ivy leaf dry extract: clinical use

Prescribing considerations

• Confirm symptoms are consistent with a self-limiting chesty cough associated with a common cold.
• Explain that the indication rests on traditional use rather than demonstrated clinical efficacy.
• Review cough suppressants and other herbal or non-prescription products.
• Use caution with gastritis or gastric ulcer because gastrointestinal reactions can occur.

Contraindications and cautions

• Hypersensitivity to ivy leaf dry extract or any product excipient.
• Hereditary fructose intolerance because the syrup contains sorbitol.

Monitoring

• No product-specific laboratory monitoring is specified.
• Review persistent or worsening cough and investigate breathlessness, fever, pus-like sputum, chest pain or haemoptysis.
• Monitor for gastrointestinal intolerance and allergic reactions.

Clinical pharmacology

Ivy leaf contains multiple constituents, including saponins. Its precise clinical mechanism is uncertain; proposed expectorant actions include increased watery bronchial secretion and bronchodilation. Product-specific pharmacokinetic studies are not provided in the SmPC.

Formulation and product differences

• The selected product is a sugar-free, brown, opalescent oral syrup with a sweet taste.
• It contains sorbitol, xanthan gum, potassium sorbate, citric acid and purified water.
• The dry extract is manufactured using ethanol 30% m/m as the extraction solvent.
• A graduated measuring spoon is supplied; the opened bottle has product-specific storage and disposal instructions in the leaflet.