INTRODUCTION
Cough is one of the most common childhood health complaints, often prompting anxious parents to seek medical advice or purchase over-the-counter remedies. Although coughing is a natural defense mechanism, it can disturb sleep, reduce appetite, and affect quality of life for both children and parents.
As a pharmacist, I frequently encounter parents looking for a safe, effective, and non-sedating solution for their child’s cough. Conventional cough syrups containing dextromethorphan, guaifenesin, codeine, or antihistamines have long been used, but research shows they may not be the best choice for children. Safety concerns and limited effectiveness make many of these products less suitable, especially for young children.
One promising alternative is Coferb syrup (ivy leaf extract) an herbal cough remedy made with Hedera helix and, in some formulations (Coferb Plus), thyme and licorice. Coferb works as an expectorant and mucolytic, helping children clear mucus and breathe more easily. Unlike chemical suppressants, it does not simply silence the cough; it supports the natural healing process.
In this article, I will share the scientific evidence, my professional pharmacist perspective, and my personal experience using ivy leaf extract (Coferb) with my own children.
WHY CONVENTIONAL COUGH SYRUPS MAY NOT BE IDEAL FOR CHILDREN
Conventional cough syrups may not be ideal for children due to the following reasons:
1. Limited Efficacy
The American Academy of Pediatrics (AAP) and the U.S. Food and Drug Administration (FDA) both highlight that most cough and cold syrups are not effective for children under six years. Research shows little difference between these medications and placebo when it comes to relieving cough in young children.
2. Safety Concerns
• Dextromethorphan (a cough suppressant): May cause nausea, dizziness, or even hallucinations in high doses. It has also been linked to misuse in adolescents.
• Codeine: Once common in cough syrups, it is now banned for children under 12 years in many countries due to risks of respiratory depression and even death in ultra-rapid metabolizers.
• First-generation antihistamines: May cause excessive drowsiness or paradoxical hyperactivity in children.
• Multi-ingredient syrups: Increase the risk of accidental overdose and drug interactions.
3. Regulatory Warnings
• The FDA advises against cough syrups in children under 2 years.
• Several pediatric guidelines recommend avoiding them under 6 years.
These concerns leave many parents searching for safer alternatives. Herbal options especially ivy leaf extract syrups such as Coferb have gained attention for easing cough while supporting natural recovery.
COFERB SYRUP (IVY LEAF EXTRACT): HERBAL COMPOSITION AND MECHANISM
1. Ivy Leaf Extract (Hedera helix)
• Mucolytic – loosens thick mucus
• Expectorant – aids mucus clearance
• Bronchodilator – relaxes airway muscles, easing breathing
2. Thyme Extract (in Coferb Plus)
• Rich in thymol with anti-inflammatory and antimicrobial properties
• Airway relaxation helps relieve congestion and supports easier breathing
3. Licorice Extract (in Coferb Plus)
• Soothing effect calms irritated throats
• Anti-inflammatory action reduces discomfort and irritation
Together, these ingredients make ivy leaf extract (Coferb) more than just a cough syrup it supports airway clearance, reduces irritation, and restores comfort.
SCIENTIFIC EVIDENCE SUPPORTING IVY LEAF EXTRACT (COFERB)
The effectiveness of ivy leaf extract is supported by several studies:
• Systematic Review (European Journal of Pediatrics, 2020): Herbal syrups containing ivy leaf significantly reduced cough severity and improved mucus clearance in children with acute bronchitis.
• Randomized Controlled Trial (Journal of Medical Food, 2017): Compared ivy leaf extract with ambroxol (a chemical mucolytic). Results showed both improved symptoms, but ivy extract was associated with fewer side effects.
• Combination Studies (Phytomedicine, 2015): Ivy leaf plus thyme extract shortened the duration of acute cough, improved sleep quality, and reduced night-time cough in children.
• Safety Data: Decades of European use have demonstrated ivy extract’s tolerability in children ≥2 years.
This growing body of evidence makes ivy leaf–based syrups like Coferb a scientifically credible option for pediatric cough management.
MY PERSONAL EXPERIENCE WITH COFERB (IVY LEAF EXTRACT)
As both a pharmacist and a parent, I am cautious when choosing medicines for my children. Conventional syrups worried me because of their sedation potential and questionable effectiveness.
When my children developed chesty coughs with mucus, I tried Coferb (ivy leaf extract) syrup. The results were encouraging:
• Their cough became more productive, helping clear mucus instead of suppressing it.
• There was no daytime drowsiness, so they could remain alert in school.
• Nighttime coughing reduced, and both my children and I finally got better sleep.
• I also appreciated the sugar-free formulation, which gave me confidence to use it regularly during illness.
Seeing this real-life benefit strengthened my professional trust in ivy leaf-based syrups.
BENEFITS OF COFERB (IVY LEAF EXTRACT) OVER CONVENTIONAL COUGH SYRUPS
• Evidence in children: Proven effective in studies vs. limited or no benefit under 6 years
• Sedation risk: Non-sedating vs. high with antihistamines or opioids
• Safety: Well, tolerated in children ≥2 years vs. risk of nausea, misuse, or respiratory depression
• Mode of Action: Clears mucus and soothes throat vs. merely suppresses cough reflex
• Formulations available: Syrup, sugar-free, drops, lozenges vs. mostly chemical syrups
• Parent acceptance: Herbal with pleasant taste vs. bitter taste or sedating effects
DOSAGE AND SAFETY GUIDELINES
• Age: Recommended for children ≥2 years.
• Dosage Guidelines (Coferb/Coferb Plus): Always check the product label or follow your doctor/pharmacist’s advice, as doses may vary by formulation and strength.
1. Children 2–5 years: 2.5 mL, 3 times daily
2. Children 6–12 years: 5 mL, 3 times daily
3. Adults: 5–7.5 mL, 3 times daily
PRECAUTIONS
• Not suitable for infants <2 years.
• Avoid in cases of allergy to ivy, thyme, or licorice.
• Pregnant or breastfeeding women should consult a doctor.
• If cough lasts beyond 7 days, worsens, or is associated with fever or breathing difficulty, seek medical evaluation.
PHARMACIST’S PERSPECTIVE
From my professional standpoint, ivy leaf extract (Coferb) stands out for three key reasons:
• Evidence-based herbal medicine supported by published research in children.
• Non-sedating and gentle ideal for school-aged children who need daytime alertness.
• Supports natural healing by thinning mucus and soothing the throat rather than simply suppressing symptoms.
CONCLUSION
Cough in children is common but challenging for parents to manage. While conventional syrups have been widely used, their safety concerns and lack of proven benefit in young children make them less than ideal. Coferb syrup (ivy leaf extract) offers a safer, scientifically supported, and non-sedating alternative.
As both a pharmacist and a parent, I have seen its benefits scientifically through clinical trials and personally through the comfort it brought my children during illness.
KEY TAKEAWAY:
Coferb, an ivy leaf–based cough syrup, is a safe, effective, and evidence-based choice for children aged 2 years and above with productive cough. Always follow the recommended dosage and consult a healthcare professional if symptoms persist.
FREQUENTLY ASKED QUESTIONS (FAQ) ABOUT COFERB / IVY LEAF EXTRACT
1. What is Coferb used for?
It is a herbal cough syrup mainly used to relieve productive (wet) cough by loosening mucus and easing breathing.
2. Is Coferb safe for children?
Yes, studies support its safety in children aged 2 years and above, but always follow the recommended dosage.
3. Does Coferb cause drowsiness?
No, unlike conventional cough syrups with antihistamines or opioids, Coferb is non-sedating.
4. Can Coferb be taken with other medicines?
Generally, yes, but consult a healthcare professional before combining it with other medications.
5. How long should I use Coferb?
If the cough persists for more than 7 days or worsens, consult a doctor for further evaluation.
DISCLAIMER
This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional before making any decisions about your child’s health or treatment.
CALL TO ACTION
Give your child safe, evidence-based relief from cough.
Ask your doctor or pharmacist about ivy leaf extract cough syrups such as Coferb to see if they’re suitable for your child.
Always follow the recommended dosage and seek medical attention if the cough lasts more than a week, worsens, or is accompanied by fever or breathing difficulty.
REFERENCES
1. Matthys H, Kamin W. Herbal remedies in children with cough: a systematic review. Chest. 2013;143(3):881–896. doi:10.1378/chest.12-2046
2. Kardos P, et al. Treatment of acute cough with herbal remedies: evidence and safety. Respir Med. 2020;170:106021. doi:10.1016/j.rmed.2020.106021
3. European Medicines Agency. Hedera helix L., folium: Community herbal monograph. 2016. 4. Coferb Product Monograph – Manufacturer Information (latest revision).