Cough Clear Ivy Leaf Extract & Menthol

Ivy leaf helps a lot of people move a stubborn chesty cough along, but it isn't right for everyone, so these are the quick questions our naturopaths ask in store.

A good fit if

• You have a chesty cough with mucus that won't clear on its own
• You're an adult, or your child is over 2, with a cough from a cold
• You want a standardised extract with real placebo-controlled trials behind it, like EA 575
• You're happy to give it three or four days before deciding whether it's helping

Check with us first if

• Your cough has already lasted more than a week
• You're not sure if it's mild bronchitis or something more serious
• You're allergic to ginseng or other plants in the Araliaceae family, because ivy belongs to the same family
• You're managing a young child's cough and aren't sure whether it needs a doctor's diagnosis first

• Dry extract EA 575. Best known for: The most studied ivy extract, and the one in the Australian listed product. Absorption: Standardised, with a herb-to-extract ratio of 5 to 7.5:1, made with 30% ethanol. Typical use: The extract with real placebo-controlled trial data behind it.
• Liquid extract, DER 1:1. Best known for: Needs a much bigger dose in milligrams for a similar effect. Absorption: It's a 1:1 extract, so its mg number isn't directly comparable with a dry extract's. Typical use: Check the extraction ratio on the label before comparing it with a dry extract.
• Soft extract. Best known for: Used in some syrups, and tested head to head against another ivy extract. Absorption: A semi-solid extract with a herb-to-extract ratio of 2.2 to 2.9:1; it contains propylene glycol. Typical use: A middle-strength extract, mainly found in syrups.
• Thyme and ivy leaf combination. Best known for: The strongest placebo-controlled trial result of any product containing ivy. Absorption: Adds thyme's airway-relaxing (antispasmodic) action to ivy's mucus-loosening one. Typical use: For a chesty cough with frequent coughing fits, though the benefit belongs to the combination, not ivy alone.
• Ivy leaf tea or fresh leaf. Best known for: No recognised use of any kind. Absorption: Not standardised, and there's no dose data. Typical use: Skip it. Only use standardised extracts made as medicines.

Reference values. There aren't any. Ivy leaf isn't a nutrient, so there's no NHMRC Nutrient Reference Value or RDI for it.

Typical supplemental range. Doses depend entirely on the extract and strength a product uses. For the most studied dry extract (EA 575 type, extract ratio 5 to 7.5:1), adults usually take around 45 to 105 mg a day, split into several doses. Other registered extracts range from about 42 mg to 300 mg a day depending on how concentrated they are. Children's doses are lower and set by age.

Upper level. There's no NHMRC Upper Level of Intake, and Australia's permitted ingredients list (Schedule 1) sets no maximum daily dose. Most trials ran for 5 to 14 days.

Worth knowing. If your cough is still there after about a week, it's time to see a doctor or pharmacist rather than keep going. What you need depends on your age, diet and health, so talk to one of our naturopaths.

If any of these sound like you, talk to one of our naturopaths or your doctor before you start.

• Children under 2. Don't give it: it can make breathing symptoms worse, not better.
• Children aged 2 to 4 with a persistent or recurring cough. See a doctor for a diagnosis first.
• Pregnancy. Not recommended; safety hasn't been established.
• Breastfeeding. Not recommended; safety hasn't been established.
• Allergy to ivy or other plants in the Araliaceae family, including ginseng. Don't take it.
• Stomach upset. Nausea, vomiting or diarrhoea can occur.
• Allergic reactions, including rash, difficulty breathing or, rarely, anaphylaxis. Stop and get help.
• A cough lasting more than a week. See a doctor or pharmacist.
• There's no documented data on ivy leaf interacting with medicines. Check with your pharmacist if you take regular medicines.
• If you take prescription medicines, check with your doctor, pharmacist or one of our naturopaths before you start.