Herbal Medicine: Expanded Commission E
Ivy leaf
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Latin Name: Hedera helix
Pharmacopeial Name: Hederae helicis folium
Other Names: English ivy, wood bine
Overview
Ivy grows across Europe and into northern and central Asia, and has been naturalized to the United States. It has been cultivated to climb along trellises, and to provide ornamental covering to stone and brickwork buildings. Commission E approves the use of ivy for the symptomatic relief of acute and chronic respiratory inflammation. An in vitro study recently confirmed the antispasmodic action of ivy, showing significant activity for both the saponial and phenolic compounds (Trute et al., 1997). Not much clinical research is available on the medicinal use of ivy; however, traditional healers in Europe had more uses for the plant than contemporary herbalists. They described ivy leaves as cathartic, anthelmintic, and useful for lowering fever, and inducing perspiration. As far back as classical Greece, ivy leaves were bruised and simmered in wine, and drunk as a deterrent to intoxication. It has been proposed that this is why Bacchus is depicted wearing an ivy wreath around his head in old paintings and statues. Greek priests gave newlyweds ivy wreaths to signify fidelity (Grieve, 1979). Early experimental tests isolated glycosidic saponins in ivy leaf, and demonstrated that they were antifungal and molluscicidal in vitro, and able to kill liver flukes both in vitro and in vivo (Wren, 1988). More recently, biochemists have postulated that these saponins are responsible for the plant's expectorant actions: Saponins trigger responses in gastric mucosa, which in turn activate mucous glands in the bronchi through parasympathetic signaling, to aid in the removal of mucous. Ivy leaves contain up to 6% saponin (Schulz et al., 1998). Saponins are a common focus in plant research. Bitter tasting, saponins foam when shaken with water, and their irritant nature can cause nausea and vomiting. Because they have been shown to be effective in the treatment of chronic venous insufficiency (CVI), saponins occuring in significant levels in plants target those plants for further circulatory research. Recently, however, ivy's purported use as an alternative treatment for CVI was disproved, and its saponins were found to be ineffective for this indication (Facino et al., 1995). Ivy saponins do demonstrate significant antileishmanial activity. Specifically, the monodesmosides are as effective as pentamidine against the flagellate promastigote, and hederagenin is as effective as N-methylglucamine against amastigote (Majester-Savornin et al., 1991). Leishmaniasis is an infection caused by the flagellate protozoans of sand flies, such as promastigote and amastigote. Because ulcers that form with the infection can lead to blindness, further study of ivy's saponin effects may one day be useful to the people of Africa, India, and Asia, where sand flies are prevalent. In addition, in ongoing experimental anticancer testing, ivy's saponins were found to be cytotoxic to cultured B16-melanoma cells (Danloy et al., 1994).
Description
Ivy leaf consists of the dried leaf of Hedera helix L. [Fam.Araliaceae] and its preparations in effective dosage. The preparation contains saponins.
Chemistry and Pharmacology
The main constituents include saponins, comprising the hederagenin glycosides hederacoside C and a-hederin and the oleanolic-acid glycosides hederacoside B and b-hederin (Wichtl and Bisset, 1994). The saponins range in concentration from 58%. Ivy leaves contain sterols, flavonoids, polyalkynes: falcarinol, falcarinone, 11-dehydrofalcarinol (Bruneton, 1995). Other constituents include the polyacetylenes falcarinone and falcarinol; the sterols stigmasterol, sitosterol, cholesterol, campesterol, a-spinasterol, and 5a-stigma-7-en-3b-ol; scopolin; chlorogenic acid; caffeic acid; the sesquiterpene hydrocarbons germacrene; b-elemene; and elixin (Wichtl and Bisset, 1994). The Commission E reported that skin and mucosa are sensitive to ivy leaf and it performs correspondingly expectorant and antispasmodic activity. There are also apparent antiparasitic properties in the leaf extract (Bruneton, 1995). Experiments have found that the extract is cytotoxic and antibacterial (Bruneton, 1995). Specifically, the constituent falcarinol has been confirmed as having antibacterial, analgesic, and sedative effects. Both falcarinone and falcarinol are considered antimycotic (Wichtl and Bisset, 1994). In vitro studies conclude that the sodium salts of the monodesmosides create a toxicity toward Amoeba, Trichomonas, and Leishmania (Bruneton, 1995).
Uses
The Commission E confirms ivy leaf as treatment for catarrhs of the respiratory passages and for symptoms of chronic inflammatory bronchial conditions. Ivy is suggested as an expectorant, secretolytic, and antispasmodic in response to, specifically, whooping cough, spastic bronchitis, and chronic catarrh (Wichtl and Bisset, 1994). Topical applications of ivy-based products are suggested for their anti-cellulite and weight loss properties. Emollient and itch-relieving preparations, including creams, lotions, and shampoos, are used cosmetically and in the treatment of skin disorders (Bruneton, 1995). The ivy leaf is additionally indicated for arthritis, rheumatism, and scrofula (Wichtl and Bisset, 1994).
Contraindications
None known.
Side Effects
Contact dermatitis (Bruneton, 1995).
Use During Pregnancy and Lactation
No restrictions known.
Interactions with Other Drugs
None known.
Dosage and Administration
Unless otherwise prescribed: 0.3 g per day of cut herb. Infusion: 0.3 g of herb in 150 ml water. Fuidextract 1:1 (g/ml): 0.3 ml. Tincture 1:5 (g/ml): 1.5 ml. Note: Repeated contact with ivy leaves may cause erythematous or vesicular reactions of the face, hands, and arms up to 48 hours after contact (Bruneton, 1995).
References
Bruneton, J. 1995. Pharmacognosy, Phytochemistry, Medicinal Plants. Paris: Lavoisier Publishing. Danloy, S. et al. 1994. Effects of alpha-hederin, a saponin extracted from Hedera helix, on cells cultured in vitro.Planta Med 60(1):4549. Facino, R.M., M. Carini, R. Stefani, G. Aldini, L. Saibene. 1995. Anti-elastase and anti-hyaluronidase activities of saponins and sapogenins from Hedera helix,Aesculus hipposcastanum, and Ruscus aculeatus: factors contributing to their efficacy in the treatment of venous insufficiency. Arch Pharm (Weinheim) 328(10):720724. Grieve, M. 1979. A Modern Herbal. New York: Dover Publications, Inc. Majester-Savornin, B. et al. 1991. Saponins of the ivy plant, Hedera helix, and their leishmanicidic activity. Planta Med 57(3):260262. Schulz, V., R. Hnsel, V.E. Tyler. 1998. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. New York: Springer. Trute, A. et al. 1997. In vitro antispasmodic compounds of the dry extract obtained from Hedera helix.Planta Med 63(2):125129. Wichtl, M. and N.G. Bisset (eds.). 1994. Herbal Drugs and Phytopharmaceuticals. Stuttgart: Medpharm Scientific Publishers. Wren, R.C. 1988. Potter's New Cyclopaedia of Botanical Drugs and Preparations. Essex: The C.W. Daniel Company Ltd.
Additional Resources
Garcia, M., E. Fernandez, J.A. Navarro, M.D. del Pozo, L. Fernandez de Corres. 1995. Allergic contact dermatitis from Hedera helix L. Contact Dermatitis 33(2):133134. Johnke, H. et al. 1994. [Contact dermatitis allergy to common ivy] [In Danish]. Ugeskr Laeger 156(25):37783779. This material was adapted from The Complete German Commission E MonographsTherapeutic Guide to Herbal Medicines. M. Blumenthal, W.R. Busse, A. Goldberg, J. Gruenwald, T. Hall, C.W. Riggins, R.S. Rister (eds.) S. Klein and R.S. Rister (trans.). 1998. Austin: American Botanical Council; Boston: Integrative Medicine Communications.
1) The Overview section is new information. 2) Description, Chemistry and Pharmacology, Uses, Contraindications, Side Effects, Interactions with Other Drugs, and Dosage sections have been drawn from the original work. Additional information has been added in some or all of these sections, as noted with references. 3) The dosage for equivalent preparations (tea infusion, fluidextract, and tincture) have been provided based on the following example: - Unless otherwise prescribed: 2 g per day of [powdered, crushed, cut or whole] [plant part]
- Infusion: 2 g in 150 ml of water
- Fluidextract 1:1 (g/ml): 2 ml
- Tincture 1:5 (g/ml): 10 ml
4) The References and Additional Resources sections are new sections. Additional Resources are not cited in the monograph but are included for research purposes. This monograph, published by the Commission E in 1994, was modified based on new scientific research. It contains more extensive pharmacological and therapeutic information taken directly from the Commission E.
Excerpt from Herbal Medicine: Expanded Commission E Monographs
Copyright 2000 American Botanical Council
Published by Integrative Medicine Communications
Available from the American Botanical Council.
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