Acute respiratory tract infections: Can Umckaloabo or Kaloba relieve symptoms?

There is some weak evidence that in respiratory tract infections an extract from the root of the Pelargonium sidoides could shorten the length of the illness and relieve symptoms. Yet this remedy can have adverse effects, for example gastrointestinal problems. 

A respiratory tract infection, for example a common cold or acute bronchitis, usually develops over several days. It often begins with a sore throat, which is then followed within a few days by other symptoms such as a stuffy or runny nose, a cough, or sometimes a headache and mild fever. It usually takes people who are otherwise healthy about a week to get over a cold, bronchitis or influenza. These types of respiratory tract infections are very common: children get them about 6 times a year, and adults have them 2 to 4 times a year. You can find out more about the common cold, the flu and similar infections, as well as ways to protect yourself from respiratory tract infections in our feature.

To relieve symptoms of respiratory tract infections, herbal remedies containing an extract from the root of the Pelargonium sidoideshas been used more and more frequently over the last several years. In Germany these remedies are marketed using the trade names Umckaloabo and Kaloba and are available over-the-counter in pharmacies. They should not be used, however, in children under the age of 6 years without consulting a doctor.

Umckaloabo and Kaloba contain an extract from the root of the South African Geranium. The herbal active ingredient (phytotherapeutic agent) is available in the form of drops and tablets. It is thought to strengthen the immune system, and also to have some effect loosening mucous and relieving a cough. It is suspected that during its use, it is harder for viruses and bacteria to settle on the mucous membranes lining the airways. Only good-quality scientific trials can determine whether these remedies actually have a benefit.

Treatment options for respiratory tract infections

Simple respiratory tract infections like colds are usually caused by viruses. Only rarely do bacteria also play a role. Antibiotics are nevertheless often used in treatment, although they are only effective against bacteria. Both the overuse of antibiotics as well as their improper use promotes resistance to such drugs. You can read more about this here.

Because there is no one medicine that is entirely successful against respiratory viruses, it is usually only the symptoms of the cold that are treated – that means symptoms such as a stuffy nose, coughing, aches or fever are relieved with therapies or drugs for reducing swelling, loosening mucous, easing pain or lowering fever.

Analysis of trials on the effectiveness of Pelargonium root extract

Researchers from the Cochrane Collaboration, an international research network, looked for trials suitable for finding out how effective and safe the use of Pelargonium root extract is for treating respiratory tract infections. The researchers from Freiburg found 8 randomized controlled trials suited to testing the effectiveness of these products.

In these types of trials, volunteers are randomly divided into two or more groups. One group uses the drug that is to be tested and is then compared with one of the other groups, which receives a dummy drug (placebo) – or with a group that receives either no treatment or a different form of treatment. This way it is possible to find out whether an effect observed in the participants is due to the drug or not.

In the trials that the Freiburg researchers analyzed, Pelargonium root extract was compared with a placebo. The 8 trials involved a total of 1,771 children and adults. Three of these trials with a total of 746 adult volunteers, as well as 3 more involving 819 children had studied the effect of this herbal remedy for acute bronchitis. In addition to drops, tablets were also tested. These tests showed that mostly the use of the active ingredient in drop form had small positive effects: Seven days after becoming ill, more participants in groups that took Pelargonium root extract had completely recovered from the infection than in the other groups, which had received a placebo. One trial involving 104 adults indicated that geranium extract may also help in sinusitis. One trial on effectiveness for simple colds, however, showed no important effects.

The adverse effects participants most commonly experienced resulting from the herbal remedies were gastrointestinal symptoms (nausea, vomiting, diarrhea, heartburn), and in individual cases reactions on the skin (itching, hives). In July 2011 the Drug Commission of the German Medical Association (AkdÄ) pointed out that in the last few years 10 cases have been reported in which the use of this product was associated with hepatitis (inflammation of the liver). But it is not ultimately clear whether the Pelargonium root extract actually caused these cases of hepatitis. It is also worth noting that the drops do contain alcohol.

Weak effect, unanswered questions

From their analysis the researchers carefully reached the conclusion that Pelargonium root extract could somewhat relieve the symptoms of children and adults with acute bronchitis or sinusitis. But it remains unclear what practical implications these effects have. Because the analysis was not able to include many trials overall, more research is needed to better assess the effectiveness and safety of these products. It cannot yet be said with certainty how the use of these products influences absences from school or work, or the use of antibiotics. It is also not yet clear how they could possibly interact with other drugs, or what other risks Umckaloabo and Kaloba could have.

Author: German Institute for Quality and Efficiency in Health Care (IQWiG)

Next planned update: August 2014. You can find out more about how our health information is updated here.

© IQWiG (Institute for Quality and Efficiency in Health Care)