
Cocoa contains caffeine. In vitro evidence suggests that ticlopidine can inhibit caffeine metabolism (23557). However, this effect has not been reported in humans.
|
Theoretically, cocoa might reduce the effects of valproate and increase the risk for convulsions.
Details
|
Theoretically, verapamil might increase the levels and adverse effects of caffeine.
Details
Cocoa contains caffeine. Verapamil increases plasma caffeine concentrations by 25% (11741).
|
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Details
Elderberry has immunostimulant activity, increasing the production of cytokines, including interleukin and tumor necrosis factor (10796).
|
Theoretically, propolis might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Details
In vitro research shows that propolis water extract and the propolis constituent, caffeic acid phenethyl ester, can inhibit platelet aggregation (50794,95885). Additionally, evidence from an animal model shows that taking propolis in addition to warfarin decreases INR, suggesting that propolis can decrease the effectiveness of warfarin (95874).
|
Theoretically, high doses of propolis might increase blood levels of drugs metabolized by CYP1A2.
Details
In vitro research shows that propolis extract can inhibit CYP1A2 (92797,92799). However, animal research shows that propolis extract does not significantly affect CYP1A2 activity when administered to rats at doses up to 250 mg/kg. It is postulated that the constituents of propolis that inhibit CYP1A2 in vitro do not have significant effects in vivo due to low bioavailability and hepatic first-pass effect (92797). This effect has not been reported in humans.
|
Theoretically, high doses of propolis might increase blood levels of drugs metabolized by CYP2C19.
Details
In vitro research shows that propolis extract can inhibit CYP2C19 (92797,92799). However, animal research shows that propolis extract does not significantly affect CYP2C19 activity when administered to rats at doses up to 250 mg/kg. It is postulated that the constituents of propolis that inhibit CYP2C19 in vitro do not have significant effects in vivo due to low bioavailability and hepatic first-pass effect (92797). This effect has not been reported in humans.
|
Theoretically, high doses of propolis might increase blood levels of drugs metabolized by CYP2C9.
Details
In vitro research shows that propolis extract can inhibit CYP2C9 (92797,92799). However, animal research shows that propolis extract does not significantly affect CYP2C9 activity when administered to rats at doses up to 250 mg/kg. It is postulated that the constituents of propolis that inhibit CYP2C9 in vitro do not have significant effects in vivo due to low bioavailability and hepatic first-pass effect (92797). This effect has not been reported in humans.
|
Theoretically, high doses of propolis might increase blood levels of drugs metabolized by CYP2D6.
Details
In vitro research shows that propolis extract can inhibit CYP2D6 (92797,92799). However, animal research shows that propolis extract does not significantly affect CYP2D6 activity when administered to rats at doses up to 250 mg/kg. It is postulated that the constituents of propolis that inhibit CYP2D6 in vitro do not have significant effects in vivo due to low bioavailability and hepatic first-pass effect (92797). This effect has not been reported in humans.
|
Theoretically, propolis might increase levels of drugs metabolized by CYP2E1.
Details
In vitro research shows that propolis can inhibit CYP2E1 (92799). This effect has not been reported in humans.
|
Theoretically, high doses of propolis might increase blood levels of drugs metabolized by CYP3A4.
Details
Some in vitro research shows that propolis extract can inhibit CYP3A4 (92797); however, other in vitro research shows that propolis has no effect on CYP3A4 activity (92799). Furthermore, animal research shows that propolis extract does not significantly affect CYP3A4 activity when administered to rats at doses up to 250 mg/kg. It is postulated that the constituents of propolis that might in inhibit CYP3A4 in vitro do not have significant effects in vivo due to low bioavailability and hepatic first-pass effect (92797). This effect has not been reported in humans.
|
Theoretically, propolis might decrease the effectiveness of warfarin.
Details
Animal research shows that taking propolis in addition to warfarin decreases the international normalized ratio (INR) (95874). This effect has not been reported in humans.
|
Below is general information about the adverse effects of the known ingredients contained in the product Honeybee Propolis with Elderberry. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
General
...Orally, carob seems to be generally well tolerated when eaten as food or when added to food.
Serious Adverse Effects (Rare):
Orally: Serious allergic reactions in sensitive individuals.
Gastrointestinal ...Orally, the addition of a carob milk thickener (Carobel) to preterm infant feeds has been associated with necrotizing enterocolitis leading to death in two low birth-weight infants (39991). This adverse effect has not been reported in term infants.
Immunologic
...A five month-old child who was allergic to an anti-regurgitation milk formula containing carob gum experienced urticaria, rash, and explosive vomiting within 30 minutes of administration of the formula (39969).
In a separate case, an 11-week-old infant with Down syndrome presented with persistent vomiting, watery diarrhea, and lethargy requiring IV hydration. The infant had previously been diagnosed with food protein-induced enterocolitis syndrome (FPIES), likely due to cow's milk. He had consumed formula containing a carob gum thickener; the reaction resolved upon discontinuation of the carob gum additive. An oral challenge test to carob produced a reaction, confirming this as the likely causative agent (104235). In another case, a 52-year-old man experienced chest tightness, throat discomfort, and burning sensations related to an oral allergy to carob pods (97850).
Occupational exposure to carob flour has been reported to cause allergic asthma and rhinitis (39987,40015).
General
...Orally and topically, cocoa is generally well tolerated.
Most Common Adverse Effects:
Orally: Borborygmi, constipation, diuresis, gastrointestinal discomfort, headaches, and nausea.
Serious Adverse Effects (Rare):
Orally: Tachycardia.
Cardiovascular ...Some cases of increased heart rate have been reported with oral cocoa use (13161,42132).
Dermatologic ...In some cases, when taken orally, cocoa can cause allergic skin reactions (13161). Topically, cocoa butter has occasionally caused a rash. In animals, it has been shown to block pores and cause acne; however, this has not been found in humans (11).
Gastrointestinal ...In human trials, chocolate consumption was associated with a higher incidence of flatulence, irritable bowel syndrome, upset stomach, gastric upset, borborygmi (a gurgling noise made by fluid or gas in the intestines), bloating, nausea, vomiting, and constipation or obstipation (41986,42221,41921,1374,42220,1373,42099,42097,42156,42123,18229,42169,42111). Chocolate consumption has been implicated as a provoking factor in gastroesophageal reflux disease (GERD) (41974,42005,41946,1374). Unpalatability has been reported (42079,42169). Consumption of chocolate and other sweet foods may lead to increased dental caries (42129,42030).
Genitourinary ...In some cases, when taken orally, cocoa can cause increased urination (13161).
Neurologic/CNS ...In some cases, when taken orally, cocoa can cause shakiness and might trigger migraine and other headaches (13161,42169,92271).
Other ...Due to the high sugar and caloric content of chocolate, there is concern about weight gain in people who consume large amounts of chocolate (17187).
General
...Orally, elderberry extracts prepared from ripe fruit seem to be well tolerated.
Most Common Adverse Effects:
Orally: When adverse effects occur, they are likely due to ingestion of raw and unripe elderberries, or seeds, leaves, and other plant parts. Due to cyanogenic glycosides, these may cause nausea, vomiting, severe diarrhea, weakness, dizziness, numbness, and stupor. Cooking eliminates the toxin.
Gastrointestinal
...Orally, nausea and vomiting have been reported after consuming a specific elderberry and echinacea product
Vogel Bioforce AG) (95650). However, it is unclear if this was due to the elderberry or Echinacea contained in the product.
Raw and unripe elderberries, and the seeds, leaves, and other elder tree parts might cause nausea, vomiting, or severe diarrhea due to cyanogenic glycosides (17020,17021). Cooking eliminates the toxin.
Hepatic ...In one case report, a 60-year-old female with underlying autoimmune disease presented with autoimmune hepatitis after taking elderberry at an unknown dose for several years. The patient presented with nausea, jaundice, abdominal pain, and abdominal distention. Liver function tests returned to baseline 4 weeks after initiating treatment with prednisone 40 mg daily and discontinuing elderberry (110123).
Immunologic ...Elder tree pollen might cause an allergic reaction characterized by rhinitis and dyspnea in some patients who are allergic to grass pollen. These patients might also experience an allergic reaction to elderberry extracts (11095).
Neurologic/CNS ...Raw and unripe elderberries might cause weakness, dizziness, numbness, and stupor due to cyanogenic glycosides (17020,17021). Cooking eliminates the toxin.
General
...Orally and topically, propolis seems to be well tolerated.
Most Common Adverse Effects:
Orally: Headache.
Topically: Contact cheilitis and contact dermatitis in sensitive individuals.
Serious Adverse Effects (Rare):
Orally: Severe allergic reactions in sensitive individuals.
Dermatologic
...Propolis can cause allergic reactions and acute oral mucositis with ulceration from the use of the propolis-containing lozenges (2632).
Topically, propolis-containing products, including some cosmetics, can cause eczematous contact dermatitis, erythema multiforme-like contact dermatitis, or allergic contact cheilitis (2632,15647,92796,92798,95878,95882,102517).
Patients allergic to bees or bee products may be more likely to experience allergic reactions to propolis.
Genitourinary ...Vulvar eczema caused by propolis sensitization after topical therapy has been reported (70067).
Hepatic ...Orally, propolis may cause an increase in liver enzymes when used long-term at high doses. In one case, a 30-year-old male presented with persistent abnormal liver enzymes for six months. With other causes ruled out, the patient disclosed using more than 10 propolis lozenges per day for several months to treat a sore throat. Upon discontinuation of the propolis lozenges, liver enzymes returned to normal (105788). Despite concerns presented in this case, analyses of small clinical studies suggest that propolis may have hepatoprotective effects when used at doses of 500-1000 mg daily for up to one year (108521,108522).
Immunologic
...In one case report, a 36-year-old female developed severe erythematous papules and patches with edema of the face, neck, arms, abdomen, and thighs after consuming propolis solution for a few weeks.
After symptom resolution, a patch test showed an extreme positive reaction to propolis (106443). In another case, laryngeal edema and severe anaphylactic reaction has been reported in a patient who used topical propolis for the treatment of acute pharyngitis. The patient died due to complications of hypoxia that resulted from the allergic reaction (70063).
Topically, propolis-containing products can cause allergic contact dermatitis, including cheilitis, when used on or near the lips or mouth (15647,92796,92798,102517). Propolis-containing lozenges can cause allergic reactions as well as acute oral mucositis with ulceration (2632).
Patients allergic to bees or bee products may be more likely to experience allergic reactions to propolis.
Neurologic/CNS ...Orally, propolis may cause headache in some patients. In one clinical trial, around 7% of patients taking propolis 250 mg twice daily for 4 months reported mild headache (105786).
Renal ...In one case report, a 59-year-old male with cholangiocarcinoma developed acute kidney failure requiring hemodialysis after taking a Brazilian preparation of propolis 5 mL three times daily for 2 weeks. Renal function improved when propolis was discontinued. The patient restarted taking propolis and symptoms developed again and the patient again required hemodialysis. Symptoms of renal failure improved when propolis was finally discontinued. This product was not screened for contaminants; however, family members of this patient used the same product without apparent adverse effects (14300).