Benefits
May shorten acute bronchitis symptoms
Placebo-controlled trials of EPs 7630 in adults with acute bronchitis reported a faster fall in the bronchitis symptom score and an earlier return to work, typically by about two days. The effect is on how quickly symptoms settle, not on whether the illness happens at all.
Eases cough and nasal congestion during a common cold
In cold and sinusitis trials, cough, nasal discharge and blocked nose eased sooner on the extract than on placebo. Independent reviewers accepted the direction of that difference but not its size, because the trials were short, modest in size and run by the company that makes the extract.
Supports immune defense against upper respiratory infection
Laboratory work shows the root extract interferes with bacteria sticking to airway cells and raises interferon-beta release from infected cells. That gives a plausible route by which it could blunt an upper respiratory infection, though the mechanism work is cell-based and has not been confirmed in people.
Studied in children with airway infections
The main independent review included pediatric trials, and syrup and drops are licensed for children in Germany. Benefit in children was rated the same way as in adults: possible, but resting on low-quality evidence. Any child with fever, wheeze or difficulty breathing needs a clinician, not a herbal extract.
Mechanism of action
Anti-adhesion at the airway surface
Prodelphinidin-type proanthocyanidins in the root reduce the ability of bacteria such as Streptococcus pyogenes to attach to throat and airway epithelium, and appear to favor attachment to shed cells instead, which helps clearance.
Interferon and cytokine signaling
Cell studies show the extract increases release of interferon-beta and tumor necrosis factor alpha from infected cells and raises natural killer cell activity, consistent with an indirect antiviral effect rather than direct virus killing.
Ciliary beat and mucus clearance
The extract raises ciliary beat frequency in cultured respiratory epithelium, which would speed the mucociliary escalator that moves mucus and trapped particles up and out of the airway.
Coumarins as characteristic constituents
Umckalin and related coumarins are the extract's analytical markers and show modest antibacterial activity in the laboratory, but they sit at concentrations too low to explain the clinical picture through direct antimicrobial action.
Clinical trials
Cochrane systematic review of randomized placebo-controlled trials of Pelargonium sidoides extract in acute respiratory infection (Timmer A, Gunther J, Motschall E, Rucker G, Antes G, Kern WV 2013, Cochrane Database Syst Rev 2013(10):CD006323, PMID 24146345).
Adults and children with acute bronchitis, sinusitis, tonsillopharyngitis or the common cold.
The reviewers concluded the liquid extract may relieve symptoms of acute bronchitis in adults and children and of sinusitis in adults, while grading all of the evidence as low quality. Tablet preparations did not show a consistent benefit. Every included trial was conducted by the same manufacturer, which the reviewers flagged as a limitation on how much weight the result can carry.
Randomized, double-blind, placebo-controlled trial of EPs 7630 liquid extract (Matthys H, Eisebitt R, Seith B, Heger M 2003, Phytomedicine 10 Suppl 4:7-17, PMID 12807337).
Adults with acute bronchitis, treated for 7 days.
The bronchitis-specific symptom score fell further on EPs 7630 than on placebo, and more people in the extract group were rated completely or almost completely recovered by day 7. Tolerability matched placebo. The trial was sponsored by the extract's manufacturer.
Randomized, double-blind, placebo-controlled dose-finding study of EPs 7630 tablets (Matthys H, Lizogub VG, Malek FA, Kieser M 2010, Curr Med Res Opin 26(6):1413-22, PMID 20387996).
Adults with acute bronchitis, randomized to three tablet strengths or placebo.
Symptom scores improved more at the higher tablet strengths than at the lowest, which supports a dose relationship for the tablet form. Cochrane nevertheless judged the tablet evidence weaker than the evidence for the liquid extract, so the drops remain the better-supported preparation.