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Ivy leaf

EMA Well-Established Use monograph for productive cough, the leading paediatric herbal expectorant in Europe.

Why

Ivy leaf (Hedera helix) extract holds an EMA Well-Established Use monograph for productive cough, the higher regulatory tier requiring bibliographic evidence of clinical efficacy. The standardised extract EA 575 (Prospan) is one of the most-prescribed herbal expectorants in German and European paediatric practice. RCTs in children with acute bronchitis report symptom improvement comparable to ambroxol.

How it works

Saponins (hederagenin, α-hederin) reduce bronchial mucus viscosity and stimulate β2-adrenoceptor signalling in airway smooth muscle, producing mild bronchodilation and mucolytic effect without the dry-cough adverse effect of suppressants.

Expected onset · Symptom improvement often within 4–7 days

How to take

Dosage

EA 575 syrup: paediatric doses banded by age (e.g. 2.5 ml 3 times daily for ages 1–5). Adult dose: 5–7.5 ml three times daily. Dry extract tablets: 35 mg twice daily.

Timing

Three times daily during symptomatic phase

On the label

EA 575 (Prospan) or extracts standardised to '5–7.5:1 ethanol extract' or with stated hederacoside C content. Generic ivy syrups vary widely.

Ideal for

Adults and children (typically aged 1+ depending on local product) with productive cough associated with acute bronchitis or upper respiratory tract infection.

Safety

Mild GI upset and rare allergic skin reactions. Some liquid preparations contain sorbitol. Note for fructose intolerance. Pregnancy and breastfeeding data are limited, defer to the product's age and pregnancy labelling.

Evidence

At a glance

EMA HMPC classifies ivy leaf extract as Well-Established Use for productive cough, the higher regulatory tier for botanicals, requiring bibliographic evidence of clinical efficacy. Holzinger 2011 systematic review of 10 trials (n>17,000 children): symptom improvement comparable to ambroxol, favourable safety profile. The dominant herbal expectorant in European paediatrics.

Where to get it

Shop Ivy leaf on Amazon

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