African Geranium (Pelargonium sidoides) in the Treatment of Acute Respiratory Tract Infections: A Review of Mechanisms of Action, Efficacy, and Clinical Applications
DOI:
https://doi.org/10.12775/JEHS.2025.80.59360Keywords
Pelargonium sidoides, EPs 7630, Geraniaceae, respiratory tract infectionsAbstract
Introduction:
African geranium (Pelargonium sidoides) is a plant endemic to the mountainous regions of South Africa, traditionally used for centuries to treat respiratory infections and gastrointestinal disorders. The main active ingredient is an extract from the roots and rhizomes, designated as EPs 7630, which contains coumarins, coumarin glycosides, phenolic acids, flavonoids, fatty acids, and proanthocyanidins. Modern phytotherapy utilizes this extract to treat acute respiratory infections such as bronchitis, tonsillitis, and the common cold.
Aim of the study:
The aim of this work is to present the mechanisms of action and efficacy of African geranium in the treatment of acute respiratory infections, with particular emphasis on its antiviral, antibacterial, and immunomodulatory properties. The study synthesizes available scientific research to evaluate the therapeutic potential of EPs 7630 as an alternative to conventional therapies.
Materials and methods:
The article was prepared by analyzing multiple databases, including PubMed, Google Scholar, and Elsevier, covering the period from 1995 to 2024.
Conclusions:
African geranium, thanks to its antiviral, antibacterial, and immunomodulatory properties, represents an effective and safe option for treating acute respiratory infections. Clinical trials confirm its efficacy in reducing the duration and severity of illness, making it a valuable alternative to conventional therapies. However, further research is needed to determine optimal dosing and long-term effects of the preparation
References
1. Brendler T, van Wyk BE. A historical, scientific and commercial perspective on the medicinal use of Pelargonium sidoides (Geraniaceae). J Ethnopharmacol. 2009;119:420-433. https://doi.org/10.1016/j.jep.2008.07.037
2. Panara A, Aalizadeh R, Thomadis NS. Chemical characterisation of Pelargonium sidoides root based on LC-QTOF-MS non-target screening strategies. Phytochem Anal. 2022;33:40-56. https://doi.org/10.1002/pca.3067
3. Cinatl J Jr, Wass MN, Michaelis M. Multiple mechanisms enable broad-spectrum activity of the Pelargonium sidoides root extract EPs 7630 against acute respiratory tract infections. Front Pharmacol. 2024. https://doi.org/10.3389/fphar.2024.1455870
4. Wang P, Yu Z. Species authentication and geographical origin discrimination of herbal medicines by near infrared spectroscopy: A review. J Pharm Anal. 2015;5(5):277-284. https://doi.org/10.1016/j.jpha.2015.04.001
5. Timmer A, Motschall E, Rücker G, Antes G, Kern WV. Pelargonium sidoides extract for treating acute respiratory tract infections. Cochrane Database Syst Rev. 2013;CD006323. https://doi.org/10.1002/14651858.CD006323.pub3
6. Kayser O. Highly oxygenated coumarins from Pelargonium sidoides. Phytochemistry. 1995;39(5):1181-1185. https://doi.org/10.1016/0031-9422(95)00166-5
7. Kayser O, Kolodziej H. Antibacterial activity of extracts and constituents of Pelargonium sidoides and Pelargonium reniforme. Planta Med. 1997;63(6):508-510. https://doi.org/10.1055/s-2006-957752
8. Mativandlela SPN, Lall N, Meyer JJM. Antibacterial, antifungal and antitubercular activity of (the roots of) Pelargonium reniforme (CURT) and Pelargonium sidoides (DC) (Geraniaceae) root extracts. S Afr J Bot. 2006;72(2):232-237. https://doi.org/10.1016/j.sajb.2005.08.002
9. Mahomoodally MF. Traditional medicines in Africa: an appraisal of ten potent African medicinal plants. Evid Based Complement Alternat Med. 2013;2013:617459. https://doi.org/10.1155/2013/617459
10. Lewu FB, Adebola PO, Afolayan AJ. Commercial harvesting of Pelargonium sidoides in the Eastern Cape, South Africa: Striking a balance between resource conservation and rural livelihoods. J Arid Environ. 2007;70(2):380-388. https://doi.org/10.1016/j.jaridenv.2006.12.022
11. Matthys H, Kamin W, Funk P, Heger M. Pelargonium sidoides preparation (EPs 7630) in the treatment of acute bronchitis in adults and children. Phytomedicine. 2007;14 Suppl 6:69-73. https://doi.org/10.1016/j.phymed.2006.11.015
12. Wopker PM, Schwermer M, Sommer S, et al. Complementary and alternative medicine in the treatment of acute bronchitis in children: A systematic review. Complement Ther Med. 2020;49:102217. https://doi.org/10.1016/j.ctim.2019.102217
13. Gericke N. Muthi to medicine. S Afr J Bot. 2011;77(4):850-856. https://doi.org/10.1016/j.sajb.2011.08.007
14. Careddu D, Pettenazzo A. Pelargonium sidoides extract EPs 7630: a review of its clinical efficacy and safety for treating acute respiratory tract infections in children. Int J Gen Med. 2018;11:91-98. https://doi.org/10.2147/IJGM.S154198
15. de Boer HJ, Bate J, Meyboom RHB. Allergic reactions to medicines derived from Pelargonium species. Drug Saf. 2007;30(8):677-680. https://doi.org/10.2165/00002018-200730080-00004
16. Conrad A, Jung I, Tioua D, et al. Extract of Pelargonium sidoides (EPs 7630) improves phagocytosis, oxidative burst, and intracellular killing of human peripheral blood phagocytes in vitro. Phytomedicine. 2007;14 Suppl 6:9-12. https://doi.org/10.1016/j.phymed.2007.09.005
17. Schoetz K, Engels I, Holzgrabe U. Quality control of Pelargonium sidoides extract (EPs 7630). Phytomedicine. 2008;15 Suppl 6:2-6. https://doi.org/10.1016/j.phymed.2008.09.006
18. Wittschier N, Faller G, Hensel A. Aqueous extracts of Pelargonium sidoides inhibit the adherence of Helicobacter pylori to gastric epithelial cells. Phytomedicine. 2007;14 Suppl 6:5-8. https://doi.org/10.1016/j.phymed.2007.09.004
19. Kolodziej H, Kiderlen AF, Kayser O. Immunomodulatory principles of Pelargonium sidoides. Phytother Res. 2001;15(2):122-126. https://doi.org/10.1002/ptr.785
20. Matthys H, Heger M. Treatment of acute bronchitis with a liquid herbal drug preparation from Pelargonium sidoides (EPs 7630): a randomised, double-blind, placebo-controlled, multicentre study. Curr Med Res Opin. 2007;23(2):323-331. https://doi.org/10.1185/030079906X167318
21. Theisen LL, Muller CP. EPs 7630 (Umckaloabo®), an extract from Pelargonium sidoides roots, exerts anti-influenza virus activity in vitro and in vivo. Antiviral Res. 2012;94(2):147-156. https://doi.org/10.1016/j.antiviral.2012.03.006
22. Lizogub VG, Riley DS, Heger M. Efficacy of a Pelargonium sidoides preparation in patients with the common cold: a randomized, double-blind, placebo-controlled clinical trial. Explore (NY). 2007;3(6):573-584. https://doi.org/10.1016/j.explore.2007.09.004
23. Kamin W, Maydannik V, Malek F, Kieser M. Efficacy and tolerability of EPS 7630 in patients (aged 6–18 years old) with acute bronchitis: A randomized, double-blind, placebo-controlled clinical dose-finding study. Acta Paediatr. 2010;99(4):537-543. https://doi.org/10.1111/j.1651-2227.2009.01656.x
24. Kamin W, Ilvenko L, Malek F, Kieser M. Treatment of acute bronchitis with EPS 7630: Randomized, controlled trial in children and adolescents. Pediatr Int. 2012;54(2):219-226. https://doi.org/10.1111/j.1442-200X.2012.03598.x
25. Berezhnoi VV, Heger M, Lehmacher W, Seifert G. Clinical efficacy and safety of liquid Pelargonium sidoides preparation (EPs 7630) in children with acute non-streptococcal tonsillopharyngitis. J Compr Ped. 2016;7(4):e42158. https://doi.org/10.17795/compreped-42158
26. Seifert G, Brandes-Schramm J, Zimmermann A, et al. Faster recovery and reduced paracetamol use – a meta-analysis of EPs 7630 in children with acute respiratory tract infections. BMC Pediatr. 2019;19:119. https://doi.org/10.1186/s12887-019-1473-z
27. Gökçe Ş, Dörtkardeşler BE, Yurtseven A, et al. Effectiveness of Pelargonium sidoides in pediatric patients diagnosed with uncomplicated upper respiratory tract infection: a single-blind, randomized, placebo-controlled study. Eur J Pediatr. 2021;180:3019-3028. https://doi.org/10.1007/s00431-021-04211-y
28. Michaelis M, Doerr HW, Cinatl J. Investigation of the influence of EPs® 7630, a herbal drug preparation from Pelargonium sidoides, on replication of a broad panel of respiratory viruses. Phytomedicine. 2011;18:384-386. https://doi.org/10.1016/j.phymed.2010.09.008
29. Wittke K, Koch E, Volk HD, et al. The herbal extract EPs® 7630 increases the antimicrobial airway defense through monocyte-dependent induction of IL-22 in T cells. J Mol Med (Berl). 2020;93:1493-1503. https://doi.org/10.1007/s00109-020-01970-3
30. Nawrocka J, Gomonajko-Porowska J, Budzianowski J, et al. Medicinal herbs in the relief of neurological, cardiovascular, and respiratory symptoms after COVID-19 infection. A literature review. Cells. 2022;11:1897. https://doi.org/10.3390/cells11121897
31. Kolodziej H, Kiderlen AF. In vitro evaluation of antibacterial and immunomodulatory activities of Pelargonium reniforme, Pelargonium sidoides and the related herbal drug preparation EP8® 7630. Phytomedicine. 2007;14 Suppl 1:18-26. https://doi.org/10.1016/j.phymed.2007.09.003
32. Kardos P, Lehrl S, Kamin W, et al. Assessment of the effect of pharmacotherapy in common cold/acute bronchitis – the Bronchitis Severity Scale (BSS). Pneumologie. 2014;68:542-546. https://doi.org/10.1055/s-0034-1365649
33. Schapowal A, Dobos G, Cramer H, et al. Treatment of signs and symptoms of the common cold using EP8 7630 – results of a meta-analysis. Heliyon. 2019;6(11):e02904. https://doi.org/10.1016/j.heliyon.2019.e02904
34. Brendler T, Al-Harrasi A, Bauer R, et al. Botanical drugs and supplements affecting the immune response in the time of COVID-19: Implications for research and clinical practice. Phytother Res. 2021;35:3013-3031. https://doi.org/10.1002/ptr.7008
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Anna Kwasniewska, Aleksandra Wiśniewska, Jakub Dąbek, Wiktoria Kosucka, Dominik Balik, Joanna Lara, Martyna Grabowska, Karolina Grabowska, Karolina Kaszyńska, Jagoda Kubicka
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 70
Number of citations: 0
