Quick summary
Ivy (Hedera helix) is commonly used as an herbal medicine, primarily for respiratory conditions such as acute upper respiratory tract infections (URTIs), bronchitis, and cough. Clinical trials suggest it may reduce cough severity and improve expectoration with a favorable safety profile. However, the overall quality of evidence is limited by methodological weaknesses and a lack of placebo-controlled studies. Ivy is generally well tolerated with minimal adverse effects reported. There is insufficient evidence to support its use in pregnancy or breastfeeding, and safety data remain incomplete. Drug interactions via CYP enzymes are not well documented but warrant consideration.
What is it
Ivy (Hedera helix) is a climbing evergreen plant native to Europe and parts of Asia. Extracts from its leaves are used in herbal medicine, mainly for their potential effects on respiratory ailments. Ivy preparations typically contain dried leaf extracts standardized for active compounds, commonly used to address symptoms such as cough and bronchial congestion.
Traditional uses
Traditionally, ivy leaf preparations have been used to relieve symptoms of respiratory conditions such as bronchitis, upper respiratory tract infections, and cough. It has also been used as an expectorant to help clear mucus from the airways.
Active compounds
The main active compounds in ivy leaf extracts include saponins (such as hederacoside C), flavonoids, and polyphenols. These constituents are thought to contribute to the plant’s secretolytic (expectorant) and spasmolytic effects on the respiratory tract.
Potential benefits with evidence levels
- Reduction in cough severity and acceleration of recovery in acute respiratory tract infections (Moderate evidence)
Meta-analysis of two double-blind, randomized, placebo-controlled trials demonstrated that ivy leaf dry extract (EA 575) significantly reduced bronchitis severity scores and increased the number of cough-free patients compared to placebo, with similar adverse event rates.
A systematic review including randomized controlled trials (RCTs) in adults and children concluded that ivy leaf extract is effective and safe for cough due to acute URTIs and bronchitis; however, the effects were minimal and the clinical significance uncertain.
Another systematic review identified ivy leaf dry extract among phytopharmaceuticals used in children with respiratory tract infections but noted that further research is needed to confirm efficacy. - Expectorant effect and improvement in respiratory symptoms (Limited evidence)
Rapid reviews indicated that ivy preparations may improve expectoration, reduce dry cough frequency, and improve inflammatory markers related to respiratory symptoms, though evidence quality was variable.
Mechanistic reviews support secretolytic (expectorant) and spasmolytic activities of ivy leaf as part of herbal combinations used for uncomplicated respiratory tract infections.
Side effects
Ivy preparations are generally well tolerated. Mild adverse events such as gastrointestinal symptoms or rare allergic reactions have been reported but are uncommon and typically non-serious. Cutaneous adverse reactions associated with traditional herbal medicines have been documented, although specific associations with ivy preparations remain unclear.
Drug interactions
No specific clinical evidence of drug interactions involving ivy was found in the reviewed literature. Nonetheless, compounds in herbal supplements, potentially including ivy, may influence the CYP2C8 enzyme involved in drug metabolism based on in vitro and animal studies. The clinical relevance of such interactions with ivy extracts has not been established and requires further investigation.
Who should avoid it
There are no well-defined contraindications for ivy use described in clinical literature. However, individuals with known hypersensitivity or allergic reactions to ivy or related constituents should exercise caution. Use during pregnancy and breastfeeding is not supported by sufficient safety evidence and should be avoided unless clearly necessary and supervised by a healthcare provider.
Evidence limitations
- Most clinical studies suffer from methodological limitations such as small sample sizes, lack of placebo controls, and short study durations.
- There is a lack of extensive high-quality randomized controlled trials, particularly involving pediatric populations.
- Long-term safety data, especially in special populations like pregnant or breastfeeding women, are insufficient.
- Variability in preparations and dosages limits the generalizability of results.
- Pharmacokinetic and herb-drug interaction data remain limited, hampering definitive conclusions.
References
- Völp A et al. (2022). Ivy leaves extract EA 575 in the treatment of cough during acute respiratory tract infections: meta-analysis of double-blind, randomized, placebo-controlled trials.
- Sierocinski E et al. (2021). Ivy leaf (Hedera helix) for acute upper respiratory tract infections: an updated systematic review.
- Kamin W et al. (2025). Phytotherapy for acute respiratory tract infections in children: a systematically conducted, comprehensive review.
- Mssusa AK et al. (2023). Safety profile of herbal medicines submitted for marketing authorization in Tanzania: a cross-sectional retrospective study.
- Barvaliya MJ et al. (2023). Suspected cutaneous adverse drug reactions reported with traditional medicines: analysis of data for United Nations Asia region from WHO VigiBase.
- Zhu LL et al. (2025). CYP2C8-Mediated Drug-Drug Interactions and the Factors Influencing the Interaction Magnitude.
- Barnes LA et al. (2020). The effects of Hedera helix on viral respiratory infections in humans: A rapid review.
- Veldman LBM et al. (2023). Mechanistic Evidence of Andrographis paniculata and others in the Treatment of Acute, Uncomplicated Respiratory Tract Infections.
Last reviewed
June 2024
Disclaimer: This content is for informational purposes only and does not constitute medical advice. Always consult a healthcare professional before starting any herbal supplement, especially if you are pregnant, breastfeeding, have an existing medical condition, or are taking other medications.