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65,000 patients, and has demonstrated
efficacy and excellent tolerability.
Ivy leaf has been used for decades
and scientific studies suggest it
has mucolytic, expectorant and
bronchodilating effects. Constituents
in ivy leaf have been shown to increase
the secretion of surfactant and improve
bronchodilation; thinning mucus,
improving expectoration, relieving
bronchospasm, and ultimately reducing
Ivy leaf extract has been shown to be
a well tolerated and effective option
for children with uncomplicated acute
coughs, and the tolerability of ivy leaf
has been rated as ‘good’ or ‘very good’
by over 96% of patients, carers and
There are no known drug
interactions for ivy leaf.
For uncomplicated coughs patients
should be advised to get plenty of rest,
drink lots of fluids and take something
for the symptomatic relief of cough.
It can be useful to have a product on
hand that is low risk and suitable for the
whole family, from children (children
under the age of two should see a
doctor first) to elderly family members.
1. Irwin RS, Madison JM. The Diagnosis and Treatment
of Cough. New England Journal of Medicine
2. Family Doctor. Cough. ND [cited 4 Jun 2016]. At: http://
3. Kloosterboer SM, McGuire T, Deckx L, et al. Self-medication
for cough and the common cold: information needs of
consumers. Aust Fam Physician 2015;44(7):497–501.
4. Therapeutic Goods Administration. OTC cough and cold
medicines for children - Final outcomes of TGA review.
[updated 15 Aug 2012; cited 5 May 2016]. At: https://www.
5. Lang C, Rottger-Luer P, Staiger C. A Valuable Option for the
Treatment of Respiratory Diseases: Review on the Clinical
Evidence of the Ivy Leaves Dry Extract EA 575(R). Planta
6. Schmidt M, Thomsen M, Schmidt U. Suitability of ivy extract
for the treatment of paediatric cough. Phytother Res
7. Stauss-Grabo M, Atiye S, Warnke A, et al. Observational
study on the tolerability and safety of film-coated tablets
containing ivy extract (Prospan(R) Cough Tablets) in
the treatment of colds accompanied by coughing.
Phytomedicine 2011;18(6):433–6 .
8. Hedera helix [Internet]. MIMS Online. 2016 [cited 6 Jun].
Available from: http://www.mims.com.au/index.php/
This column is supported through an unrestricted
grant from Flordis.
clinically proven natural medicines
The World Health Organization (WHO) and the International
Pharmaceutical Federation (FIP) have released guidelines for healthcare
professionals prescribing or supplying medicines for children when no
authorised product exists.
Paediatricians and health professionals
around the world have long struggled
with the lack of authorised and
commercially available child‐specific
medicines. They are often forced to
use adult medicines when treating
children, for example by crushing
tablets or making products from scratch.
This approach poses significant risks,
increasing the potential for inaccurate
dosing and impacting on the quality,
safety and efficacy of the medicine.
The new guidlines provides advice
based on the available evidence,
best practices and sound scientific and
therapeutic principles. For example, if a
prescribed medicine is not available in
an age‐appropriate formulation, using
a commercially available medicine with
a similar therapeutic action, which is
available in a more suitable form, may
Dr Régis Vaillancourt, Director of
Pharmacy at the Children’s Hospital
of Eastern Ontario, Canada, and a
contributor to the guidance document
said: ‘Children are more susceptible to
medication errors and at greater risk
of negative consequences from them.
Right now in hospitals we still have to
compound products for children every
day, many times a day, and this guidance
– the first international consensus‐based
approach dealing with this subject –
is much needed.
Dr Sabine Kopp, Group Lead, Medicines
Quality Assurance, WHO said: ‘We need
to ensure these guidelines are made
available to all countries, particularly
in poorly‐resourced ones, where the
burden of disease and children’s need
for treatments are more acute. While we
wait for the research industry to catch
up on children’s medicines, this is the
best alternative we have at present.’
The guidelines are available on the FIP
and WHO websites.
Paediatricians and health
professionals all over the
world have long struggled
with the lack of authorised
and commercially available
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