Ivy leaf extract (Hedera helix)

Q: Does ivy leaf extract help a cough?

Pooled data from two manufacturer-funded trials (390 adults) showed cough severity improving faster than with placebo over a week. An independent review of six trials rated the effect minimal at best and the studies at high risk of bias.

Q: Can young children use it?

The EU monograph contraindicates it under 2 years and asks for a medical diagnosis before use for persistent or recurrent cough in children aged 2–4.

Q: What side effects are reported?

Nausea, vomiting, diarrhoea and allergic reactions such as hives, rash and breathing difficulty, with unknown frequency. In the pooled trials, adverse event rates were similar to placebo, and 2.1% of 9,657 syrup users reported adverse events in an open post-marketing study.

Q: Does it interact with medicines?

None are known: the EU monograph reports no interactions, and LiverTox, LactMed, NCCIH and MedlinePlus have no ivy leaf entries. Formal interaction studies have not been published in the sources we checked.

Q: Can it be used in pregnancy or while breastfeeding?

The EU monograph does not recommend it during pregnancy or lactation because safety has not been established.

Q: Is ivy leaf better than combination cough products?

In one open-label 2025 trial co-authored by the maker's employees, EA 575 was non-inferior to ivy/thyme and thyme/primrose drops and better than ivy/thyme; there was no placebo arm.

Also called Hedera helix, ivy leaf, Hederae helicis folium, common ivy extract, EA 575, ivy leaves dry extract.

Best grade B across 3 graded outcomes Botanical Last checked Oct 21, 2026

The short answer

From 8 sources

Ivy leaf extract comes from the leaves of common ivy and is authorised in the EU as an expectorant for productive cough. Pooled data from two manufacturer-funded trials in 390 adults showed faster easing of cough over a week, but an independent review judged the benefit minimal and the studies at high risk of bias.

Every graded outcome on this page

3 rows · line = participants

Grade BCough and bronchitis severity during acute respiratory infectionsAcute coughn 390
Grade CBronchitis severity compared with two other herbal cough productsAcute bronchitisn 325
Grade DLung function in children with asthma (add-on use)Asthman 30

Key facts

What it is: Ethanol-based dry, soft or liquid extracts of Hedera helix leaves; EA 575 is the most-studied extract^6,1
EU status: Well-established use as an expectorant for productive cough; contraindicated under 2 years of age⁶
Pooled trials: 390 adults with acute respiratory infections: Bronchitis Severity Score fell 8.6 vs 6.2 points after 7 days; 18.1% vs 9.3% cough-free at treatment end¹
Independent review: A 2021 systematic review (6 RCTs) rated effects minimal at best, with low reporting quality and high risk of bias²
Funding: The pooled analysis and the 2025 comparison trial both have authors paid by or employed at the EA 575 maker, Engelhard Arzneimittel^1,3
Real-world tolerability: In an open post-marketing study of 9,657 people (5,181 children) using an ivy leaf syrup for bronchitis, 2.1% reported adverse events, mostly digestive (1.5%)⁸

What it is

Ivy leaf extract is a dried-leaf extract of common ivy (Hedera helix), sold in cough syrups, drops and tablets.

How it works

Proposed

How ivy leaf extract might loosen mucus or ease cough is not established in humans. The EU monograph lists its mechanism of action as not known and reports no pharmacokinetic data.⁶

Forms, side by side

2 forms named in our sources. The rest show what our data holds, and say plainly where it holds nothing yet.

Ivy leaf extract (Hedera helix) forms compared

2 forms

Ivy leaf extract (Hedera helix) forms compared: 2 forms by 3 attributes. Empty cells are labelled No data yet, or Not graded in the evidence row.
2 forms	EA 575 dry extract in cough liquid	Other ivy leaf dry, soft or liquid extracts (drops, tablets, syrups)
Absorption in people	No human absorption data; the EU monograph lists pharmacokinetic data as not available.⁶	No human absorption data; the EU monograph lists pharmacokinetic data as not available.⁶
GI tolerance	Adverse event rates were comparable to placebo in the pooled trials.¹	The EU monograph lists nausea, vomiting, diarrhoea and allergic reactions, frequency not known; 2.1% of 9,657 syrup users reported adverse events in an open post-marketing study.^6,8
Studied for	Acute cough and bronchitis in adults (placebo-controlled and comparison trials)	Older paediatric asthma trials; only one of three reviewed in 2003 had a placebo arm

EA 575 dry extract in cough liquid
Absorption in people
No human absorption data; the EU monograph lists pharmacokinetic data as not available.⁶
GI tolerance
Adverse event rates were comparable to placebo in the pooled trials.¹
Studied for
Acute cough and bronchitis in adults (placebo-controlled and comparison trials)
Other ivy leaf dry, soft or liquid extracts (drops, tablets, syrups)
Absorption in people
No human absorption data; the EU monograph lists pharmacokinetic data as not available.⁶
GI tolerance
The EU monograph lists nausea, vomiting, diarrhoea and allergic reactions, frequency not known; 2.1% of 9,657 syrup users reported adverse events in an open post-marketing study.^6,8
Studied for
Older paediatric asthma trials; only one of three reviewed in 2003 had a placebo arm

What the human research says

Human trials only, one row per outcome. The form line shows what each trial actually tested. Grades follow our evidence-grading policy.

Trial map

3 graded outcomes, largest study first

3 graded outcomes: 1 improved, 1 mixed, 1 no effect. The largest, a 2022 meta-analysis of 390 people on cough and bronchitis severity during acute respiratory infections, found an improvement.

By sizeTable

1Cough and bronchitis severity during acute respiratory infections

Improved · Grade B · Meta-analysis, 390 people, 2022

Adults with acute respiratory tract infection and cough in 2 double-blind placebo-controlled trials (228 extract, 162 placebo)

Dose, result and source

Every graded outcome on this page, largest study first
Outcome	Found	People	Study	Who was studied
Cough and bronchitis severity during acute respiratory infections	Improved	390	Grade B · Meta-analysis, 2022	Adults with acute respiratory tract infection and cough in 2 double-blind placebo-controlled trials (228 extract, 162 placebo)
Bronchitis severity compared with two other herbal cough products	Mixed	325	Grade C · Open-label trial, 2025	Adults with acute bronchitis
Lung function in children with asthma (add-on use)	No effect	30	Grade D · Crossover RCT, 2014	Children aged 6–11 with partly controlled or uncontrolled mild persistent allergic asthma despite inhaled corticosteroids (400 µg budesonide equivalent)

Every graded row

3 rows

Grade BCough and bronchitis severity during acute respiratory infectionsAcute coughImprovedMeta-analysis
n 390 · 2022

Improved Bronchitis Severity Score fell 8.6 vs 6.2 points by day 7 (p<0.001); 18.1% vs 9.3% were cough-free at treatment end and 56.2% vs 25.6% a week later. Adverse event rates were comparable.

Design: Meta-analysis, n = 390, 2022
Population: Adults with acute respiratory tract infection and cough in 2 double-blind placebo-controlled trials (228 extract, 162 placebo)
Form: Ivy leaves dry extract EA 575 (cough liquid)
Dose: As labelled (mg not stated in the abstract)
Duration: 7 days of treatment plus 7 days of follow-up
Source: Reference 1 · PubMed 36414647 (opens PubMed)

Grade CBronchitis severity compared with two other herbal cough productsAcute bronchitisMixedOpen-label trial
n 325 · 2025

Mixed Ivy extract was non-inferior to both comparators on Bronchitis Severity Score change to day 7, superior to ivy/thyme (p<0.0001) and not significantly better than thyme/primrose (p=0.0607). All adverse events were non-serious.

Design: Open-label trial, n = 325, 2025
Population: Adults with acute bronchitis
Form: EA 575 drops vs ivy/thyme and thyme/primrose combination drops
Dose: As labelled for each product
Duration: 7 days
Source: Reference 3 · PubMed 40430571 (opens PubMed)

Grade DLung function in children with asthma (add-on use)AsthmaNo effectCrossover RCT
n 30 · 2014

No effect No treatment effect on the primary outcomes (FEV1 p=0.68; MEF75-25 p=0.70) in the crossover analysis; some secondary lung-function values improved within the ivy period only.

Design: Crossover RCT, n = 30, 2014
Population: Children aged 6–11 with partly controlled or uncontrolled mild persistent allergic asthma despite inhaled corticosteroids (400 µg budesonide equivalent)
Form: Ivy leaves dry extract cough medicine, added to inhaled corticosteroid
Dose: Not stated in the abstract
Duration: 4 weeks per period
Source: Reference 4 · PubMed 24916707 (opens PubMed)

What the numbers add up to

Each point is worked out from the data and the sources numbered on this page, with the arithmetic shown under it. It adds no new data and is not medical advice.

Modest effect, mostly from one maker

The placebo-controlled data come largely from EA 575 trials linked to its maker; an independent 2021 review found the benefit minimal at best and of uncertain clinical importance.^1,2

Studied doses

Doses used in research, shown against the official limits. They describe the studies, not a recommendation for you.

Studied doses in research, not advice. These are amounts used in research, not personal advice. Your clinician or pharmacist can say what fits you.

Doses studied in human trials

Doses studied in human trials ranged from labelled cough-liquid amounts two or three times daily for 7 days in adults to 4 weeks of add-on use in children with asthma. The EU monograph lists adult daily amounts of 42–120 mg for the dry and soft extracts (300 mg for the 1:1 liquid extract) and says to see a doctor or pharmacist if symptoms last longer than a week.^1,4,6

When trials measured an effect

2 outcomes

How long trials ran before effects were measured
Outcome	Measured at	Basis
Lower cough severity than placebo	Within 48 hours of the first dose	One placebo-controlled EA 575 trial in 181 adults with acute cough (taken three times a day for a week)⁷
Larger fall in bronchitis severity score	Day 7 (end of treatment); more people cough-free a week later	Pooled analysis of two placebo-controlled EA 575 trials (390 adults)¹

Interactions and safety

Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.

Interactions

0 agents

None found in our sources.

Check with what you take

Kept on this device only

Add what you take. We list every interaction our evidence profiles cite between Ivy leaf extract and your picks, and between your picks.

Add a supplement or medicine

Most cited:

Add a supplement or medicine you take to check it against Ivy leaf extract.

Starting from one medicine? The interaction checker rates how serious each pair is, on a curated list of 19 entries for 11 medicines. This cabinet has no severity rating: it lists every interaction row our supplement pages cite.

Who should be careful

6 groups

Children under 2: The EU monograph contraindicates ivy leaf under 2 years because secretolytic products can worsen breathing symptoms; persistent or recurrent cough in children aged 2–4 needs a medical diagnosis first.⁶
Allergy to ivy or related plants: Contraindicated with hypersensitivity to ivy or other Araliaceae plants. Urticaria, rash, breathing difficulty and anaphylactic reactions have been reported.⁶
Gastritis or stomach ulcer: The EU monograph advises caution; nausea, vomiting and diarrhoea are listed side effects. Overdose can cause nausea, vomiting, diarrhoea and agitation.⁶
Pregnancy and breastfeeding: Safety has not been established, and the EU monograph does not recommend use during pregnancy or lactation.⁶
Alcohol content: Many liquids contain ethanol; the EU monograph says the 1:1 liquid extract should not be given to children under 6 because of its alcohol content.⁶
Worsening symptoms: See a doctor or pharmacist if shortness of breath, fever or purulent sputum occurs, or if symptoms last longer than a week.⁶

How to read the label

What to check on the Supplement Facts panel.

How to read the label

3 checks

Which extract, and how much

Ivy products use different dry, soft or liquid extracts. The EU monograph lists adult daily amounts of 42–120 mg for dry and soft extracts and 300 mg for the 1:1 liquid extract, so compare the extract type, not just the syrup volume.⁶

Single herb or combination

Many cough products combine ivy or primrose with thyme. The placebo-controlled data are for ivy extract EA 575 alone; combinations were tested separately.^1,3

Alcohol content

Many liquids contain ethanol, and the EU monograph says the 1:1 liquid extract should not be given to children under 6 because of it.⁶

Have the bottle? Photograph its Supplement Facts panel and see each line, ivy leaf extract (hedera helix) included, beside the doses and forms the trials used in Label X-Ray.

Frequently asked questions

Short answers to common questions; the numbers link to the sources below.

Common questions

6 answers

Does ivy leaf extract help a cough?

Pooled data from two manufacturer-funded trials (390 adults) showed cough severity improving faster than with placebo over a week. An independent review of six trials rated the effect minimal at best and the studies at high risk of bias.^1,2

Can young children use it?

The EU monograph contraindicates it under 2 years and asks for a medical diagnosis before use for persistent or recurrent cough in children aged 2–4.⁶

What side effects are reported?

Nausea, vomiting, diarrhoea and allergic reactions such as hives, rash and breathing difficulty, with unknown frequency. In the pooled trials, adverse event rates were similar to placebo, and 2.1% of 9,657 syrup users reported adverse events in an open post-marketing study.^6,1,8

Does it interact with medicines?

None are known: the EU monograph reports no interactions, and LiverTox, LactMed, NCCIH and MedlinePlus have no ivy leaf entries. Formal interaction studies have not been published in the sources we checked.⁶

Can it be used in pregnancy or while breastfeeding?

The EU monograph does not recommend it during pregnancy or lactation because safety has not been established.⁶

Is ivy leaf better than combination cough products?

In one open-label 2025 trial co-authored by the maker's employees, EA 575 was non-inferior to ivy/thyme and thyme/primrose drops and better than ivy/thyme; there was no placebo arm.³

Sources

8 sources: trial abstracts, NIH fact sheets and reference databases. Numbers in the text link here.

Sources cited on this page

8 sources

1Ivy leaves extract EA 575 in the treatment of cough during acute respiratory tract infections: meta-analysis of double-blind, randomized, placebo-controlled trials.Meta-analysis Sci Rep, 2022 · PMID 36414647
2Ivy leaf (Hedera helix) for acute upper respiratory tract infections: an updated systematic review.Systematic review Eur J Clin Pharmacol, 2021 · PMID 33523253
3Efficacy and Safety of a Single Ivy Extract Versus Two Herbal Extract Combinations in Patients with Acute Bronchitis: A Multi-Center, Randomized, Open-Label Clinical Trial.Open-label trial Pharmaceuticals (Basel), 2025 · PMID 40430571
4Tolerance and effect of an add-on treatment with a cough medicine containing ivy leaves dry extract on lung function in children with bronchial asthma.Crossover RCT Phytomedicine, 2014 · PMID 24916707
5Efficacy of dry extract of ivy leaves in children with bronchial asthma--a review of randomized controlled trials.Review Phytomedicine, 2003 · PMID 12725580
6European Union herbal monograph on Hedera helix L., folium (Revision 2, EMA/HMPC/325716/2017)Guideline European Medicines Agency (HMPC), 2017 · ema.europa.eu
7A randomized, controlled, double-blind, multi-center trial to evaluate the efficacy and safety of a liquid containing ivy leaves dry extract (EA 575(®)) vs. placebo in the treatment of adults with acute cough.RCT Pharmazie, 2016 · PMID 29441845
8Tolerance, safety and efficacy of Hedera helix extract in inflammatory bronchial diseases under clinical practice conditions: a prospective, open, multicentre postmarketing study in 9657 patients.Observational Phytomedicine, 2009 · PMID 16860549

What changed

Every dated change to this page: what changed, who made it and why.

Change log

2 entries

Dated changes to this page
Date	Change	Who and why
Oct 21, 2026key facts, forms, time to effect, label guide, FAQ, questions, related	Added time-to-effect rows (cough lower than placebo within 48 hours in a 181-person EA 575 trial; bronchitis score at day 7 in the pooled analysis), a label guide (extract type and EU daily amounts, combinations, alcohol), a post-marketing tolerability fact (2.1% adverse events in 9,657 syrup users), page questions and the immune goal hub. Interactions checked: the EU monograph reports none, and LiverTox, LactMed, NCCIH and MedlinePlus have no ivy leaf entry, so the list stays empty. PubMed search for 2023–2026 meta-analyses and RCTs found only active-controlled trials of an ivy plus Coptis combination (2024, 2026) and a 2025 maker-funded review of paediatric herbal medicines; none added as rows because they do not test ivy alone against placebo. The 2016 EA 575 trial is one of the two pooled in the 2022 meta-analysis, so it is cited for timing only.	Writer: Kymata Health EditorialTrigger: A–Z audit against docs/supplements/AUDIT-STANDARD.md
Oct 14, 2026all	Initial editorial evidence review	Writer: Kymata Health EditorialTrigger: new page

Supplement & Nutrient Encyclopedia. Educational information only; it is not medical advice and does not replace a clinician. Dietary supplements are not intended to diagnose, treat, cure or prevent any disease. Statements about supplements have not been evaluated by the FDA.