In several studies, Sinupret has been compared to established mucokinetic drugs, including acetylcysteine and ambroxol (derived from the Ayuverdic herb, vasaka) for patients with acute bronchitis. Similar clinical benefits were shown, and there was equivalent improvement in mucociliary clearance In an observational study involving over 300 centers, 3187 patients with acute bronchitis or exacerbations of chronic bronchitis were evaluated. Similar symptomatic benefits were reported with Sinupret as were seen with the standard mucokinetic drugs.
These studies did not evaluate elderberry separately, and those for bronchitis did not evaluate Sinupret against a placebo. Since the beneficial effects of allopathic expectorants and mucolytics have not been adequately demonstrated, Sinupret and elder flowers cannot be regarded as having objectively proved their value.
Using a standardized black elderberry extract (Sambucol), a double-blind, placebo-controlled trial of 40 Israeli subjects was carried out during an influenza outbreak. Symptoms and fever improved significantly within 2 days in 93.3% of subjects in the treatment group, whereas the same degree of improvement was achieved by 91.7% of the controls at 6 days (P < 0.001). The preparation was also reported to increase hemagglutination inhibition titers to infuenza B, and to inhibit replication of strains of influenza A and . Although this surprisingly successful outcome has led to the promotion of Sambucol for influenza, the study has yet to be replicated.
There are no recognized adverse effects, although data is limited. It is suggested that a diuretic effect may result in hYPokalemia, but this has not been objectively reported or studied.
Side Effects and Interactions:
There are no recognized drug interactions.
The stems, roots, unripe berries, and seeds may contain cyanide, and could cause vomiting and severe diarrhea if chewed or eaten uncooked. Ripe berries are safe when prepared for use in foods.
Preparations & Doses:
The flower preparations are usually administered as teas and alcoholic extracts, and are often found in composite herbal remedies. The traditional dose is 3-5 g of the flower, and this is typically administered 2-3 times a day. Topical cosmetic preparations are used for the skin and eyes. Sinupret contains 18 mg of powdered elder flower extract per dose in combination with other herbs, and Sambucol (a standardized elderberry extract) is marketed in the U.S. by both J.B. Harris and Nature's Way.
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