Pelargonium Sidoides Mechanisms of Action

Amy Doyle, MS, CNS

Upper respiratory tract concerns are historically among the leading reasons for visits to primary care for both children and adults.1,2  Duration of these concerns is often more problematic than severity.

A specific extract of Pelargonium sidoides has been studied to shorten the duration of upper respiratory tract irritations. Pelargonium sidoides is a potential solution to this challenge. A specific extract of pelargonium sidoides has been studied to shorten the duration of upper respiratory tract irritations. Commonly known as African geranium, South African cultures have traditionally used the root extract and in the South African Zulu language it is referred to as Umckaloabo, which means “heavy cough.”3Pelargonium sidoides root extract preparation contains the same properties.

Pelargonium sidoides Mechanisms of Action

Pelargonium sidoides engages multiple mechanisms of action in upper respiratory defense.4,5 It acts as a mucolytic agent by stimulating mucous secretion and clearance which is important for microbial balance in the upper respiratory system. Pelargonium sidoides extract contains primarily polyphenols (mainly catechin and gallocatechin), proteins, minerals, and, in lower concentrations, 7-hydroxycoumarin derivatives.6 These coumarin derivatives differ in chemical structure from the known anticoagulant coumarins and are not associated with anticoagulant activity.Pharmacological studies have suggested that the mechanism of action of Pelargonium sidoides is multifactorial.8 Studies have found that EPs 7630 may act as an immunomodulator, help support the body’s defense mechanisms, and possess antimicrobial actions invitro. These actions are mediated mainly by the release of tumor-necrosis factor (TNF-a) and nitric oxide, stimulation of interferon-a synthesis, and increase of natural killer cell activity.9 Studies have also found that pelargonium sidoides increases phagocytosis.10

Pelargonium sidoides Studies

In 2015 a prospective, open-label trial studied the tolerability and treatment effects of a tablet form of Pelargonium sidoides in 120 adults.5 The dose of Pelargonium sidoides was 20 mg three times per day for ten days. Effectiveness outcomes were measured by daily investigator observation (CCS) and daily self-rating by participants of CCS. By day ten 42% of patients reported expected outcomes and another 42% showed significant improvement. No serious adverse events were reported.

Pelargonium sidoides has been studied in more than 20 clinical trials with more than 9,000 subjects, including 3,900 children. With proven tolerability and effectiveness in adults and children, it is a viable solution to support the upper respiratory system.


  1. Kamin W et al. Acta Paediatrica. 2010. 99:pp. 537-43.
  2. CDC/NCHS, National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey. Accessed November 19, 2016.
  3. Ross, SM. Holist Nurs Pract. 2012. 26(2): 106-9.
  4. Kamin W et al. Pediatr Int. April 2012. 54(2):219-26.
  5. Keck T et al. Alternative & Integrative Medicine. 2015. 4:4.
  6. Kolodziej H et al. Deutsche Apotheker Zeitung 2003;143:55–64.
  7. Koch K, Biber A. Phytomedicine 2007;14(Suppl 1):40-5.
  8. Kolodziej H et al. Phytomedicine 2003;10(Suppl 4):18-24.
  9. Kolodziej H et al. Phytomedicine 2007;14(suppl 1):18-26.
  10. Conrad A et al. Phytomedicine 2007;14(suppl 1):46-51.