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Overview: Pelargonium sidoides is a plant native to Southern Africa. It is available over the counter as a dietary supplement in the form of liquid extracts (drops), tablets, and syrups taken by mouth. People take Pelargonium sidoides for respiratory tract infections, such as acute bronchitis, sinus infections, and colds. Some research suggests it may offer benefits for certain respiratory infections, although the evidence is mixed. Common side effects include stomach discomfort, nausea, and diarrhea. Check with your health care provider before using Pelargonium sidoides, especially if you have any health conditions or take any medicines.

Uses

What is Pelargonium sidoides used for?

Pelargonium sidoides (P. sidoides) is used for infections of the airways (respiratory tract infections). Many studies suggest it may help relieve symptoms of acute bronchitis, but other research did not find clear evidence of benefit. People also take P. sidoides for the following reasons.

  • Sinusitis
  • Common cold
  • Sore throat, cough, or runny or stuffy nose
  • General immune support

Many airway infections, including acute bronchitis, sinus infections, and the common cold, are caused by viruses. Even though antibiotics do not work against viruses, some symptoms may need medical care. You should not rely on this supplement alone to treat a possible infection. Contact a health care provider if your symptoms last longer than about a week or get worse or you have other health conditions. A health care provider can check for a more serious illness or another cause that may need different treatment.

Note: The FDA has not reviewed Pelargonium sidoides for safety and effectiveness. Learn more about dietary supplements here.

How does Pelargonium sidoides work (mechanism of action)?

Pelargonium sidoides is a plant, also called Pelargonium sidoides DC., that belongs to the geranium family. It is also sometimes called South African geranium, Umckaloabo, or by its standardized extract name EPs 7630. P. sidoides supplements are usually made from the roots of the plant.

The root extract of Pelargonium sidoides contains natural plant compounds, including benzopyranones, prodelphinidins (a type of polyphenol), and coumarins such as umckalin. These compounds are thought to be the main active ingredients.

P. sidoides may work to help with airway infections in many ways. It may help the body fight infections by boosting parts of the immune system, such as increasing the production of substances that help the body defend against germs. It may also make it harder for viruses and other germs to attach to cells in the body, which could help prevent infections from taking hold or getting worse. In addition, P. sidoides may help loosen mucus and improve the movement of tiny hair-like structures (called cilia) in the airways, which helps clear mucus from the lungs and sinuses.

P. sidoides has weak direct antibacterial effects that are unlikely to kill bacteria on their own. Instead, its main benefit appears to come from helping the body’s own defenses work better and making it harder for germs to infect cells.

Herbal products such as P. sidoides naturally contain many different chemicals. The amounts of each chemical in a specific product may vary. Some, none, or all of these chemicals may have effects on the body. These effects may change depending on how much of each chemical is found in the P. sidoides supplement you are using.

How should I store Pelargonium sidoides?

You should store Pelargonium sidoides according to the product label. Most dietary supplements should be kept in a cool, dry location that is out of the reach of children and pets and not in direct sunlight.

Side Effects

What are the most common side effects of Pelargonium sidoides?

The most common side effects of Pelargonium sidoides are listed below. These side effects may vary depending on the dose you are taking or the specific product you are using. Tell your health care provider if you have any of these side effects that bother you.

  • Stomach pain
  • Nausea
  • Diarrhea

There may be other side effects of P. sidoides that are not listed here. Contact your health care provider if you think you are having a side effect of a supplement. In the U.S., you can report side effects to the FDA at www.safetyreporting.hhs.gov or by calling 888-SAFEFOOD (888-723-3366). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Pelargonium sidoides?

While less common, the most serious side effects of P. sidoides are described below, along with what to do if they happen.

Severe Allergic Reactions.Pelargonium sidoides may cause allergic reactions, which can be serious. Stop taking it and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Liver Problems. There have been reports of possible liver problems in people using P. sidoides supplements. But it is not clear if Pelargonium sidoides was the cause. Still, the possibility of liver effects cannot be ruled out. Call your health care provider right away if you have any of the following symptoms of liver problems.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish (also called jaundice)

Warnings & Precautions

Who should not use Pelargonium sidoides?

Allergies to Ingredients. People who are allergic to any of the following should not take Pelargonium sidoides.

  • Pelargonium sidoides
  • South African geranium
  • Umckaloabo
  • Any of the ingredients in the specific product

Your pharmacist can tell you all of the ingredients in the specific Pelargonium sidoides products they stock.

What should I know about Pelargonium sidoides before using it?

Pelargonium sidoides is a dietary supplement. It cannot be marketed to treat or cure a disease.

Read and follow the directions on the specific P. sidoides product you are taking, or take it as recommended by your health care provider.

Keep Pelargonium sidoides out of the reach of children.

Pelargonium sidoides is available in many forms, including liquid extract (drops), tablets, and syrup. Each of these forms may contain different amounts of the chemicals naturally found in the plant. The liquid (alcoholic extract) form has been more widely studied than the tablet form. Some research suggests the liquid form may be more effective than tablets, but more studies are needed to confirm this.

The liquid extract form of Pelargonium sidoides contains alcohol. It is important to check the product label to see if it contains alcohol (ethanol) before giving it to a child or if you avoid alcohol for any reason.

Herbal products, such as Pelargonium sidoides, naturally contain many different chemicals. The amount of each chemical in a specific P. sidoides product can change for many reasons, including the area where the plant was grown, the weather during growth, the time of year when it was harvested, and the way the plant was processed after being harvested. If you switch to a new bottle or a different brand, you may not have the same effects or side effects because of this variability. Talk to your health care provider if you have questions or concerns.

The FDA has not tested Pelargonium sidoides products to confirm that they contain the ingredients stated on their labels. Some dietary supplements have been tested by third-party organizations to confirm that they contain the ingredients listed on their labels and do not contain any harmful chemicals. Learn more about how to choose a safe dietary supplement product here.

What should I tell my health care provider before using Pelargonium sidoides?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. Also tell them if you have an upcoming surgery planned. Sharing this information will help your health care provider know if this or other supplements are right for you.

In particular, make sure that you discuss any of the following.

Other Medicines and Supplements. P. sidoides may interact with other medicines and supplements. Before using P. sidoides, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Liver problems
  • Kidney problems
  • Bleeding disorders
  • An ongoing infection
  • Any condition that affects your immune system

Pregnancy. It is not known if or how P. sidoides could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if P. sidoides passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does Pelargonium sidoides interact with foods or drinks?

There are no known interactions between P. sidoides and foods or drinks.

It is unknown if drinking alcohol will affect Pelargonium sidoides. However, the liquid extract form of P. sidoides may contain alcohol (ethanol). So, drinking additional alcohol while using this form may increase the effects of alcohol.

Does Pelargonium sidoides interact with medicines (drug interactions)?

Pelargonium sidoides may interact with medicines, but this has not been confirmed in human studies. Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking Pelargonium sidoides.

Blood thinner or antiplatelet medicine. Pelargonium sidoides contains natural compounds that may raise the risk of bleeding when used with a blood thinner, which is a medicine used to help prevent or treat blood clots. Examples include apixaban (Eliquis), clopidogrel (Plavix), rivaroxaban (Xarelto), and warfarin. However, the research on this is limited, and the risk is not well defined.

Medicine that affects the immune system. Because Pelargonium sidoides may have effects on the immune system, it is possible that it could interact with medicines that suppress the immune system or change immune function.

The interactions between Pelargonium sidoides and medicines are not fully understood. As with most dietary supplements, the research on drug interactions with Pelargonium sidoides is incomplete. Always check with your health care provider before taking P. sidoides with any medicines.

Overdose/Missed Dose

What should I do if I accidentally use too much Pelargonium sidoides?

If you or someone else has used too much Pelargonium sidoides, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

Pelargonium sidoides comes in a range of doses and forms, including liquid extract (drops), tablets, and syrup. Read the product label closely, and speak to a health care provider about how to use Pelargonium sidoides safely. Do not take double or extra doses, even if you miss a dose.