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Pelargonium sidoides added to NHS dm+d 7.1.0 — event medicine guidance

Pelargonium sidoides: a new herbal entry in dm+d

The NHS Business Services Authority has added Pelargonium sidoides to the dm+d dictionary (version 7.1.0). This herbal extract, derived from the South African geranium plant, is used to support respiratory health — particularly in acute bronchitis and cough. Event medics and clinical teams should understand its role, limitations, and safety profile.

What is Pelargonium sidoides used for?

Pelargonium sidoides is indicated for:

  • Acute bronchitis
  • Productive cough
  • Upper respiratory tract symptoms

It is supplied as a liquid extract (10–20 mL three times daily) or tablet formulations (typically 20 mg three times daily, product-dependent). Evidence for efficacy is limited; use is largely symptomatic and adjunctive.

Event medicine relevance

Pelargonium sidoides has a slow onset (typically 3–5 days) and is unsuitable for acute emergency management. Its role at events is limited to symptomatic relief in mild–moderate cough in attendees who are otherwise well.

Do not use for:

  • Severe respiratory distress
  • Suspected pneumonia
  • Acute asthma

Consider standard analgesics and cough suppressants first. Advise medical review if symptoms persist beyond 48–72 hours. Any respiratory distress or systemic illness must be escalated to ambulance services immediately.

Key cautions and side effects

Common side effects: nausea, abdominal discomfort, diarrhoea, and headache.

Serious (rare): allergic reaction (rash, angioedema) and hepatotoxicity with prolonged use.

Cautions:

  • Avoid in pregnancy and breastfeeding (limited safety data)
  • Hepatic impairment (monitor liver function if used beyond 2 weeks)
  • Concurrent hepatotoxic medications
  • Gastrointestinal ulceration or severe gastritis

Interactions: No major interactions with common event-medicine drugs (paracetamol, ibuprofen, antihistamines). Theoretical risk with hepatotoxic agents; avoid paracetamol overuse. No significant interaction with alcohol, but gastrointestinal irritation may worsen.

Further information

Always verify current dosing and safety information against the BNF (Herbal medicines) and product-specific summaries of product characteristics (SmPC) before administration.

For the full dm+d entry, visit the NHS BSA dm+d dictionary.