Hederae folium

Authors: Prof. Dr. med. Peter Altmeyer, Prof. Dr. med. Martina Bacharach-Buhles

All authors of this article

Last updated on: 13.06.2024

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Synonym(s)

Folia Hederae helicis; Hederae helicis folium; hedera folium; Herba Hederae; Ivy leaves; ivy leaves (engl.)

Definition
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Whole or cut leaves of Hedera helix the ivy, harvested and dried in spring and monographed by the E and ESCOP commissions.

The quality is laid down in the European Pharmacopoeia (Ph. Eur.).

HMPC monograph: well-established use as dry extracts, liquid extracts and thick extracts: expectorant for productive coughs

Clinically proven indications with marketing authorization: Relief of symptoms in chronic inflammatory bronchial diseases; colds of the respiratory tract.

ESCOP monographs: cough, especially with excessive secretion of viscous mucus; supportive in inflammatory bronchial diseases.

Commission E monograph: catarrhs of the airways; symptomatic treatment of chronic inflammatory bronchial diseases.

Empirical medicine: Irritable cough, spasmodic cough, adjuvant for pertussis

Ingredients
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Ivy leaves contain 5% triterpene saponine glycosides like hederacoside C (according to Ph.Eur. at least 3% based on the dried drug). By hydrolytic cleavage the saponine glycosides are transformed into the aglycone hederagenin as well as the toxic (haemolytic) alpha-hederin and beta-hederin. In addition, the drug also contains chlorogenic acid, caffeic acid, scopolin, rutoside and polyins such as falcarinol (a medium strength contact allergen).

Effects
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Ivy leaf extracts have expectorant, secretolytic and mucolytic effects. Their efficacy is determined by alpha-hederine, which has anti-edematous, spasmolytic and vasodilating effects. Due to their antibacterial and fungicidal properties, ivy extracts are also found in medicinal ointments, shampoos and tinctures as well as in natural cosmetics. Used in folk medicine for whooping cough, bronchitis and eczema. Frequently used Rubefaciens (skin irritating effect).

Field of application/use
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Respiratory catarrh, chronic inflammatory respiratory diseases (Commission E, ESCOP). For this indication, numerous positive study results are also available in placebo-controlled, double-blind clinical studies in children and adults.

Dosage
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Depending on the package leaflet of the finished preparations.

Depending on dry extracts, fluid extracts and thick extracts: s.a. under

https://www.ema.europa.eu/en/documents/herbal-monograph/final-european-union-herbal-monograph-hedera-helix-l-folium-revision-2_en.pdf

Undesirable effects
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Urticaria, nausea, vomiting, diarrhea, headache. Irritation of mucous membranes by the juice of fresh ivy leaves.

Contraindication
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Allergies to family members of the Araliaceae; see also Rhus dermatitis, see also ivy dermatitis.

No recommendation for use during pregnancy and lactation, as safety studies are not yet available.

Children under 2 years! Exacerbation of respiratory symptoms.

Children between 2 and 4 years only under medical supervision.

Respiratory distress, fever or purulent sputum only under medical supervision.

Caution with gastritis!

Recipe(s)
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The combination thyme herb + ivy leaves consists of

and acts expectorant, antiseptic, antibacterial and is used in case of bronchitis or catarrh of the upper respiratory tract.

Trade names
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Prospan® Liq (20-20-20 drops/day)

Bronchipret® drops contain a thyme/ivy combination

Ivy Special Extract EA 575®; Esberi® Ivy Cough Syrup,

Literature
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  1. Cwientzek U et al.(2011) Acute bronchitis therapy with ivy leaves extracts in a two-arm study. A double-blind, randomised study vs. an other ivy leaves extract. Phytomedicine 18:1105-1109.
  2. Fazio S et al.(2009) Tolerance, safety and efficacy of Hedera helix extract in inflammatory bronchial diseases under clinical practice conditions: a prospective, open, multicentre postmarketing study in 9657 patients. Phytomedicine 16:17-24.
  3. Greunke C et al.(2015) A systematic study on the influence of the main ingredients of an ivy leaves dry extract on the β2-adrenergic responsiveness of human airway smooth muscle cells. Pulm Pharmacol Ther 31:92-98.
  4. Hecker, M et al. (2002) Treatment of chronic bronchitis with a special extract of ivy leaves - multicenter observational study of application in 1350 patients. Forsch. Complementärmed. Klass. Naturheilkd 9: 77-84.
  5. Jones JM et al.(2009) Allergic contact dermatitis to English ivy (Hedera helix)--a case series. Contact Dermatitis 60:179-180.
  6. Lang C et al.(2015) A Valuable Option for the Treatment of Respiratory Diseases: Review on the Clinical Evidence of the Ivy Leaves Dry Extract EA 575®. Planta Med 81:968-974.
  7. Mansfeld, HJ et al (1998) Therapy of bronchial asthma with ivy leaves dry extract. Münch. Med. wschr 140 26-30.
  8. Mendel M et al. (2011) The effect of the whole extract of common ivy (Hedera helix) leaves and selected active substances on the motor activity of rat isolated stomach strips. https://www.J Ethnopharmacol 134:796 802.
  9. Schulte-Michels J et al,(2016) Ivy leaves dry extract EA 575® decreases LPS-induced IL-6 release from murine macrophages. Pharmacy 71:158-161.
  10. Zeil S et al. (2014) Tolerance and effect of an add-on treatment with a cough medicine containing ivy leaves dry extract on lung function in children with bronchial asthma. Phytomedicine 21:1216-1220.
  11. https://arzneipflanzenlexikon.info/efeu.php.
  12. https://www.ema.europa.eu/en/documents/herbal-monograph/final-european-union-herbal-monograph-hedera-helix-l-folium-revision-2_en.pdf
  13. Wenigmann M. (2017) Phytotherapy medicinal drugs, phytopharmaceuticals, application. Urban & Fischer, pp. 97-98