Pelargonium — Benefits Deep Dive

Pelargonium sidoides is unusual among herbal remedies: it has a real stack of randomised, placebo-controlled trials behind it. More than a dozen trials, several meta-analyses and two Cochrane reviews have examined its root extract in bronchitis, colds, sinusitis and sore throat. That makes it tempting to call the question settled. It is not, and the reasons why are as interesting as the results.

Nearly all of the trials tested one extract, coded EPs 7630, and the European Medicines Agency notes that the trials reviewed in the meta-analyses were run by the same investigators — the manufacturer — in the same region. Independent reviewers rate the overall evidence as low to moderate quality. The EMA declined to accept the trials as proof of efficacy and registers the root only as a traditional herbal medicine for the symptoms of the common cold. The one large trial run independently in ordinary family practice, published in 2026, found no significant benefit. Meanwhile a set of liver-injury reports led to a warning in European product information, and the plant's own history begins with a tuberculosis "cure" that was never shown to work.

These four pages set out each part of that picture with the numbers from the original papers, so readers can weigh it themselves.

Deep-Dive Articles

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Acute Bronchitis Trials

Every adult and child placebo-controlled trial of the root extract, what the Bronchitis Severity Score measures, what the meta-analyses pooled, why drops did better than tablets in the Cochrane analysis, why European regulators did not accept the trials as proof, and the 2026 Swiss pragmatic trial that found no significant effect.

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Sinusitis, Sore Throat and Colds

Beyond bronchitis the evidence thins out fast: one common-cold trial, one sinusitis trial, a 2023 network meta-analysis, and a sore-throat review that found too little to conclude. How certainty ratings work, and what the EU's "common cold" registration does and does not mean.

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Liver Injury Reports and Safety

The 30 German liver reports, the regulator's conclusion of an at-least-possible link, the re-analyses that disputed it, and the warning now in EU product information. Plus trial side effects, allergic reactions, the coumarin-and-warfarin question, and what nobody yet knows.

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Umckaloabo History and Wild Harvest

An Englishman with tuberculosis in 1897, a "Consumption Cure" sold in London, a Geneva doctor's case series, a plant nobody could identify until 1977, and a modern trade that pulls tubers from the wild — plus a 2010 patent revocation brought on behalf of a South African community.

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Table of Contents

  1. Deep-Dive Articles
  2. The Evidence in One Page
  3. Evidence Ledger at a Glance
  4. Why "One Extract" Matters
  5. Questions Readers Often Ask
  6. Key Research: Systematic Reviews
  7. Key Research: Bronchitis Trials
  8. Key Research: Colds, Sinusitis and Sore Throat
  9. Key Research: Laboratory and Mechanism
  10. Key Research: History, Chemistry and Conservation
  11. External Resources
  12. Connections

The Evidence in One Page

What has been tested. Almost exclusively one standardised ethanol-water extract of the root, given as drops or tablets for about seven days, in people with acute respiratory infections. Teas, home tinctures and other commercial extracts have essentially no trial data of their own.

What the trials reported. In acute bronchitis, placebo-controlled trials in adults and children reported larger falls in a 0–20 point symptom score with the extract than with placebo after a week — a difference of roughly 1.5 to 3.6 points between groups. In the largest adult trial (468 people), the proportion unable to work fell to 16 per cent with the extract versus 43 per cent on placebo.

How reviewers graded it. The 2013 Cochrane review rated the quality of evidence as low for bronchitis and very low for sinusitis and the common cold, and noted suspected publication bias. Other meta-analyses described the evidence as "encouraging" (2008, bronchitis) or "moderate" (2015, cough; 2018, children; 2023, colds and post-viral sinusitis).

What regulators decided. The EMA's herbal committee found that the trials had not pre-defined a clinically relevant difference and did not reach the effect size it considered strongly relevant for a self-limiting illness. It registers pelargonium root only as a traditional herbal medicinal product for common-cold symptoms.

The independent test. PHYTOBRONCH (Switzerland, 2026), an open-label pragmatic trial in 332 adults in family practice, found no significant difference in time to symptom improvement or in antibiotic use compared with usual care, and more frequent mild adverse events with the extract.

Safety. Mostly mild digestive side effects in trials; allergic reactions including rare severe ones; and liver-injury reports whose causality is disputed but which led to a warning in EU product information.

Evidence Ledger at a Glance

Why "One Extract" Matters

Plant extracts are not interchangeable. The amount of coumarins, tannins and other compounds in a product depends on the species, where and how the roots were grown or harvested, the solvent, and the ratio of root to solvent. The EU monograph lists three specific preparations, each defined by its drug-to-extract ratio and its solvent (11 per cent ethanol by mass, or 14 per cent by volume). A product made another way is a different product, and a scoping review published in 2024 noted that variations in extract origin, composition and extraction method make it hard even to set a standard concentration for laboratory studies.

The concentration of evidence on one product has a second consequence. When almost all trials come from one research programme, results have not been tested by groups with no stake in the answer. The EMA's 2024 assessment report states this directly, and the Cochrane team noted suspected publication bias. The single large trial run outside that programme in routine care (PHYTOBRONCH) was negative on both of its main outcomes. That is one trial, and an open-label design can bias results in either direction, but it is the kind of replication the evidence base has lacked.

Questions Readers Often Ask

Is pelargonium an antibiotic?

No. Reviews describe only moderate direct antibacterial activity in the laboratory. Several trials studied it in bronchitis "outside the strict indication for antibiotics", meaning in people who would not normally need antibiotics. PHYTOBRONCH tested whether it reduced antibiotic use and did not find a significant reduction.

Is it the same as a garden geranium?

It belongs to the same family and genus as the pelargoniums sold as "geraniums", but it is a different species. The medicine comes from the roots of P. sidoides (and, under the Pharmacopoeia definition, P. reniforme), not from the ornamental plants.

Does the coumarin in it thin the blood?

The EMA notes that the coumarins identified in the root lack the chemical features needed for anticoagulant activity and that a rat study found no effect on clotting or on warfarin. It has not been tested in people taking warfarin.

Was it a cure for tuberculosis?

The remedy was first sold in Britain as a tuberculosis cure, and a Geneva physician reported favourable results in the 1920s, but there were no controlled studies. Laboratory work found only modest activity against the tuberculosis bacterium. No regulator recognises it as a tuberculosis treatment.

Key Research: Systematic Reviews

  1. Timmer A, Günther J, Motschall E, et al. Pelargonium sidoides extract for treating acute respiratory tract infections. The Cochrane database of systematic reviews. 2013;2013(10):CD006323. PubMed PMID: 24146345
  2. Timmer A, Günther J, Rücker G, et al. Pelargonium sidoides extract for acute respiratory tract infections. The Cochrane database of systematic reviews. 2008;(3):CD006323. PubMed PMID: 18646148
  3. Agbabiaka TB, Guo R, Ernst E. Pelargonium sidoides for acute bronchitis: a systematic review and meta-analysis. Phytomedicine : international journal of phytotherapy and phytopharmacology. 2008;15(5):378-85. PubMed PMID: 18222667
  4. Wagner L, Cramer H, Klose P, et al. Herbal Medicine for Cough: a Systematic Review and Meta-Analysis. Forschende Komplementarmedizin (2006). 2015;22(6):359-68. PubMed PMID: 26840418
  5. Anheyer D, Cramer H, Lauche R, et al. Herbal Medicine in Children With Respiratory Tract Infection: Systematic Review and Meta-Analysis. Academic pediatrics. 2018;18(1):8-19. PubMed PMID: 28610802
  6. Hoang MP, Seresirikachorn K, Chitsuthipakorn W, et al. Herbal Medicines for Rhinosinusitis: A Systematic Review and Network Meta-analysis. Current allergy and asthma reports. 2023;23(2):93-109. PubMed PMID: 36609950
  7. Koch AK, Klose P, Lauche R, et al. [A Systematic Review of Phytotherapy for Acute Rhinosinusitis]. Forschende Komplementarmedizin (2006). 2016;23(3):165-9. PubMed PMID: 27404100
  8. Büttner R, Schwermer M, Ostermann T, et al. Complementary and alternative medicine in the (symptomatic) treatment of acute tonsillitis in children: A systematic review. Complementary therapies in medicine. 2023;73:102940. PubMed PMID: 36868289

Key Research: Bronchitis Trials

  1. Matthys H, Eisebitt R, Seith B, et al. Efficacy and safety of an extract of Pelargonium sidoides (EPs 7630) in adults with acute bronchitis. A randomised, double-blind, placebo-controlled trial. Phytomedicine : international journal of phytotherapy and phytopharmacology. 2003;10 Suppl 4:7-17. PubMed PMID: 12807337
  2. Chuchalin AG, Berman B, Lehmacher W. Treatment of acute bronchitis in adults with a pelargonium sidoides preparation (EPs 7630): a randomized, double-blind, placebo-controlled trial. Explore (New York, N.Y.). 2005;1(6):437-45. PubMed PMID: 16781588
  3. 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. Current medical research and opinion. 2007;23(2):323-31. PubMed PMID: 17288687
  4. Matthys H, Funk P. EPs 7630 improves acute bronchitic symptoms and shortens time to remission. Results of a randomised, double-blind, placebo-controlled, multicentre trial. Planta medica. 2008;74(6):686-92. PubMed PMID: 18449849
  5. Matthys H, Lizogub VG, Malek FA, et al. Efficacy and tolerability of EPs 7630 tablets in patients with acute bronchitis: a randomised, double-blind, placebo-controlled dose-finding study with a herbal drug preparation from Pelargonium sidoides. Current medical research and opinion. 2010;26(6):1413-22. PubMed PMID: 20387996
  6. Kamin W, Maydannik V, Malek FA, et al. Efficacy and tolerability of EPs 7630 in children and adolescents with acute bronchitis - a randomized, double-blind, placebo-controlled multicenter trial with a herbal drug preparation from Pelargonium sidoides roots. International journal of clinical pharmacology and therapeutics. 2010;48(3):184-91. PubMed PMID: 20197012
  7. Kamin W, Ilyenko LI, Malek FA, et al. Treatment of acute bronchitis with EPs 7630: randomized, controlled trial in children and adolescents. Pediatrics international : official journal of the Japan Pediatric Society. 2012;54(2):219-26. PubMed PMID: 22360575
  8. Bourqui A, Corpataux O, Bonofiglio F, et al. Pelargonium sidoides extract (EPs® 7630) versus usual care for acute bronchitis in Swiss primary care (PHYTOBRONCH): a pragmatic, open-label, randomised controlled trial. NPJ primary care respiratory medicine. 2026;36(1). PubMed PMID: 42014704
  9. Han KI, Kim TH, Ra SW, et al. Efficacy and safety of mixture of ivy leaf extract and coptidis rhizome in the treatment of acute bronchitis: multicenter, randomized, double-blinded, active-controlled, parallel, therapeutic confirmatory clinical trial. Current medical research and opinion. 2024;40(7):1235-1243. PubMed PMID: 38889376
  10. Lee YS, Lim SY, Min KH, et al. The efficacy and safety of DW1601 in patients with acute bronchitis: a multi-center, randomized, double-blind, phase III clinical trial. The Korean journal of internal medicine. 2022;37(6):1195-1204. PubMed PMID: 36153858

Key Research: Colds, Sinusitis and Sore Throat

  1. Kamin W, Funk P, Seifert G, et al. EPs 7630 is effective and safe in children under 6 years with acute respiratory tract infections: clinical studies revisited. Current medical research and opinion. 2018;34(3):475-485. PubMed PMID: 29119837
  2. Fashner J, Ericson K, Werner S. Treatment of the common cold in children and adults. American family physician. 2012;86(2):153-9. PubMed PMID: 22962927
  3. Seneghini M, Albrich WC. [Non-antibiotic Prophylaxis of Infections]. Praxis. 2022;111(8):463-468. PubMed PMID: 35673840

PubMed Topic Searches

  1. PubMed: Pelargonium sidoides and sinusitis
  2. PubMed: Pelargonium sidoides and the common cold
  3. PubMed: Pelargonium sidoides and tonsillopharyngitis

Key Research: Laboratory and Mechanism

  1. Kolodziej H. Antimicrobial, Antiviral and Immunomodulatory Activity Studies of Pelargonium sidoides (EPs(®) 7630) in the Context of Health Promotion. Pharmaceuticals (Basel, Switzerland). 2011;4(10):1295-1314. PubMed PMID: 27721327
  2. Papies J, Emanuel J, Heinemann N, et al. Antiviral and Immunomodulatory Effects of Pelargonium sidoides DC. Root Extract EPs® 7630 in SARS-CoV-2-Infected Human Lung Cells. Frontiers in pharmacology. 2021;12:757666. PubMed PMID: 34759825
  3. Veldman LBM, Belt-Van Zoen E, Baars EW. Mechanistic Evidence of Andrographis paniculata (Burm. f.) Wall. ex Nees, Pelargonium sidoides DC., Echinacea Species and a Combination of Hedera helix L., Primula veris L./Primula elatior L. and Thymus vulgaris L./Thymus zygis L. in the Treatment of Acute, Uncomplicated Respiratory Tract Infections: A Systematic Literature Review and Expert Interviews. Pharmaceuticals (Basel, Switzerland). 2023;16(9). PubMed PMID: 37765014
  4. Reina BD, Malheiros SS, Vieira SM, et al. Unlocking the therapeutic potential of Pelargonium sidoides natural extract: A scoping review. Heliyon. 2024;10(23):e40554. PubMed PMID: 39654721
  5. Perić A, Vezmar Kovačević S, Barać A, et al. Immunomodulatory Effects of Pelargonium sidoides Extract (EPs7630) in the Treatment of Acute Rhinosinusitis. Expert reviews in molecular medicine. 2025;27:e25. PubMed PMID: 40660733

Key Research: History, Chemistry and Conservation

  1. Brendler T, van Wyk BE. A historical, scientific and commercial perspective on the medicinal use of Pelargonium sidoides (Geraniaceae). Journal of ethnopharmacology. 2008;119(3):420-33. PubMed PMID: 18725280
  2. Kolodziej H. Fascinating metabolic pools of Pelargonium sidoides and Pelargonium reniforme, traditional and phytomedicinal sources of the herbal medicine Umckaloabo. Phytomedicine : international journal of phytotherapy and phytopharmacology. 2007;14 Suppl 6:9-17. PubMed PMID: 17188477
  3. Moyo M, Van Staden J. Medicinal properties and conservation of Pelargonium sidoides DC. Journal of ethnopharmacology. 2014;152(2):243-55. PubMed PMID: 24463034
  4. Siegfried NL, Hughes G. Herbal medicine, randomised controlled trials and global core competencies. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde. 2012;102(12):912-3. PubMed PMID: 23498035
  5. Beckwith CJ. Umckaloabo. Canadian Medical Association journal. 1932;26(5):620. PubMed PMID: 20318749

External Resources

Connections

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