Yashtimadhu (Glycyrrhiza Glabra L.) in Pediatric Upper Respiratory Tract Disorders: A Narrative Review of Classical Rationale, Pharmacology and Clinical Evidence

Background: Acute cough, sore throat and common cold are among the most frequent reasons for pediatric consultation. Evidence for over-the-counter cough and cold medicines in young children is weak, and safety concerns are well recognised, which sustains interest in traditional remedies. Yashtimadhu (Glycyrrhiza glabra L., Fabaceae; liquorice) is a classical Ayurvedic drug described as Kanthya (beneficial to the throat) and used in cough and throat disorders. Objective: To review the Dravyaguna profile of Yashtimadhu and to appraise contemporary pharmacological, clinical and safety evidence relevant to pediatric upper respiratory tract disorders. Methods: Classical texts and the Ayurvedic Pharmacopoeia of India were reviewed. PubMed, Scopus, Google Scholar and AYUSH research portals were searched using the terms Glycyrrhiza glabra, liquorice, glycyrrhizin, Yashtimadhu, cough, pharyngitis, sore throat, upper respiratory tract infection and children. Results: Yashtimadhu is Madhura in Rasa, Guru and Snigdha in Guna, Sheeta in Virya and Madhura in Vipaka, and it pacifies Vata and Pitta. Experimental studies report demulcent, anti-inflammatory, antiviral and antioxidant activity, largely attributed to glycyrrhizin and flavonoids. Randomised trials of liquorice gargle for postoperative sore throat show benefit, but these were conducted in adults. Direct pediatric trials in infectious or allergic upper respiratory disorders are lacking. Glycyrrhizin can cause hypertension, hypokalemia and pseudohyperaldosteronism with excessive or prolonged intake. Conclusion: The classical profile and experimental pharmacology support plausibility, but there is no adequate pediatric clinical evidence to recommend routine use. Pediatric dose-finding, safety and controlled studies with standardised, glycyrrhizin-characterised preparations are needed.