Prospan (Ivy Leaf Extract) Syrup for Respiratory Symptoms
Prospan syrup containing ivy leaf extract (EA 575) is an effective herbal option for treating productive cough with a favorable safety profile, but should not be used as the primary treatment for chronic cough without addressing the underlying cause.
Mechanism and Efficacy
Prospan contains dried ivy leaf extract (EA 575) which has expectorant and bronchodilatory properties:
- Acts as a mucolytic agent that helps thin and loosen mucus in the respiratory tract 1
- Demonstrates comparable efficacy to conventional expectorants like acetylcysteine for acute bronchitis 1
- Shows significant improvement in key respiratory symptoms:
- Cough (92.2% improvement)
- Expectoration (94.2% improvement)
- Dyspnea (83.1% improvement)
- Respiratory pain (86.9% improvement) 2
Usage Guidelines
Dosage
- Adults and children >12 years: 4-5 mL syrup 2-3 times daily
- Children 6-12 years: 2-3 mL syrup 2-3 times daily
- Children 2-5 years: 1-2 mL syrup 2-3 times daily 3, 4
Duration
- For acute cough: 7-14 days is typically sufficient 1
- For chronic bronchitis: Up to 4 weeks may be beneficial 2
Precautions and Contraindications
- Not recommended for children under 2 years due to limited safety data
- Should not be used as the sole treatment for chronic cough without proper diagnosis of underlying cause 5
- Not recommended for patients with known hypersensitivity to ivy or plants in the Araliaceae family
- Caution in patients with gastritis or gastric ulcer due to potential irritant effects of saponins
- Avoid in pregnant or breastfeeding women unless specifically recommended by a healthcare provider
When to Seek Medical Attention
According to guidelines, patients should see a doctor if 5:
- Cough is accompanied by blood
- Breathing difficulties or shortness of breath occur
- Prolonged fever and feeling unwell persist
- Patient has underlying conditions like COPD, heart disease, diabetes, or asthma
- Patient has recently been hospitalized
- Symptoms persist for more than three weeks
Limitations and Considerations
Current guidelines emphasize that cough should be treated based on etiology rather than symptomatically 5
For chronic cough, the CHEST guidelines recommend identifying and treating the three most common causes 6:
- Upper airway cough syndrome
- Asthma
- Gastroesophageal reflux disease (GERD)
OTC cough medications (including herbal preparations) should not be prescribed for children with chronic cough until they have been shown to make cough less severe or resolve sooner 5
Common Pitfalls
Using Prospan as the sole treatment for chronic cough: The underlying cause should be identified and treated appropriately 5, 6
Expecting immediate results: Improvement typically occurs over several days of consistent use
Overlooking serious underlying conditions: Persistent cough may indicate more serious conditions requiring medical evaluation 5
Not considering drug interactions: Although rare, herbal medications can interact with conventional medications
Advantages Over Other OTC Cough Medications
- Better safety profile compared to conventional OTC cough medications, especially in children 5
- Lower incidence of adverse events compared to some conventional expectorants 1, 2
- Can be used in children as young as 2 years with appropriate dosing 3, 4
- Does not contain codeine or other opioid derivatives that are contraindicated in children 5
Prospan syrup represents a reasonable option for symptomatic relief of productive cough, particularly in acute bronchitis, but should be used as part of a comprehensive approach that addresses the underlying cause of persistent cough.