Pelargonium sidoides

Health Care Professional Information

Scientific Name
Pelargonium sidoides
Common Name

EPs 7630

Brand Name

Umckaloabo®, Umcka® cold care

Clinical Summary

Pelargonium sidoides is an herb that has been used in traditional medicine in South Africa for centuries to treat infectious respiratory disease, and dysentery diarrhea. The root extracts are currently being used in Germany for the treatment of respiratory infections (1). Patients take the supplemental form to treat common cold and acute bronchitis. In vitro studies indicate that P. sidoides has antibacterial (2), antiviral (3), immunomodulatory (4) and anti-adhesive (5) properties.

Data from clinical trials suggest its effectiveness against acute bronchitis in adults and children (6) (7) (8), and against rhinosinusitis (9). Conclusions of a meta-analysis also show a significant decrease in bronchitis symptoms with P. sidoides use (10).
An herbal preparation from P. sidoides roots was found effective in treatment of moderate to severe chronic obstructive pulmonary disease (COPD) (15).

Purported Uses
  • Dysentery
  • Diarrhea
  • Common cold
  • Bronchitis
Constituents
  • Polymeric proanthocyanidins
  • Monomeric falvan-3-ols
  • 7-Hydroxyl-Coumarins (umckalin)
  • Polyphenols (catechin)
  • Phenolic acids with gallic acid
  • Quercetin
  • Sitosterol-glucoside
    (1) (5)
Mechanism of Action

P. sidoides extract has anti-microbial and immunomodulatory effects. It was shown to increase natural killer cell formation, tumor necrosis factor alpha, iNO and interferon-beta release, and also demonstrated anti-adhesive effects (5). In addition, the extract improved peripheral blood phagocytes by enhancing the oxidative burst and intracellular killing in vitro (11).

Adverse Reactions
  • Allergic reactions (12)
  • Gastrointestinal upset (13)
  • Ear and labyrinth disorders (13)
  • Exacerbation of existing respiratory symptoms, fever, exanthema, psychomotor unrest, and diarrhea in children have been reported (8).
Herb-Drug Interactions

Due to its coumarin content, P. sidoides may increase the risk of bleeding. However, coadministration with warfarin did not change the blood coagulation values in animals (14).

Literature Summary and Critique

Matthys H, Eisebitt R, Seith B, Heger M. Efficacy and safety of an extract of Pelargonium sidoides (EPs 7630) in adults with acute bronchitis. A randomised, double-blind, placebo-controlled trial. Phytomedicine. 2003;10 Suppl 4:7-17.
In this study, 468 adults presenting with bronchitis were randomized, to Pelargonium sidoides (EPs 7630) or placebo for seven days. On day seven, the treatment group had a higher recovery rate and improvement in hoarseness, headache and pain in limbs compared to patients on placebo. Patients in the treatment group also had a shorter duration of illness compared to those who took placebo.

Schulz V. Liquid herbal drug preparation from the root of Pelargonium sidoides is effective against acute bronchitis: results of a double-blind study with 124 patients. Phytomedicine. 2007;14 Suppl 6:74-75.
One hundred and twenty-four adults aged 18 years and over with a Bronchitis Severity Score (BSS) of greater than 5 points were randomized to Pelargonium sidoides liquid or placebo for seven days. Researchers report that on day seven, patients who were administered P. sidoides had a greater reduction in BSS, the primary outcome measure, than those on placebo. The findings should be confirmed in larger trials.

Dosage (Inside MSKCC Only)
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References
  1. Schulz V. Liquid herbal drug preparation from the root of Pelargonium sidoides is effective against acute bronchitis: results of a double-blind study with 124 patients. Phytomedicine. 2007;14 Suppl 6:74-75.
  2. Kim CE, Griffiths WJ, Taylor PW. Components derived from Pelargonium stimulate macrophage killing of Mycobacterium species. J Appl Microbiol. Apr 2009;106(4):1184-1193.
  3. Michaelis M, Doerr HW, Cinatl J, Jr. Investigation of the influence of EPs((R)) 7630, a herbal drug preparation from Pelargonium sidoides, on replication of a broad panel of respiratory viruses. Phytomedicine. Oct 29 2010.
  4. Luna LA, Jr., Bachi AL, Novaes EBRR, et al.Immune responses induced by Pelargonium sidoides extract in serum and nasal mucosa of athletes after exhaustive exercise: Modulation of secretory IgA, IL-6 and IL-15. Phytomedicine. Sep 16 2010.
  5. Wittschier N, Faller G, Hensel A. An extract of Pelargonium sidoides (EPs 7630) inhibits in situ adhesion of Helicobacter pylori to human stomach. Phytomedicine. Apr 2007;14(4):285-288.
  6. Matthys H, Heger M. Treatment of acute bronchitis with a liquid herbal drug preparation from Pelargonium sidoides (EPs 7630): a randomised, double-blind, placebo-controlled, multicentre study. Curr Med Res Opin. Feb 2007;23(2):323-331.
  7. Kamin W, Maydannik V, Malek FA, Kieser M. Efficacy and tolerability of EPs 7630 in children and adolescents with acute bronchitis - a randomized, double-blind, placebo-controlled multicenter trial with a herbal drug preparation from Pelargonium sidoides roots. Int J Clin Pharmacol Ther. Mar 2010;48(3):184-191.
  8. Haidvogl M, Heger M. Treatment effect and safety of EPs 7630-solution in acute bronchitis in childhood: report of a multicentre observational study. Phytomedicine. 2007;14 Suppl 6:60-64.
  9. Bachert C, Schapowal A, Funk P, Kieser M. Treatment of acute rhinosinusitis with the preparation from Pelargonium sidoides EPs 7630: a randomized, double-blind, placebo-controlled trial. Rhinology. Mar 2009;47(1):51-58.
  10. Agbabiaka TB, Guo R, Ernst E. Pelargonium sidoides for acute bronchitis: a systematic review and meta-analysis. Phytomedicine. May 2008;15(5):378-385.
  11. Conrad A, Hansmann C, Engels I, Daschner FD, Frank U. Extract of Pelargonium sidoides (EPs 7630) improves phagocytosis, oxidative burst, and intracellular killing of human peripheral blood phagocytes in vitro. Phytomedicine. 2007;14 Suppl 6:46-51.
  12. de Boer HJ, Hagemann U, Bate J, Meyboom RH. Allergic reactions to medicines derived from Pelargonium species. Drug Saf. 2007;30(8):677-680.
  13. Matthys H, Eisebitt R, Seith B, Heger M. Efficacy and safety of an extract of Pelargonium sidoides (EPs 7630) in adults with acute bronchitis. A randomised, double-blind, placebo-controlled trial. Phytomedicine. 2003;10 Suppl 4:7-17.
  14. Koch E, Biber A. Treatment of rats with the Pelargonium sidoides extract EPs 7630 has no effect on blood coagulation parameters or on the pharmacokinetics of warfarin. Phytomedicine. 2007;14 Suppl 6:40-45.
  15. Matthys H, Pliskevich DA, Bondarchuk OM, et al. Randomised, double-blind, placebo-controlled trial of EPs 7630 in adults with COPD. Respir Med. 2013 May;107(5):691-701.

Consumer Information

How It Works

Bottom line: Pelargonium sidoides helps reduce cold symptoms.

Pelargonium sidoides is an herb that has been used in traditional medicine in South Africa for centuries. It is used in Europe in treating common cold, and bronchitis. In laboratory studies, this herb was shown to kill bacteria, viruses, and stimulate the immune system. Human studies show that it can reduce the symptoms of common cold and bronchitis.

Purported Uses
  • Dysentery
    Although P. sidoides is used to treat dysentery in traditional medicine, there is no scientific evidence to back this claim.
  • Common cold
    A few studies support use of P. sidoides in reducing symptoms.
  • Bronchitis
    Clinical trial data shows that P. sidoides is effective against acute and chronic bronchitis.
Research Evidence

Bronchitis:
In this study, 468 adults presenting with symptoms of bronchitis were randomized to Pelargonium sidoides (EPs 7630) or placebo for seven days. On day seven, researchers observed that the treatment group had a higher recovery rate and improvement in hoarseness, headache and pain in limbs compared to patients on placebo. Patients in the treatment group also had a shorter duration of illness compared to those who took placebo.

In another study 124 adults aged 18 years and over with a Bronchitis Severity Score (BSS) of greater than 5 points were randomized to Pelargonium sidoides liquid or placebo. Patients who were administered P. sidoides had a greater reduction in BSS than those on placebo.

Side Effects
  • Allergies
  • Gastrointestinal upset
  • Ear and labyrinth disorders
  • Fever
  • Diarrhea
  • Restlessness
E-mail your questions and comments to aboutherbs@mskcc.org.