Index of Herbs

Herbal formula

Thyme and Ivy

Also known as Bronchipret, Bronchipret Saft TE, Bronchipret Tropfen, Bronchipret Thymian Efeu, BNO 1200 (drops), thyme–ivy syrup, thyme and ivy leaf fluid extract

A fixed thyme and ivy leaf extract combination for chesty coughs, tested against placebo in one trial of 361 adults with bronchitis.

Main use: Acute bronchitis with chesty cough

Promising clinical evidence

2 ingredients

Updated October 10, 2026

Key points

  1. 01

    One large placebo trial in adults

    In 361 adults with acute bronchitis, 11 days of the syrup cut daytime coughing fits by 68.7% versus 47.6% with placebo (Kemmerich 2006).

  2. 02

    Mostly thyme, a little ivy

    The German syrup holds ten parts thyme extract to one part ivy; the drops about seventeen to one. Trial results belong to these products, not to either herb.

  3. 03

    No EU monograph for the pair

    EMA rates thyme alone as traditional and ivy alone as well-established but has never assessed them together. Germany licenses the syrup; the US expectorant monograph lists only guaifenesin.

  4. 04

    Age limits and alcohol differ by product

    The German syrup is labeled from age 1 and is about 7% alcohol; the drops start at 6 and are about 24%. EMA bars single-herb ivy medicines under 2.

  5. 05

    Stomach, allergy, and red flags

    Expect occasional stomach upset. Avoid with mint-family, ivy, birch, mugwort, or celery allergy and in pregnancy; see a doctor for breathlessness, fever, or bloody phlegm.

Thyme and ivy is a fixed combination of two liquid plant extracts, one from thyme herb (Thymus vulgaris or Thymus zygis) and one from ivy leaf (Hedera helix), sold as a medicine for chesty coughs with thick mucus. The best-known versions are Bronchipret Saft TE, a syrup, and Bronchipret Tropfen, drops, made by Bionorica SE in Neumarkt, Germany, where the syrup is sold only in pharmacies. Their German labels describe them as herbal medicines for colds of the airways, used to improve the symptoms of acute bronchitis with cough and of colds with thick, sticky mucus. Related versions are sold in other countries, for example as Bronchipret Thymian Efeu in Austria. Thyme is by far the larger ingredient: the syrup contains ten parts thyme extract to one part ivy extract. Other companies sell different cough blends that contain ivy and thyme alongside further herbs, and Bionorica also makes a sister product, Bronchipret TP tablets, which pair thyme with primula (cowslip) root instead of ivy. This page is about the thyme–ivy combination, and the results described here belong to the products that were tested.

Both ingredients have long histories in European cough medicine, though the combination itself is a modern pharmacy product. According to the European Medicines Agency (EMA) assessment report on thyme, the type of thyme liquid extract used in Bronchipret, made with a mixture of ammonia solution, glycerol, ethanol, and water, has been described in the German Pharmacopoeia since 1968, and Germany’s Commission E listed a thyme fluid extract in 1984. Ivy took a stranger path. EMA’s ivy assessment report quotes the French physician Leclerc, who called ivy leaves a “specific” for whooping cough, and notes that Leuret of Bordeaux tested the idea clinically; ivy extracts have been in well-established medicinal use in Germany since at least 1976. Bionorica’s current syrup received its German marketing authorization on October 31, 2006, the year Kemmerich and colleagues published the placebo-controlled trial that still anchors the combination’s evidence. A year later the same lead author published a matching trial of the thyme–primula tablets, and EMA’s current thyme–primula monograph, published in 2016, rates certain thyme–primula combinations as well-established for adults. No equivalent EMA monograph exists for thyme with ivy.

How the combination works is not settled. Bronchipret’s German prescribing information says laboratory and animal studies suggest weak expectorant and antispasmodic effects for thyme, and that both herbs are thought to act partly by irritating the stomach lining, which reflexly increases watery secretion in the airways. It adds that no pharmacological or pharmacokinetic studies in people exist, either for the single extracts or for the fixed combination. In a rat study by Bionorica scientists, the syrup reduced lung inflammation and mucus-producing goblet cells after an inflammatory challenge (Seibel and colleagues, Phytomedicine 2015). In a cell study funded by Engelhard, which makes a rival ivy-only product, the thyme fraction blunted a β2-receptor effect seen with ivy alone (Bussmann and colleagues, Heliyon 2020). Neither shows what happens in a coughing person. This page covers the ingredients and amounts, the trials of the combination itself, how the products are labeled to be taken, and who should avoid them. Nothing here is medical advice.

See also

Herbs for Cough and Sore Throat

02 The blend

What’s in it

Ingredients in label order. Results from trials of this formula belong to the combination, not to any single herb in it.

  1. Thyme · Herb (leaf and flower), fluid extract

    16.8 g fluid extract (1:2–2.5) per 100 ml syrup; 0.5 ml per ml of drops

    Thymus vulgaris

    The main ingredient by weight, made by the German Pharmacopoeia method with ammonia, glycerol, ethanol, and water. EMA rates thyme on its own as a traditional remedy for productive cough with a cold.

    Read the thyme monograph →

  2. Ivy leaf · Leaf, fluid extract

    1.68 g fluid extract (1:1) per 100 ml syrup; 0.03 ml per ml of drops

    Hedera helix

    A saponin-rich expectorant that EMA accepts on its own as well-established use from age 2. One part to ten of thyme in the syrup, yet the adult daily dose is close to EMA’s single-herb dose for this extract type.

    Read the ivy leaf monograph →

03 Evidence

What the research shows

Promising clinical evidence

Our rating for acute bronchitis with chesty cough, based on trials of this combination.

The key trial is Kemmerich, Eberhardt, and Stammer (Arzneimittelforschung 2006), a double-blind, placebo-controlled, multicenter phase IV study of the marketed syrup. It enrolled 361 adult outpatients with acute bronchitis who had at least 10 daytime coughing fits, mucus that had started within the previous two days and was hard to cough up, and a Bronchitis Severity Score (BSS) of at least 5. They took 5.4 ml of Bronchipret Saft (n=182) or a matched placebo syrup (n=179) three times a day for 11 days and counted their coughing fits with a hand counter. By days 7 to 9, daytime coughing fits had fallen 68.7% from baseline with the syrup and 47.6% with placebo, and a 50% reduction came two days sooner. Investigator-rated responder rates were 83.0% versus 53.9% on day 4 and 96.2% versus 74.7% at the end. Adverse events did not differ between groups, and none was serious. The abstract does not name a funder. No second placebo-controlled trial of the combination appears in the reviews checked for this page, and the placebo group shows how much an acute cough improves on its own.

Evidence in children and for the drops comes from studies without a placebo group. Marzian (MMW Fortschritte der Medizin 2007), a pediatrician, reported a post-marketing study of the syrup in 1,234 children and adolescents with acute bronchitis, 12 of them under age 2; the average BSS fell from 8.8 to 4.8 points by day 4 and to 1.3 after about ten days. Safina (Zeitschrift für Phytotherapie 2014) randomized 54 children aged 1 to 6 to the syrup plus standard care or standard care alone, without blinding; according to Sierocinski and colleagues’ review, coughing fits were fewer at days 3–4 (about 12 versus 18 a day) but not at later visits. For the drops (research code BNO 1200), Kardos and colleagues (Current Medical Research and Opinion 2021) followed 730 adults who bought them in 305 German pharmacies, and the BSS fell from 8.7 to 2.4 over a mean of 7 days; three of the five authors worked for Bionorica. These studies describe recovery while taking the product, not recovery caused by it. A 2025 review funded by the maker of a rival pelargonium extract concluded that thyme–ivy needs further research in children (Kamin and colleagues, Frontiers in Pediatrics).

The only head-to-head trial cuts against the combination. Kardos and colleagues (Pharmaceuticals 2025) randomized 328 adults with acute bronchitis, in a 3:2:2 ratio, to ivy-only drops (Prospan, extract EA 575), thyme–ivy drops (Bronchipret), or thyme–primrose drops for a week, and analyzed 325. The BSS fell by 9.11 points with ivy alone, 7.64 with thyme–ivy, and 8.59 with thyme–primrose; ivy alone was non-inferior to both combinations and statistically superior to thyme–ivy. The trial was funded by Engelhard, which makes the ivy product, three authors were its employees, and patients and doctors knew which product was being taken. A 2026 letter by Cho, a London respiratory physician, argued that the open-label design, reliance on patient-reported outcomes, and unequal group sizes may have biased the result; the letter’s writing support was funded by Bionorica, which makes the thyme–ivy drops. Much of what is known about thyme–ivy therefore comes from two competing manufacturers, and no independent trial has settled whether adding thyme to ivy, or ivy to thyme, adds anything.

Systematic reviews give the combination a cautious nod at most. Wagner, Cramer, and colleagues (Forschende Komplementärmedizin 2015) pooled four randomized trials of ivy-, primrose-, and thyme-based preparations and found a cough response about 40% more likely than with placebo (risk ratio 1.40, 95% confidence interval 1.23–1.60), which they called strong evidence; the group spans several products, so the figure is not a thyme–ivy result alone. Sierocinski, Holzinger, and Chenot (European Journal of Clinical Pharmacology 2021), a general-practice research group, reviewed ivy preparations including combinations and concluded that they are safe but that their effects are “minimal at best and of uncertain clinical importance,” citing a high risk of bias and frequent manufacturer ties; they added that effects in combination trials may come from the other herbs. Veldman, Belt-van Zoen, and Baars (Pharmaceuticals 2023), with no external funding, reviewed laboratory studies of ivy, primrose, and thyme published before June 2021 and proposed that ivy contributes secretolytic and spasmolytic effects and thyme antibacterial effects, while finding studies on primrose lacking. That is a hypothesis, not proof that the herbs add to each other.

Regulators have never assessed thyme–ivy as a combination at EU level. EMA’s herbal committee rates thyme alone as a traditional herbal medicine for productive cough with a cold, based on long-standing use, and ivy leaf alone as a well-established expectorant for productive cough, based on published studies; both public summaries say combinations with other herbs are not covered. The closest EU precedent is thyme with primula root, which EMA accepts as well-established for productive cough in adults for certain fixed preparations; Bionorica’s tablet version, with 160 mg thyme and 60 mg primula root dry extract, was tested by Kemmerich (2007) in another 361-adult placebo trial (coughing fits down 67.1% versus 51.3%). In Germany, Bronchipret Saft TE holds a full national marketing authorization. In the United States it is not an approved drug, and the over-the-counter expectorant monograph names a single active ingredient, guaifenesin. Still unknown: whether the combination beats either herb alone in a blinded trial, how well it works in young children or in chronic lung disease, and whether the drops perform like the syrup. Single-herb results cannot be borrowed, because the extracts, doses, and ratios differ.

04 In practice

How it is taken

Bronchipret Saft TE, the syrup, contains in every 100 ml (112 g) 16.8 g of thyme herb fluid extract (drug-to-extract ratio 1:2–2.5, made with a 1:20:70:109 mixture of 10% ammonia solution, 85% glycerol, 90% ethanol, and water) and 1.68 g of ivy leaf fluid extract (ratio 1:1, made with 70% ethanol), according to its March 2025 German prescribing information. It is sweetened with maltitol solution and contains 300 mg of alcohol in each 5.4 ml adult dose, or 56 mg per ml. Bronchipret Tropfen, the drops, contain in each ml 0.5 ml of the same kind of thyme fluid extract and 0.03 ml of ivy leaf extract (1:1, 70% ethanol), plus added ethanol: 192 mg of alcohol per ml, roughly 24% by volume, or 500 mg in a 2.6 ml adult dose. The extract types match, but the ratio does not, at about ten parts thyme to one part ivy in the syrup and about seventeen to one in the drops. Other ivy-and-thyme cough products use different extracts altogether; one syrup studied in Switzerland combined ivy dry extract with a thyme and aniseed decoction and marshmallow root.

The German labels give doses three times a day. Syrup: 3.2 ml for children aged 1 to 5, 4.3 ml for ages 6 to 11, and 5.4 ml for adolescents from 12 and adults, taken undiluted from the supplied measuring cup after shaking the bottle; people with a sensitive stomach are advised to take it after meals. Drops: 1.3 ml for ages 6 to 11 and 2.6 ml from age 12. The adult syrup dose is the one used in the Kemmerich trial, which ran for 11 days. Working from the label, a day of adult syrup supplies about 2.7 g of thyme fluid extract and about 0.27 g of ivy leaf fluid extract. That ivy amount is close to the 300 mg a day EMA lists for the same type of ivy extract used on its own, while the thyme amount sits at the low end of EMA’s single-herb range for its extract (1–4 g per dose, up to 14 g a day). The labels tie treatment length to the course of the illness and say to see a doctor if symptoms last longer than a week or get worse.

Stop and see a doctor promptly if breathlessness, fever, or pus-like or bloody phlegm appears, if the cough worsens, or if any sign of allergy develops; the labels say the product must not be taken again after an allergic reaction. When comparing products, read the leaflet rather than the front of the box: check that it names Thymus vulgaris or Thymus zygis herb and Hedera helix leaf, the extract ratios, the age band, and the alcohol content, because the syrup and drops differ on the last two and versions in other countries may differ again. Do not combine it with another ivy, thyme, or thyme–primula cough product, and keep the alcoholic drops out of children’s reach. Results from the Kemmerich trial apply to the adult syrup at the tested dose; they do not transfer to teas, homemade syrups, chest rubs, or other blends. Bronchitis often gets better on its own in around three weeks, so a product like this is optional, and this page does not recommend any brand.

05 Caution

Before you use Thyme and Ivy

The German labels list stomach and bowel complaints such as cramps, nausea, and vomiting as uncommon (up to 1 in 100 people), with diarrhea also listed for the drops. Allergic reactions with skin rash are rare with the syrup, and the drops’ leaflet lists allergic reactions as very rare; more serious reactions with breathlessness, hives, or swelling of the face, mouth, or throat are also described, and at the first sign of one the product must not be taken again. A large overdose may cause stomach complaints, vomiting, and possibly diarrhea. The digestive effects fit the ingredients: EMA lists nausea, vomiting, and diarrhea for ivy leaf medicines and gastric disorders for thyme, and both herbs are thought to work partly by irritating the stomach lining. In the Kemmerich trial, adverse events were no more frequent than with placebo and none was serious. In Marzian’s study of 1,234 children, two had temporary stomach ache or mild nausea, and in the 730-adult pharmacy study of the drops no adverse drug reactions were reported.

Do not use thyme–ivy products with an allergy to ivy or other plants of the ivy family (Araliaceae), to thyme or other plants of the mint family (Lamiaceae), or to birch, mugwort, or celery, all of which the German labels list. The labels say the products should not be used in pregnancy or breastfeeding because they have not been adequately studied, and EMA does not recommend medicinal thyme or ivy then either. Age limits depend on the product: the German syrup is labeled from age 1 and the drops from age 6, while EMA contraindicates single-herb ivy medicines under 2 because medicines that loosen mucus can worsen breathing symptoms in infants, and says a persistent or recurrent cough at ages 2 to 4 needs a diagnosis first. Given that split, talk to a doctor before giving any cough medicine to a child under 2. People with gastritis or a stomach ulcer should see a doctor first, and people with hereditary fructose intolerance should not take the syrup, which contains maltitol. The syrup’s label flags its alcohol as a health risk in pregnancy, breastfeeding, and alcohol dependence, and notes possible drowsiness in small children.

No interactions are known, but none have been studied: the German labels say exactly that, and EMA’s thyme and ivy monographs list interactions as “none reported.” One signal deserves attention. EMA’s ivy assessment report reviewed case reports in young children who had taken ivy preparations together with codeine-containing cough medicines, including a 3-year-old who died after inhaling vomit with very high codeine and morphine levels, which the treating doctor attributed to codeine. The assessor concluded that combining ivy with opioid cough suppressants such as codeine or dextromethorphan is not recommended without medical advice. Taking a medicine meant to help you cough up mucus alongside one meant to stop the cough also works against itself. The alcohol in these products, especially the drops, can change the effects of other medicines, according to the syrup’s leaflet, and its prescribing information warns that other medicines containing ethanol or propylene glycol can make alcohol accumulate in small children. Thyme–primula tablets, single-herb ivy syrups, and multi-herb cough mixtures overlap with this combination, so do not double up.

A thyme–ivy product is for an ordinary chesty cough with a cold, not for breathing trouble or a cough that will not go away. The labels say to see a doctor promptly if symptoms last more than a week or worsen, or if breathlessness, fever, or pus-like or bloody phlegm appears. The UK National Health Service (NHS) advises an urgent appointment for a cough lasting more than three weeks that is not getting better, coughing up blood, chest pain on breathing or coughing, shortness of breath, or feeling too unwell for usual activities. It gives the same advice to people over 65, pregnant people, those with a long-term condition such as diabetes or a heart, lung, or kidney condition, and anyone with a weakened immune system. Call emergency services for struggling to breathe, lips or skin turning pale, blue, or gray, sudden confusion, or a baby who is floppy or cannot be woken. The products are licensed for acute coughs only; they are not treatments for asthma, chronic obstructive pulmonary disease (COPD), pneumonia, or whooping cough.

06 Questions

Frequently Asked Questions

Probably a little, in adults. In the one placebo-controlled trial, 361 adults with acute bronchitis who took the syrup for 11 days had 68.7% fewer daytime coughing fits than at the start by days 7 to 9, against 47.6% fewer on placebo. Neither that trial nor later studies separate the effect of thyme from that of ivy leaf, and a 2025 open-label trial funded by an ivy maker found ivy drops alone at least as good as, and statistically better than, thyme–ivy drops. Bronchitis often clears up on its own in around three weeks either way.

The German syrup, Bronchipret Saft TE, contains 16.8 g of thyme herb fluid extract and 1.68 g of ivy leaf fluid extract in every 100 ml, ten parts thyme to one part ivy. The German drops contain 0.5 ml of thyme fluid extract and 0.03 ml of ivy leaf extract in each ml. Versions sold in other countries can differ in strength, age limits, and alcohol, so check the local leaflet.

It depends on the product and the age. In Germany the syrup is labeled from age 1 and the drops from age 6, but EMA contraindicates single-herb ivy medicines under 2 because loosening mucus can worsen breathing in infants. Ask a doctor before giving any cough medicine to a child under 2, and get a diagnosis for a persistent or recurring cough in a child aged 2 to 4. Honey in a warm drink is an alternative only for children over 1. A baby who is struggling to breathe, floppy, or cannot be woken needs emergency care.

The German syrup contains 300 mg of alcohol in each 5.4 ml adult dose (56 mg per ml, about 7% by volume), which its leaflet compares to less than 8 ml of beer. The drops are much stronger: 192 mg per ml, roughly 24% by volume, or 500 mg in a 2.6 ml adult dose. That is a small amount for most adults, but it matters in pregnancy, breastfeeding, alcohol dependence, and young children, and for anyone taking medicines affected by alcohol.

Nobody has shown that it is. In a 2025 open-label trial of 325 adults, funded by the maker of an ivy-only product, bronchitis scores fell by 9.1 points with ivy drops, 7.6 with thyme–ivy drops, and 8.6 with thyme–primrose drops over a week. Patients and doctors knew which product was used, so the result is not conclusive. Thyme with cowslip (primula) root has its own placebo trial in 361 adults and, unlike thyme–ivy, its own EU monograph, which rates certain versions well-established for adults.

Not without medical advice. After reviewing case reports in young children who took ivy with codeine-containing cough medicines, EMA’s ivy assessment report advised against combining ivy with opioid cough suppressants such as codeine or dextromethorphan unless a doctor recommends it. Pairing a medicine that helps you cough up mucus with one that stops the cough also works against itself. The alcohol in these products, especially the drops, can add to sedating medicines, so tell a pharmacist about everything else you take.

It is not recommended. The German leaflets say the syrup and drops should not be used in pregnancy or breastfeeding because they have not been adequately studied, and EMA does not recommend medicinal thyme or ivy leaf during pregnancy or breastfeeding either. Both products also contain alcohol. The NHS self-care advice for bronchitis is rest, plenty of fluids, and honey in a warm drink, and it lists pregnancy among the reasons to get a cough checked promptly.

The product labels say to see a doctor promptly if the cough lasts more than a week or gets worse, or if you become breathless, develop a fever, or cough up pus-like or bloody phlegm. The NHS adds a cough lasting more than three weeks, chest pain, and being over 65, pregnant, or living with a long-term condition or a weakened immune system. Struggling to breathe, blue or gray lips, or sudden confusion needs emergency care.

07 References

Sources

These references support the claims on this page. They are not an endorsement of any product. Each ingredient’s monograph carries its own full source list.

  1. 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

    Arzneimittelforschung (PubMed 17063641), 2006

    Kemmerich, Eberhardt, Stammer: double-blind phase IV trial, 361 adults, Bronchipret Saft 5.4 ml three times daily for 11 days; coughing fits down 68.7% versus 47.6% with placebo; responder rates; no difference in adverse events.

  2. Fachinformation: Bronchipret Saft TE

    Bionorica SE, via Fachinfo-Service (Rote Liste Service GmbH), 2025

    German prescribing information (March 2025): 16.8 g thyme and 1.68 g ivy fluid extract per 100 ml; 300 mg ethanol per 5.4 ml; doses from age 1; allergy contraindications; gastritis caution; side effects; no human pharmacology or interaction studies; authorization 2006.

  3. Gebrauchsinformation: Bronchipret Tropfen

    Bionorica SE, 2025

    German package leaflet for the drops (January 2025): 0.5 ml thyme fluid extract and 0.03 ml ivy leaf extract per ml; 192 mg ethanol per ml; 1.3 ml or 2.6 ml three times daily from age 6; pregnancy and side-effect wording.

  4. European Union herbal monograph on Hedera helix L., folium (Revision 2)

    European Medicines Agency (EMA/HMPC/325716/2017), 2017

    Ivy leaf as a well-established expectorant; contraindicated under 2; diagnosis needed for persistent cough at ages 2–4; gastritis caution; 300 mg daily for the 1:1 liquid extract; pregnancy not recommended; no interactions reported.

  5. Assessment report on Hedera helix L., folium (Revision 2)

    European Medicines Agency (EMA/HMPC/325715/2017), 2017

    Leclerc and Leuret on ivy for whooping cough; German use since at least 1976; codeine case reports in children; assessor advises against combining ivy with codeine or dextromethorphan without medical advice.

  6. Community herbal monograph on Thymus vulgaris L. and Thymus zygis L., herba

    European Medicines Agency (EMA/HMPC/342332/2013), 2013

    Thyme as traditional use for productive cough with a cold; 1–4 g per dose of the 1:2–2.5 liquid extract, up to 14 g a day; Lamiaceae allergy contraindication; gastric disorders; pregnancy not recommended.

  7. Assessment report on Thymus vulgaris L., vulgaris zygis L., herba

    European Medicines Agency (EMA/HMPC/342334/2013), 2013

    Ammonia–glycerol–ethanol thyme liquid extract in the German Pharmacopoeia since 1968; Commission E fluid extract 1984; assessment of thyme as a single substance only; tolerability notes on Kemmerich 2006 and an ivy–thyme–aniseed syrup.

  8. Combination: Thymi herba and Primulae radix — herbal medicinal product

    European Medicines Agency, Committee on Herbal Medicinal Products, 2016

    Certain thyme–primula root combinations are well-established for productive cough in adults, others traditional; current monograph published 2016, with a 2024 call for data for its periodic review.

  9. Treatment of acute bronchitis in children and adolescents: non-interventional postmarketing surveillance study confirms the benefit and safety of a syrup made of extracts from thyme and ivy leaves

    MMW Fortschritte der Medizin (PubMed 17619603), 2007

    Marzian: uncontrolled study of the syrup in 1,234 children and adolescents; BSS 8.8 to 1.3 points over about ten days; two mild adverse reactions.

  10. Effectiveness and tolerability of the thyme/ivy herbal fluid extract BNO 1200 for the treatment of acute cough: an observational pharmacy-based study

    Current Medical Research and Opinion (PubMed 34340607), 2021

    Kardos and colleagues: 730 adults buying the drops in 305 German pharmacies; BSS 8.7 to 2.4 over a mean 7 days; no adverse drug reactions; three Bionorica authors.

  11. Efficacy and safety of a single ivy extract versus two herbal extract combinations in patients with acute bronchitis: a multi-center, randomized, open-label clinical trial

    Pharmaceuticals (PubMed 40430571), 2025

    Engelhard-funded open-label trial, 328 randomized and 325 analyzed: BSS fell 9.11 with ivy, 7.64 with thyme–ivy, 8.59 with thyme–primrose drops; ivy superior to thyme–ivy.

  12. Ivy leaf (Hedera helix) for acute upper respiratory tract infections: an updated systematic review

    European Journal of Clinical Pharmacology (PubMed 33523253), 2021

    Sierocinski, Holzinger, Chenot: ivy preparations including combinations are safe but effects minimal at best; high risk of bias; summarizes the open-label Safina 2014 thyme–ivy trial in 54 young children.

  13. Herbal medicine for cough: a systematic review and meta-analysis

    Forschende Komplementärmedizin (PubMed 26840418), 2015

    Wagner, Cramer and colleagues: four RCTs of ivy, primrose, and thyme preparations; risk ratio 1.40 (95% CI 1.23–1.60) for cough response versus placebo.

  14. Mechanistic evidence of Andrographis paniculata, Pelargonium sidoides, Echinacea species and a combination of Hedera helix, Primula veris/elatior and Thymus vulgaris/zygis in the treatment of acute, uncomplicated respiratory tract infections

    Pharmaceuticals (PubMed 37765014), 2023

    Veldman, Belt-van Zoen, Baars: review of mechanistic studies published before June 2021; ivy secretolytic and spasmolytic, thyme antibacterial, primrose studies lacking; no external funding.

  15. Bronchitis

    NHS (UK National Health Service), 2026

    Bronchitis often settles in around three weeks; urgent and emergency warning signs, including a cough over three weeks, coughing blood, chest pain, breathlessness, and higher-risk groups.

  16. 21 CFR 341.18: Expectorant active ingredient

    Electronic Code of Federal Regulations (US), 2026

    The US over-the-counter expectorant monograph names guaifenesin as its only active ingredient.

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