English Ivy

Plant Part Used

Leaf

Active Constituents

Saponins 5-8% (including alpha-hederin and hederacoside C), sterols, flavonoids, polyalkynes (including falcarinone and falcarinol). (1)

[span class=alert]This section is a list of chemical entities identified in this dietary supplement to possess pharmacological activity. This list does not imply that other, yet unidentified, constituents do not influence the pharmacological activity of this dietary supplement nor does it imply that any one constituent possesses greater influence on the overall pharmacological effect of this dietary supplement.[/span]

Introduction

Ivy grows across Europe and into northern and central Asia, and has been naturalized to the United States. It is cultivated for use in gardens around the world to climb along trellises and as a ground cover. As a medicinal agent, ivy leaf traditionally has been used in the symptomatic relief of acute and chronic respiratory inflammation, as an antihelmintic, and as an agent to reduce fever and cause diaphoresis.(2) In Europe, preparations are available as teas, skin products, cosmetics, shampoos, anticellulite creams,and in proprietary mixtures such as those used for bronchitis.

Dosage Info

Dosage Range

Tablets: 2 x 25mg, 3-4 times daily as needed.

Syrup:

Adults – 2 to 3 teaspoonfuls (10-15ml), 2-6 times a day as needed
Children (6 and older) – 1 & ½ teaspoonful (7.5ml), 2-6 times daily
Children (Under 6) – 1 teaspoonful (5ml), 2-4 times daily

Tea: One cup using 0.3 to 0.8 gm of herb, taken 3 times per day.(3)

Most Common Dosage

Tablets: 2 x 25mg, 3 times a day as needed.

Syrup:

Adults – 2  teaspoonfuls (10ml), 2-6 times a day as needed; Children (6 and older) – 1 & ½ teaspoonful (7.5ml), 2-6 times daily

Children (Under 6) – 1 teaspoonful, 2-4 times daily

Tea: One cup using 0.3 gm of herb, taken 3 times per day.

Standardization

[span class=doc]Standardization represents the complete body of information and controls that serve to enhance the batch to batch consistency of a botanical product, including but not limited to the presence of a marker compound at a defined level or within a defined range.[/span]

The most current available medical and scientific literature indicates that this dietary supplement should be standardized to 25mg glycosidic saponins per tablet, at a strength of 5-7.5:1(w/v). Syrup: dried ivy extract (5-7.5:1w/v) 0.7gm/100ml.

Uses

Frequently Reported Uses

  • Bronchitis, acute or chronic
  • Expectorant In Coughs, Bronchial Complaints
  • Catarrhal Conditions Of The Upper Respiratory Tract
Other Reported Uses
  • Topically in Cellulitis
  • Antifungal; Antiparasitic; Antibacterial
  • Topically as an Emollient
  • Cosmetics

Toxicities & Precautions

General

Ivy leaf extract is reported safe in recommended dosages.(2)

Allergy

Ivy leaf has been reported to cause contact dermatitis in sensitive individuals.(4),(5),(19),(20) If allergy develops, discontinue use.

Pregnancy/ Breast Feeding

Safety in pregnancy has not yet been determined, so use with caution.

Pharmacology

The constituent falcarinol has reported antibacterial, analgesic, and sedative effects.(6),(1) Also, the isolated constituent alpha-hederin has been reported to have significant activity against Candida albicans in-vitro.(7) Other research helps confirm the antifungal activity of saponins found in ivy leaf.(8),(9) It is postulated that saponins found in ivy leaf trigger responses in the gastric mucosa, in turn activating mucosal cells in the bronchi to remove excess mucous via stimulation of the parasympathetic nervous system.(10) In-vitro tests also report antispasmodic activity associated with dried ivy extract.(10) In addition, saponins derived from ivy leaf have been reported to be cytotoxic to mouse melanoma cell cultures, with potential uses in support of cancer therapies.(11),(12)

The constituent alpha-hederin has also been reported to be hepatoprotective in laboratory animals.(13),(14) It was once thought that the saponins from ivy leaf would be beneficial in chronic venous insufficiency (CVI), as are the saponins from horse-chestnut seed. However, research on this concluded that saponins from ivy did not have a significant effect on venous flow.(15) Further research should be performed to evaluate these findings.

There have been several studies that have reported favorable clinical results in the use of a proprietary dried ivy leaf extract in the management of upper respiratory problems. One such report was a randomized, double-blind crossover study involving 25 school-age children aged 10-15 years with COPD.(16) Improvements in spirometric and plethysmographic parameters were reported, with a daily dose of 105mg of the proprietary dried ivy leaf extract and with 42mg daily of dried ivy leaf drops (2gm/100ml, 5-7.5:1w/v), both being therapeutically equivalent in the positive outcome.

Another double-blind, randomized, controlled study consisting of 99 individuals with chronic bronchitis, compared a proprietary dried ivy leaf extract with the pharmaceutical ambroxol, a synthetic mucolytic.(17) Efficacy was evaluated with both spirometry and auscultation, with the ivy leaf extract reported to be equivalent to that of the synthetic chemical in relieving chronic bronchitis. Another multi-center study reported that a proprietary syrup of ivy extract was effective in the management of recurrent obstructive respiratory disease in children aged 6 to 15 years, with a daily dosage of 6 teaspoonfuls.(18) Coughing, expectoration, and pulmonary function was reported to improve significantly during the study.

A  post marketing study of 9657 patients (5181 children) with bronchitis (acute or chronic) treated with dried ivy leaf extract found that after 7 days of therapy, 95% of the patients showed improvement or healing of their symptoms. The authors also found that in patients who received antibiotics along with ivy extract had no benefit respective to efficacy but did increase the relative risk for the occurrence of side effects by 26%.(21) A double-blind, placebo-controlled, multicentre Phase IV study using 361 outpatients with acute bronchitis found that administration of a combination of thyme and ivy extracts was superior to placebo in relieving symptoms.(22)

References

  1. Cioaca C, Margineanu C, Cucu V. The Saponins of Hedera helix with Antibacterial Activity. Pharmazie. Sept 1978;33(9):609-10.
  2. Blumenthal M, ed. Herbal Medicine: Expanded Commission E Monographs. Newton, MA:Integrative Medical Communications; 2000.
  3. PDR for Herbal Medicines, 2nd edition. Montvale, NJ: Medical Economics Company; 2000:276.
  4. View Abstract: Johnke H, Bjarnason B. [Contact Dermatitis Allergy to Common Ivy]. Ugeskr Laeger. Jun1994;156(25):3778-9.
  5. Garcia M, Fernandez E, Navarro JA, del Pozo MD, Fernandez de Corres L. Allergic Contact Dermatitis from Hedera helix. Contact Dermatitis. 1995;33(2):133-134.
  6. View Abstract: Tanaka S, Ikeshiro Y, Tabata M, Konoshima M. Anti-nociceptive Substances From the Roots of Angelica acutiloba. Arzneimittelforschung. 1977;27(11):2039-45.
  7. View Abstract: Moulin-Traffort J, Favel A, Elias R, Regli P. Study of the Action of Alpha-hederin on the Ultrastructure of Candida albicans. Mycoses. Nov1998;41(9-10):411-6.
  8. Timon-David P, Julien J, Gasquet M, Balansard G, Bernard P. [Research of Antifungal Activity From Several Active Principle Extracts from Climbing-ivy: Hedera helix L]. Ann Pharm Fr. 1980;38(6):545-52.
  9. Mshvildadze V, Favel A, Delmas F, Elias R, Faure R, Decanosidze G, et al. Antifungal and Antiprotozoal Activities of Saponins from Hedera colchica. Pharmazie. Apr2000;55(4):325-6.
  10. View Abstract: Trute A, Gross J, Mutschler E, Nahrstedt A. In Vitro Antispasmodic Compounds of the Dry Extract Obtained from Hedera helix. Planta Med. Apr1997;63(2):125-9.
  11. View Abstract: Danloy S, Quentin-Leclercq J, Coucke P, De Pauw MC, Elias R, Balansard G, Angenot L, et al. Effects of alpha-hederin, a saponin extracted from Hedera helix, on cells cultured in vitro. Planta Med. Feb1994;60(1):45-9.
  12. View Abstract: Jeong HG, Lee SS. Suppressive Effects of Alpha-Hederin on 2,3,7,8-Tetrachlorodibenzo-p-dioxin-Mediated Murine Cyp1a-1 Expression in the Mouse Hepatoma Hepa-1c1c7 Cells. Cancer Lett. Apr1999 26;138(1-2):131-7.
  13. View Abstract: Shi JZ, Liu GT. [Protective Effect of the Fulvotomentosides on Paracetamol-induced Hepatotoxicity in Mice]. Yao Hsueh Hsueh Pao. 1995;30(4):311-4.
  14. View Abstract: Liu J, Liu Y, Bullock P, Klaassen CD. Suppression of Liver Cytochrome P450 by Alpha-hederin: Relevance to Hepatoprotection. Toxicol Appl Pharmacol. Sept1995;134(1):124-31.
  15. View Abstract: Facino RM, Carini M, Stefani R, Aldini G, Saibene L. Anti-elastase and Anti-hyaluronidase Activities of Saponins and Sapogenins from Hedera helix, Aesculus hippocastanum, and Ruscus aculeatus: Factors Contributing to Their Efficacy in the Treatment of Venous Insufficiency. Arch Pharm (Weinheim). Oct1995;328(10):720-4.
  16. Gulyas A, Repges R, Dethlefesen U. Systematic Therapy of Chronic Obstructive Respiratory Disease in Children. Atemwegs und Lungenkrankheiten. 1997;23:291-294.
  17. Meyer-Wegener J, Liebscher K, Hettich M, Kastner HG. Ivy versus Ambroxol in Chronic Bronchitis. Zeitchrift fun Allgemeinmedizin. 1993;69:61-66.
  18. Lassig W, Generlich H, Heydolph F, Paditz E. Efficacy and Tolerance of Ivy-Containing Cough Medications. TW Pediatric. 1996:489.
  19. Hannu T, Kauppi P, Tuppurainen M, Piirilä P. Occupational asthma to ivy (Hedera helix). Allergy. Apr 2008;63(4):482-483. No abstract available.
  20. Jones JM, White IR, White JM, McFadden JP. Allergic contact dermatitis to English ivy (Hedera helix)--a case series. Contact Dermatitis. Mar 2009;60(3):179-180. No abstract available.
  21. Fazio S, Pouso J, Dolinsky D, Fernandez A, Hernandez M, Clavier G, Hecker M. Tolerance, safety and efficacy of Hedera helix extract in inflammatory bronchial diseases under clinical practice conditions: a prospective, open, multicentre postmarketing study in 9657 patients. Phytomedicine. Jan 2009;16(1):17-24. Epub 2006 Jul 24.
  22. Kemmerich B, Eberhardt R, Stammer H. Efficacy and tolerability of a fluid extract combination of thyme herb and ivy leaves and matched placebo in adults suffering from acute bronchitis with productive cough. A prospective, double-blind, placebo-controlled clinical trial. Arzneimittelforschung. 2006;56(9):652-660.