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**Ectoine + althaea + honey** is a combination medical device designated as ERS09, marketed under the brand name Ectoin Mouth & Throat Spray Althaea Honey. The formulation contains ectoine (a cyclic amino acid derivative with osmoregulatory function), *Althaea officinalis* (marshmallow root, with mucilaginous and demulcent properties), and honey, along with excipients such as water, maltodextrin, silicon dioxide, and potassium sorbate. The device is intended for symptomatic relief of **sore throat due to acute pharyngitis and dry cough**, primarily in adolescents and adults. - *Ectoine* acts via a **physical mechanism:** it stabilizes and moisturizes epithelial tissue through formation of an ectoine hydro complex, protecting cells by binding water and forming a barrier that reduces inflammation and irritation. - *Althaea* (marshmallow) provides demulcent effects by coating the mucosa and alleviating irritation. - *Honey* has traditional soothing and antimicrobial effects, potentially aiding symptomatic relief. The combination provides a multi-modal, non-pharmacological treatment that acts locally to relieve irritation and inflammation of the oropharyngeal mucosa without systemic pharmacological effects. It is classified as a **medical device** in relevant jurisdictions and used for self-limited upper airway symptoms.
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