© H. Zell · CC BY-SA 3.0 · Commons
Hedera helix
Toxic🐾Gemeiner Efeu · (Hedera helix)
Ginseng family (Araliaceae)
Description
Clinging to walls and tree trunks with aerial rootlets, common ivy climbs by way of leathery, three-lobed leaves and stays evergreen year-round. The leaves, gathered from May to August, are the part used, notably rich in saponins such as hederacoside C. Standardised finished extracts from ivy leaves are regarded by the EMA as well established for cough associated with colds and are traditionally used for respiratory complaints more broadly, and such extracts are available as licensed pharmacy products. Home-brewed ivy tea, by contrast, is essentially ineffective, since the saponins dissolve poorly in water while still being capable of causing irritation. The ripe, blue-black berries are toxic to humans and pets and can cause nausea, vomiting and abdominal pain. Contact with fresh ivy sap, especially while pruning, can also trigger allergic skin reactions, so gloves are recommended.
CONTRAINDICATED during pregnancy
EMA HMPC: safety in pregnancy not established. Do not use due to lack of data. Avoid external applications (baths, compresses with fresh leaves) as well — systemic absorption of falcarinol and saponins cannot be excluded.
CONTRAINDICATED during breastfeeding
EMA HMPC: safety during breastfeeding not established. Transfer of saponins into breast milk cannot be excluded. Do not use.
Critical drug interactions with:
Antitussiva (Codein, Dextromethorphan, Noscapin)
Expectorant (EMA well-established use) for acute productive cough — triterpene saponins (hederacoside C / alpha-hederin) thin bronchial mucus. One of Germany's best-selling herbal cough remedies, widely used in paediatrics (Prospan).
Preparation & dosage
STANDARDISED EXTRACT (EMA well-established use): Use only as a licensed finished pharmaceutical (cough syrup, drops, effervescent tablet) — e.g. Prospan, Hedelix, Bronchipret. EMA-approved extract types: dry extract DER 4–8:1 (ethanol 24–30 %), DER 6–7:1 (ethanol 40 %), DER 3–6:1 (ethanol 60 %); liquid extract DER 1:1 (ethanol 70 %); soft extract DER 2.2–2.9:1 (ethanol 50 % + propylene glycol). Adults/adolescents ≥ 12: single dose 15–100 mg dry extract, daily 45–300 mg; follow package insert. Max 1 week without medical advice. Dyspnoea, fever, deterioration or purulent sputum require immediate medical attention. NEVER as self-made infusion from garden ivy — fresh leaves are irritant to toxic.
- Liquid amount
- 15–100 ml
- Doses per day
- 3×
- Max duration
- 1 weeks
⚠ Age restriction: ≥ 2 years — Contraindicated under 2 — secretolytics may worsen airway symptoms in infants. Ages 2–5: markedly reduced dose, only on medical advice. Ethanol liquid extracts (DER 1:1, 70 % ethanol) only from age 6.
Historical folk use as chest and joint compress — not recommended today due to contact allergen risk (falcarinol); prefer standardised pharmaceutical preparations.
Preparation & dosage
FOLK EXTERNAL USE (historical, not recommended): In older folk medicine, crushed fresh ivy leaves were applied as a compress to joints or the chest for rheumatic complaints and bronchitis. NOT RECOMMENDED TODAY: falcarinol in fresh leaves is a known contact allergen — contact dermatitis possible, especially on sensitive skin or in sunlight (phototoxic reaction). If used: patch test first, no open wounds, max 30 min, wash off afterwards. Standardised pharmaceutical salves with controlled-low-falcarinol ivy extract are considerably safer.
Ethnobotanically recorded folk wound compress (Madaus 1938) — no clinical evidence and not advisable today due to falcarinol.
Preparation & dosage
COMPRESS (historical, folk): Older sources (incl. Madaus 1938) describe applying fresh ivy leaves to slow-healing wounds, ulcers and burns — reportedly cleansing and anti-inflammatory. NOT RECOMMENDED on wounds: falcarinol and saponins from fresh leaves can irritate tissue; no clinical efficacy evidence. Listed here solely as ethnobotanical record.
Folk ivy bath for rheumatism and skin irritations — photosensitising and allergenic potential from falcarinol; only use with great caution and brief skin contact today.
Preparation & dosage
IVY BATH / ADDITIVE (folk, very limited): In some European folk traditions, ivy sprigs were used as a bath additive for rheumatism, joint swelling and skin rashes — decoction of ~100 g fresh or 50 g dried leaves in 1 litre water, simmer 15 min, strain, add to bath. IMPORTANT: falcarinol can act transdermally — contact dermatitis possible in sensitive individuals, especially with extended baths. Photosensitisation after exposure. Not recommended for children or pregnant women.
Historical documentation only — do NOT use
These internal applications are historically documented. This plant is highly toxic — self-treatment can cause severe poisoning or death. For documentation only, explicitly NOT a recommendation.
Adjunctive inhalation for respiratory infections as licensed pharmaceutical only — not as home preparation from raw ivy leaves.
Preparation & dosage
INHALATION (finished preparation only): Some licensed ivy-based preparations are available as inhalation solution (medical prescription advised). Home steam inhalation with fresh or dried ivy leaves NOT recommended — falcarinol and saponins may irritate mucous membranes. As adjunct in bronchitis, plain saline inhalation (0.9 % NaCl) can complement oral ivy preparations.
Kommission E (1988, positive): ivy leaf for catarrh of the airways and as expectorant — basis for today's standardised drops and syrup pharmaceuticals.
Preparation & dosage
TINCTURE / LIQUID EXTRACT (licensed pharmaceutical only): Kommission E positively assessed ivy leaf for catarrh of the airways and as an expectorant in bronchitis. Modern use: standardised finished pharmaceuticals only (drops, syrup). Do not prepare household tincture from fresh or dried ivy leaves — standardisation and falcarinol removal require pharmaceutical extraction.
- Doses per day
- 3×
- Max duration
- 1 weeks
Historical folk infusion of dried ivy leaves for cough — not recommended today due to poor saponin water-solubility and falcarinol irritation risk; standardised pharmaceuticals strongly preferred.
Preparation & dosage
HISTORICAL INFUSION (not recommended, ethnobotanical record only): Older folk medicine used 0.5–1 g dried ivy leaves in 200 ml hot water, steeped 5 min, for cough. NOT RECOMMENDED TODAY: (1) triterpene saponins are poorly water-soluble — efficacy far below pharmaceutical ethanol extracts; (2) falcarinol partly passes into infusion, may irritate gastric mucosa and cause contact sensitisation; (3) very bitter taste. EMA and Kommission E recommend only standardised extracts. Products like Prospan far outperform the infusion in both efficacy and safety.
- Dry amount
- 0.5–1 g
- Doses per day
- 2×
- Max duration
- 1 weeks
KEY SAFETY WARNINGS: (1) BERRIES TOXIC — ivy berries (blue-black, ripe Sept–Oct) are toxic to humans and pets. Symptoms: nausea, vomiting, abdominal pain, diarrhoea, in larger amounts convulsions, respiratory depression, loss of consciousness. Call Poison Control immediately on suspected berry ingestion. (2) CONTACT ALLERGEN — falcarinol in fresh ivy leaves and stems is a common contact allergen. Gardeners and people cutting ivy regularly often develop allergic contact dermatitis (redness, vesicles, itching). Phototoxic reactions possible in sunlight. Wear gloves and long sleeves when cutting. (3) FINISHED PREPARATIONS ONLY — medicinal use exclusively as a licensed standardised pharmaceutical (Prospan, Hedelix, Bronchipret). Home-made ivy tea is ineffective (saponins poorly water-soluble) AND potentially irritant. (4) MAX. 1 WEEK self-treatment without medical advice. Worsening, fever, dyspnoea or purulent sputum: see a doctor immediately. ASPCA classification (accessed 2026-08-10): toxic to dogs and cats.
⏱ Max continuous use: 1 weeks
EMA HMPC: safety in pregnancy not established. Do not use due to lack of data. Avoid external applications (baths, compresses with fresh leaves) as well — systemic absorption of falcarinol and saponins cannot be excluded.
EMA HMPC: safety during breastfeeding not established. Transfer of saponins into breast milk cannot be excluded. Do not use.
Contraindicated under 2 — secretolytics can worsen airway symptoms in infants and trigger bronchospasm. Ages 2–5: only on medical advice, reduced dose, low-/alcohol-free preparations only. Ethanol liquid extracts only from age 6. Persistent cough in children aged 2–4 always requires medical diagnosis. In practice, ivy cough syrups (e.g. Prospan) are among Germany's most-prescribed herbal medicines for children.
Drug interactions
Antitussiva (Codein, Dextromethorphan, Noscapin)
Ivy extract is secretolytic (liquefies mucus, promotes expectoration). Cough suppressants (antitussives) inhibit the cough reflex and may cause pooling of the promoted secretions in the bronchial tree — risk of mucus accumulation and secondary bronchial infection. Pharmacologically contradictory combination; per EMA HMPC and ESCOP, do not use simultaneously.
Antidiabetika (Metformin, Sulfonylharnstoffe, Insulin)
In vitro and animal studies showed ivy saponins (alpha-hederin) to have hypoglycaemic properties. Theoretical additive risk with blood glucose-lowering medications. Clinical relevance at therapeutic doses of standardised extracts considered low — monitor blood glucose closely if used concomitantly.
CYP3A4-Induktoren/-Inhibitoren (z. B. Rifampicin, Ketoconazol, Johanniskraut)
Alpha-hederin and related saponins undergo metabolic breakdown. In vitro hints at cytochrome P450 interactions; clinical data lacking. When co-administered with CYP3A4-sensitive drugs (e.g. ciclosporin, statins, oral anticoagulants), caution and monitoring for enhanced side effects or loss of efficacy.
Contraindications
- Hypersensitivity to Hedera helix or other Araliaceae.
- Children under 2 years — secretolytics may worsen airway symptoms and trigger bronchospasm.
- Home-made preparations (tea, tincture, fresh juice, infusion) from garden ivy leaves — raw plant is irritant to toxic due to falcarinol and saponins.
- Pregnancy and breastfeeding — contraindicated due to lack of data (EMA HMPC).
- Ivy berries in any form — toxic to humans and animals.
- Open wounds or severely inflamed skin with external fresh-leaf applications — falcarinol irritation and contact dermatitis risk.
Harvested part: leaves
- Time of day:
- Ivy leaves can be harvested year-round (evergreen), but constituent concentrations (hederacoside C) are highest from spring to early autumn. For pharmaceutical processing: harvest preferably on dry, sunny mornings (9–12 h) once dew has dried. For home use: harvest NOT recommended — use exclusively finished pharmaceuticals.
- Drying:
- RELEVANT FOR PHARMACEUTICAL PRODUCTION ONLY: Leaves (without stems) dried in a single layer on screens/drying racks at max. 35–40 °C; target air humidity below 10 %; comply with Ph. Eur. quality standard (Hederae helicis folium). Wear protective gloves and long sleeves during harvest and drying — falcarinol in plant sap is a potent contact allergen. DO NOT dry for home use — home-made ivy tea is pharmacologically ineffective and irritant.
- Time of day:
- Ivy berries ripen September–November (blue-black). NO HARVEST FOR CONSUMPTION — berries are TOXIC (to humans and animals: saponins, falcarinol, other glycosides). Listed for botanical completeness only. Berries serve as important winter food for birds (thrushes, blackbirds) — harmless to them. Remove ripe berries from garden plants if children or pets have access.
- Drying:
- Berries MUST NOT be collected, dried or processed for personal use — TOXIC. Do not use any folk preparation based on ivy berries. If berry ingestion is suspected, call Poison Control immediately: Germany 030 19240, Austria 01 406 43 43, Switzerland 145.
- Hederacosid C (Hederasaponin C)SaponinContent: 2.5-6 %Leaf
Most abundant triterpene saponin in ivy leaves — lead marker for pharmaceutical standardisation. Bisdesmosidic oleanolic acid glycoside; cleaved in vivo and by gut microbiota to alpha-hederin (monodesmosidic, pharmacologically more active). High concentration in standardised dry extracts (DER 4–8:1).
- alpha-HederinSaponinContent: 0.1-0.5 %Leaf
Active metabolite of hederacoside C; monodesmosidic triterpene saponin. Main mechanism: beta-2-adrenergic receptor modulation in bronchial smooth muscle (upregulation of receptor density), secretolytic via Cl-/HCO3- transport activation in bronchial epithelium, bronchodilatory. Key to the clinically documented efficacy of ivy cough preparations.
- Hederacosid B und weitere HederasaponineSaponinContent: 0.5-2 %Leaf
Accompanying saponins of ivy — bisdesmosidic glycoside variants with oleanolic acid and hederagenin aglycones. Contribute to total saponin content; less intensively studied than hederacoside C and alpha-hederin, but likely act synergistically.
- Falcarinol (Polyacetylen)OtherContent: 0.001-0.05 %Leaf
Potently skin-sensitising polyacetylene — primary cause of allergic contact dermatitis after contact with fresh or wilted ivy leaves and stems. Also present in other Araliaceae and Apiaceae (carrot, celery). Phototoxic reactions may also involve furanocoumarins. Largely eliminated in pharmaceutical dry extracts via ethanol extraction and spray-drying — safety profile of standardised preparations considerably better than raw plant.
- Flavonoide (Rutin, Kaempferol-3-rutinosid, Quercetin-Glykoside)FlavonoidContent: 0.1-0.5 %Leaf
Flavonoid glycosides with antioxidant and mildly anti-inflammatory action; present in ivy leaves in comparatively low amounts. Not an EMA monograph standardisation parameter — saponins are pharmacologically dominant.
- Phenolcarbonsäuren (Chlorogensäure, Kaffeesäure)Phenolic acidContent: 0.05-0.2 %Leaf
Hydroxycinnamic acid derivatives with antioxidant activity. Only detected in small amounts in ivy leaves; pharmacologically clearly secondary to the triterpene saponins.
- Sterole (beta-Sitosterol, Stigmasterol)OtherContent: 0.05-0.2 %Leaf
Phytosterols in small amounts. Do not substantially contribute to medicinal efficacy; ubiquitous plant constituents forming part of the overall phytochemical profile.
- Furocumarine (Psoralen, Bergapten — Spuren)OtherContent: SpurenLeaf
Photosensitising substances in trace amounts — can cause phototoxic skin reactions (redness, blistering) in combination with UV light, especially after external contact with fresh leaves. Important as explanation for summer photosensitisation reactions in gardeners. No practically relevant issue in standardised finished preparations.
- [1]MonographEMA/HMPC/325716/2017 — European Union herbal monograph on Hedera helix L., folium (Final, Revision 2, 21 November 2017) — Well-Established Use(accessed: 2026-05-21)
- [2]MonographKommission E — Hederae helicis folium (Efeublätter), Positiv-Monographie, BAnz Nr. 122, 1988(accessed: 2026-05-21)
- [3]MonographESCOP Monographs — Hederae helicis folium (Ivy Leaf), 2nd edition with supplement (2009)(accessed: 2026-05-21)
- [6]MonographPlants For A Future (PFAF) — Hedera helix database entry(accessed: 2026-05-21)
- [8]MonographASPCA Animal Poison Control — Branching Ivy (Hedera helix)(accessed: 2026-08-10)
- [9]MonographCliniTox Giftpflanzen — Hedera helix L.: giftig + (Institut für Veterinärpharmakologie und -toxikologie, Universität Zürich)(accessed: 2026-08-10)
- [4]BookWichtl M. (Hrsg.) — Teedrogen und Phytopharmaka, 5. Auflage, Wissenschaftliche Verlagsgesellschaft Stuttgart, 2009 — Hederae helicis folium(accessed: 2026-05-21)
- [5]BookMadaus, Gerhard — Lehrbuch der biologischen Heilmittel, Band I: Hedera helix (Efeu), 1938 (Public Domain)(accessed: 2026-05-21)
- [7]WikipediaGemeiner Efeu (Wikipedia DE)(accessed: 2026-05-21)
Distribution in Europe
🪴 Grow at home
- ☀ Light
- partial shade
- 💧 Water
- weekly
- 🌱 Soil
- Standard potting compost
- 🪴 Pot
- 18 cm
- ⭐ Difficulty
- ★☆☆ beginner
- 🐾 Pets
- toxic to pets
Tips:
- Robust hanging plant — also in darker corners.
- Cut back regularly for bushy growth.
- TOXIC if eaten (berries!) — keep away from children/pets.
Care tips are general indoor-gardening recommendations, not scientific sources.