Andrographis
Andrographis paniculata
TL;DR
Andrographis is one of the better-evidenced herbs for acute upper respiratory infection. Pooled trials show it shortens cough and sore throat and reduces symptom severity, typically at 400-1,200 mg/day of extract standardised to andrographolides, started within 72 hours of onset. It is a short-course herb, not a daily preventive.
Ideal For
- Adults starting a course at the first signs of a cold or sore throat
- People wanting a short-course alternative to symptomatic cold remedies
- Those who have not responded to echinacea or zinc lozenges
- Adults with recurrent seasonal upper respiratory infections
Avoid If
- You have an autoimmune condition — andrographis is immunostimulant
- You are pregnant or trying to conceive; animal data raise reproductive concerns
- You take immunosuppressants after transplant
- You are on anticoagulants, given antiplatelet activity
- You have had any allergic reaction to it — anaphylaxis has been reported
Frequently Asked Questions
Overview
Andrographis paniculata is intensely bitter — the Sanskrit and Chinese names both reference it — and that bitterness comes from andrographolides, the diterpene lactones responsible for its activity. Systematic reviews covering more than 30 randomised trials in acute respiratory tract infection consistently find shorter and less severe cough, sore throat and general malaise compared with placebo, with effect sizes that hold up better than most botanical cold remedies. The KalmCold and Kan Jang preparations account for much of the higher-quality data. Beyond respiratory use, small trials in rheumatoid arthritis and ulcerative colitis show anti-inflammatory effects, with the ulcerative colitis data reaching remission rates comparable to mesalazine in one trial — interesting but not yet enough to change practice. The safety picture requires care: andrographis has been associated with anaphylactic reactions in a minority, has clear immunostimulant activity that makes it inappropriate in autoimmune disease, and animal work raises reproductive concerns. Use it as a five to ten day course at symptom onset and stop.
How It Works
- Andrographolides inhibit NF-kB activation, lowering TNF-alpha and IL-6 production
- Enhances natural killer cell and macrophage activity during acute infection
- Suppresses viral attachment and replication of influenza and RSV in vitro
- Reduces mucus hypersecretion and airway inflammation
- Inhibits COX-2 expression, contributing to analgesic and antipyretic effects
- Induces phase II detoxification enzymes via Nrf2 signalling
Health Concerns Addressed
No linked health concerns yet.
Supporting Research9 studies
Andrographis paniculata for symptomatic relief of acute respiratory tract infections in adults and children: a systematic review and meta-analysis
Hu XY, Wu RH, Logue M +9 more
Andrographis paniculata for symptomatic relief of acute respiratory tract infections in adults and children: a systematic review and meta-analysis.
Efficacy and safety of AP-Bio (KalmCold) in participants with uncomplicated upper respiratory tract viral infection (common cold) - A phase III, double-blind, parallel group, randomized placebo-controlled trial
Raj JP, et al
Participants in both the AP-Bio dose groups showed positive tendency towards resolution of URTI symptoms when compared with placebo on Day-3 but not on Day-5 and Day-7.
Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy
Coon JT, Ernst E
Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy.
Herbal Medicines for the Treatment of Active Ulcerative Colitis: A Systematic Review and Meta-Analysis
Iyengar P, Godoy-Brewer G, Maniyar I +4 more
Pooled analysis found no significant benefit of Andrographis paniculata for clinical response (RR 0.95, 95% CI 0.71-1.26) in active ulcerative colitis.
Andrographis paniculata extract (HMPL-004) for active ulcerative colitis
Sandborn WJ, Targan SR, Byers VS +4 more
Patients with mildly to moderately active ulcerative colitis treated with A. paniculata extract (HMPL-004) at a dose of 1,800 mg daily were more likely to achieve clinical response than those receiving placebo.
Safety of Andrographis paniculata: A systematic review and meta-analysis
Worakunphanich W, Thavorncharoensap M, Youngkong S +2 more
Incidence of serious AEs was very rare with the pooled incidence (95% CI) from RCTs of 0.02 per 1000 patients (0.0-0.5).
Randomised clinical trial: herbal extract HMPL-004 in active ulcerative colitis - a double-blind comparison with sustained release mesalazine
Tang T, Targan SR, Li ZS +3 more
Clinical remission and response were seen in 21% and 76% of HMPL-004-treated patients, and 16% and 82% of mesalazine-treated patients.
Andrographis paniculata decreases fatigue in patients with relapsing-remitting multiple sclerosis: a 12-month double-blind placebo-controlled pilot study
Bertoglio JC, Baumgartner M, Palma R +6 more
Patients treated with A. paniculata showed a significant reduction in their FSS score as compared to the placebo, equivalent to a 44 % reduction at 12 months.
Efficacy of an Andrographis paniculata composition for the relief of rheumatoid arthritis symptoms: a prospective randomized placebo-controlled trial
Burgos RA, Hancke JL, Bertoglio JC +4 more
The intensity of joint pain decreased in the active vs placebo group at the end of treatment, although these differences were not statistically significant.
Safety Information
Potential Side Effects
Nausea, bitter taste, diarrhoea and reduced appetite are the common effects. Headache and fatigue occur. Rare but serious: urticaria and anaphylactic reactions have been documented, which is why any allergic response means permanent discontinuation.
Contraindications
Autoimmune disease, pregnancy and attempted conception, immunosuppressive therapy, known hypersensitivity, bleeding disorders.
Drug Interactions
- Immunosuppressants including ciclosporin and tacrolimus — opposing pharmacology
- Anticoagulants and antiplatelets — additive bleeding risk
- Antihypertensives — possible additive blood pressure lowering
- Antidiabetic agents — additive glucose lowering reported
- CYP3A4 and CYP2C9 substrates — modest inhibition in preclinical work
Pregnancy & Breastfeeding
Pregnancy: likely_unsafe
Breastfeeding: insufficient_data
Dosage Guidelines
Dosage Used in Studies
200-1200 mg
Best Time to Take
Three divided doses with meals during an acute course
Best Form
Standardised extract delivering around 60 mg/day of andrographolides
Bioavailability
Andrographolide is absorbed rapidly with a short half-life of around two hours, which is why three-times-daily dosing is used in trials rather than a single dose.
Forms Compared
Standardised extract (KalmCold, 30% andrographolides)
Kan Jang (andrographis + eleuthero)
Whole herb powder
Tincture
Combination cold formulas
Food & Timing
With food — taken alone it commonly causes nausea and an unpleasant lingering bitterness
Medical Disclaimer
The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.
Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.