Pelargonium ( Pelargonium sidoides )

Pelargonium ( Pelargonium sidoides )
| Practice points|
Pelargonium appears to be useful for the treatment of respiratory tract infections, especially
bronchitis, in adults and children.
| Key indications |
Acute bronchitis: Reduces symptoms of acute
bronchitis (systematic review and meta-analysis).1,2 In
adults Pelargonium extract (EPs® 7630) significantly
improves bronchitis symptom scores after 7 days,
with improvements in coughing, pulmonary rales,
sputum, chest pain while coughing and dyspnoea.3 In
adults Pelargonium extract (EPs® 7630) significantly
improves bronchitis symptom scores after 7 days, with
improvements in coughing, pulmonary rales, sputum,
chest pain while coughing and dyspnoea.3
Paediatric bronchitis: Pelargonium extract (EPs®
7630) has been shown to significantly reduce coughing,
sputum and pulmonary rales in children and adolescents
suffering from acute bronchitis within 7 days.4,5
Sinusitis: In adults with persistent symptoms (> 7days)
of acute rhinosinusitis, presumably of bacterial origin,
Pelargonium extract (EPs® 7630) improves recovery
time and significantly reduces nasal obstruction, purulent
nasal secretion and discharge, maxillary pain and
headache.6
Chronic Obstructive Pulmonary Disease (COPD):
Pelargonium extract (EPs® 7630) prolongs the time
to acute exacerbation in patients with COPD stage II/
III (from 43 to 57 days). Patients may experience fewer
exacerbations, less antibiotic use and improved quality
of life.7
Children’s asthma: In children with mild asthma
Pelargonium extract (EPs® 7630) reduces cough
frequency and nasal congestion and may reduce the risk
of having an asthma attack during a viral infection of the
upper respiratory tract.8
| Key actions9 |
Antibacterial
Antiviral
Immune modulating
| Recommended Doses |
The majority of successful studies have been conducted
on the proprietary extract EPs® 7630 (Kaloba®)
Acute bronchitis: Adults EPs® 7630, 20 - 30 mg
three times daily3
Paediatric bronchitis: In children over 6 years the
optimal dose of EPs® 7630 is 60 - 90 mg daily.5
For example: EPs® 76304
2-6 years: 10 drops three times daily
6-12 years: 20 drops three times daily
12-18 years: 30 drops three times daily
Sinusitis: EPs® 7630, 60 drops three times daily.6
COPD: EPs® 7630, 30 drops three times daily.7
Children’s asthma: EPs® 7630, dose as per
paediatric bronchitis.8
| Adverse Effects |
Mild adverse effects may include gastrointestinal
complaints such as nausea, vomiting, diarrhoea or
heartburn, or allergic skin reactions with pruritus and
urticaria.1
There have been reports of hepatotoxicity resulting
from the use of Pelargonium however causality has
not been established and effects may have been due
to confounding variables including comedication with
synthetic drugs and major comorbidities.10
| Cautions/ Contraindications |
Human studies confirming safety in pregnancy/ lactation
are lacking, but animal models have not demonstrated
adverse effects.9
Consider risk versus benefit in patients with liver
impairment.
| Possible Interactions |
Immunosuppressant medications: may theoretically
decrease effect
REFERENCES 1. Timmer A, Gunther J, Motschall E, et al. Pelargonium sidoides extract for treating acute respiratory tract infections. Cochrane database
of systematic reviews 2013;10:CD006323. 2. Agbabiaka TB, Guo R, Ernst E. Pelargonium sidoides for acute bronchitis: a systematic review and metaanalysis. Phytomedicine : international journal of phytotherapy and phytopharmacology 2008;15(5):378-85. 3. Matthys H, Lizogub VG, Malek FA, et al.
Efficacy and tolerability of EPs 7630 tablets in patients with acute bronchitis: a randomised, double-blind, placebo-controlled dose-finding study with a herbal
drug preparation from Pelargonium sidoides. Current medical research and opinion 2010;26(6):1413-22. 4. Kamin W, Ilyenko LI, Malek FA, et al. Treatment
of acute bronchitis with EPs 7630: randomized, controlled trial in children and adolescents. Pediatrics international : official journal of the Japan Pediatric
Society 2012;54(2):219-26. 5. Kamin W, Maydannik VG, Malek FA, et al. Efficacy and tolerability of EPs 7630 in patients (aged 6-18 years old) with acute
bronchitis. Acta paediatrica (Oslo, Norway : 1992) 2010;99(4):537-43. 6. Bachert C, Schapowal A, Funk P, et al. Treatment of acute rhinosinusitis with the
preparation from Pelargonium sidoides EPs 7630: a randomized, double-blind, placebo-controlled trial. Rhinology 2009;47(1):51-8. 7. Matthys H, Pliskevich
DA, Bondarchuk OM, et al. Randomised, double-blind, placebo-controlled trial of EPs 7630 in adults with COPD. Respiratory medicine 2013;107(5):691701. 8. Tahan F, Yaman M. Can the Pelargonium sidoides root extract EPs(R) 7630 prevent asthma attacks during viral infections of the upper respiratory tract
in children? Phytomedicine : international journal of phytotherapy and phytopharmacology 2013;20(2):148-50. 9. Braun L, Cohen M. Pelargonium. Herbs
& natural supplements: an evidence based guide.[Vol. 2]. 4th ed. Australia: Elsevier; 2015. p.733-7. 10. Teschke R, Frenzel C, Wolff A, et al. Initially purported
hepatotoxicity by Pelargonium sidoides: the dilemma of pharmacovigilance and proposals for improvement. Annals of hepatology 2012;11(4):500-12.
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