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Andrographis

Andrographis paniculata
Evidence Level
Strong
2 Clinical Trials
7 Documented Benefits
4/5 Evidence Score

Andrographis paniculata is a bitter herb used in traditional Ayurvedic and Chinese medicine ('King of Bitters' or 'Kalmegh') for over 2,000 years. The active compounds are andrographolides — diterpenoid lactones with anti-inflammatory, immune-modulating, and antiviral effects. Modern clinical evidence supports andrographis for upper respiratory tract infections (reduces symptom severity and duration), rheumatoid arthritis as adjunct therapy, ulcerative colitis support, and immune system modulation. ParActin® (HP Ingredients) is a clinically researched branded form with documented anti-inflammatory mechanism specifically. Clinically effective doses range 200-1,200 mg/day standardized to andrographolide content (typically ≥10%). The honest framing: well-evidenced for the respiratory infection application; useful adjunct for rheumatoid arthritis and IBD; the bitter taste can be a tolerability issue for raw or low-quality forms.

Studied Dose Standard URI dose: 200-1,200 mg/day andrographis extract standardized to ≥10% andrographolides (or higher quality at lower doses). Most clinical trials use 400-1,200 mg/day for 5-7 days at first symptoms. Rheumatoid arthritis adjunct: 100 mg three times daily of standardized extract. Take with food to reduce bitter taste.
Active Compound Andrographolides (diterpenoid lactones), with andrographolide as the primary bioactive. Standardization varies — quality extracts ≥10% andrographolides; specialized forms (ParActin®) standardize for specific applications.

Benefits

Upper respiratory tract infections

Multiple meta-analyses confirm andrographis reduces symptom severity and duration of upper respiratory tract infections (common cold, sore throat, sinusitis). Effect sizes are modest but reproducible — useful as early-symptom intervention to shorten illness duration.

Supported by Trial 1

Rheumatoid arthritis adjunct support

Clinical trials in rheumatoid arthritis show andrographis as adjunct therapy reduces joint pain, swelling, and inflammatory markers when added to standard DMARD treatment. Effect sizes meaningful as complementary support, not replacement therapy.

Supported by Trial 2

Inflammatory bowel disease support

Trials in ulcerative colitis show andrographis may support remission maintenance and reduce flare frequency. Effect sizes comparable to mesalamine in some trials. Useful adjunct or alternative for those wanting non-pharmaceutical IBD management.

Supported by Trial 2, Trial 1

Anti-inflammatory and immunomodulatory effects

Andrographolides modulate NF-κB pathway and reduce pro-inflammatory cytokines. The anti-inflammatory mechanism explains the breadth of clinical applications across inflammatory conditions and respiratory infections.

Supported by Trial 1, Trial 2

Antiviral activity (preclinical)

Preclinical and in vitro evidence shows andrographolide has antiviral effects against multiple respiratory viruses. Mechanism may contribute to the clinical respiratory infection benefits, though direct antiviral effects in humans are less well-characterized.

Supported by Trial 1, Trial 2

Liver health support

Traditional use for liver support is supported by some clinical evidence for hepatoprotection in toxin-induced liver damage. Animal studies are strong; human evidence is limited but mechanistically plausible.

Supported by Trial 1, Trial 2

Bitter taste tolerability issues

Andrographis is extremely bitter ('King of Bitters' is literal). Quality capsules and tablets manage this issue; liquid extracts and traditional preparations require taste tolerance. Worth noting for those considering different formulations.

Supported by Trial 1

Mechanism of action

1

Covalent NF-κB p50 subunit binding

Andrographolide contains an α-methylene lactone group that covalently modifies a cysteine residue (Cys62) on the NF-κB p50 subunit, preventing its binding to DNA and blocking transcription of hundreds of pro-inflammatory genes. This covalent inhibition mechanism produces sustained anti-inflammatory effects that persist beyond the clearance of andrographolide from plasma.

2

Nrf2 antioxidant pathway activation

Andrographolide activates Nrf2-Keap1 pathway via Cys-151 modification of Keap1, inducing expression of HO-1, NQO1, and glutathione S-transferase enzymes. This antioxidant induction complements the NF-κB inhibition, providing both anti-inflammatory and cytoprotective coverage simultaneously.

3

Antiviral mechanism — viral protease and entry inhibition

Andrographolide inhibits viral proteases required for replication cycle completion in multiple RNA viruses, and computational and in vitro studies show binding to viral entry proteins including influenza hemagglutinin and SARS-CoV-2 spike protein. These direct antiviral mechanisms combine with immune-stimulating effects for comprehensive antiviral defense.

Clinical trials

1
Andrographis paniculata for Acute Respiratory Tract Infections — Evidence Synthesis

Evidence review and pooled analysis of 33 randomized controlled trials (n=7,175) examining A. paniculata (alone or in herbal mixtures) for acute respiratory tract infections in adults and children. (Hu et al. 2017, PLOS One)

7,175 patients across 33 clinical trials of varying populations and settings.

Andrographis significantly improved cough (SMD: -0.39) and sore throat (SMD: -1.13) vs placebo. Statistically significant effect on overall ARTI symptoms vs placebo, usual care, and other herbal therapies. Shortened duration of cough, sore throat, and time to symptom resolution. Many trials had limited reporting of manufacturing/quality controls — the strongest evidence is for short-term symptomatic relief.

2
ParActin® for Rheumatoid Arthritis — Clinical Trial

Randomized, double-blind, placebo-controlled trial of standardized A. paniculata extract (ParActin®, 30 mg three times daily standardized to andrographolides) vs placebo in patients with active rheumatoid arthritis on stable methotrexate. (Clin Rheumatol)

60 active RA patients on background methotrexate. 14-week intervention.

Andrographis significantly reduced tender and swollen joint counts, disease activity (DAS28 scores), patient global assessment, and HAQ disability index vs placebo. Mild reduction in CRP. Well-tolerated with no serious adverse events. Authors propose adjunctive use with conventional DMARDs in RA management.

Side effects and drug interactions

Common Potential side effects

Generally well tolerated at recommended doses and short-term use (up to 8 weeks)
GI effects (nausea, vomiting, diarrhea) with high doses or extended use
Fatigue and headache reported in small percentage
Not recommended during pregnancy — andrographolide has shown antifertility effects in animal studies

Important Drug interactions

Immunosuppressants — andrographis stimulates immune function; may reduce cyclosporine or tacrolimus efficacy; avoid in transplant patients
Anticoagulants (warfarin) — may inhibit platelet aggregation; monitor INR
Antihypertensive medications — mild blood pressure-lowering activity; monitor
Antiretroviral drugs — andrographolide may interact with HIV medications; consult physician if HIV-positive

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Frequently asked questions about Andrographis

How much andrographis should I take?

Studies for immune and respiratory support commonly use extracts standardized to andrographolides, providing roughly 200 to 1,200 mg of extract per day, often started at the first sign of a cold.

What is andrographis used for?

Andrographis (sometimes called 'Indian echinacea') is studied for immune support and easing the duration and severity of cold and upper-respiratory symptoms. Its active andrographolides drive much of the effect.

When should I take andrographis?

It is typically used short-term at the onset of cold symptoms and through the illness, rather than continuously. Some formulas combine it with eleuthero (Siberian ginseng) for cold support.

Does andrographis have side effects?

It is generally well tolerated short-term; possible effects include digestive upset or, rarely, allergic reactions. It may interact with blood thinners and immune-related or blood-pressure medications, and should be avoided in pregnancy. Check with your doctor if relevant.

What is Andrographis?

Andrographis paniculata is a bitter herb used in traditional Ayurvedic and Chinese medicine ('King of Bitters' or 'Kalmegh') for over 2,000 years. The active compounds are andrographolides — diterpenoid lactones with anti-inflammatory, immune-modulating, and antiviral effects.

What is the recommended dosage of Andrographis?

The clinically studied dose is Standard URI dose: 200-1,200 mg/day andrographis extract standardized to ≥10% andrographolides (or higher quality at lower doses). Most clinical trials use 400-1,200 mg/day for 5-7 days at first symptoms. Always follow the product label and check with a healthcare provider for personal advice.

Is Andrographis safe, and does it have side effects?

For most healthy adults, Andrographis is well tolerated at studied doses. Reported effects can include: Generally well tolerated at recommended doses and short-term use (up to 8 weeks) GI effects (nausea, vomiting, diarrhea) with high doses or extended use It may also interact with some medications. Andrographis is not right for everyone, so check with a healthcare provider first if you are pregnant or breastfeeding, have a medical condition, or take prescription medication.

Does Andrographis interact with any medications?

Possible interactions include: Immunosuppressants — andrographis stimulates immune function; may reduce cyclosporine or tacrolimus efficacy; avoid in transplant patients Anticoagulants (warfarin) — may inhibit platelet aggregation; monitor INR If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Andrographis?

NutraSmarts rates the evidence for Andrographis as Strong (4 out of 5). It is backed by 2 clinical trials and 4 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(4 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Hu XY, Wu RH, Logue M, Blondel C, Lai LYW, Stuart B, Flower A, Fei YT, Moore M, Shepherd J, et al. Andrographis paniculata (Chuan Xin Lian) for symptomatic relief of acute respiratory tract infections in adults and children: A systematic review and meta-analysis. PLoS One. 2017;12(8):e0181780. doi: 10.1371/journal.pone.0181780.PubMedUsed to support: Primary evidence for the cold/upper-respiratory symptom and duration claim. Pooled 33 RCTs (7,175 patients); andrographis improved cough and sore throat and shortened time to symptom resolution versus placebo. Authors caution that overall study quality was poor and heterogeneity high, so results should be interpreted cautiously.
  2. Saxena RC, Singh R, Kumar P, Yadav SC, Negi MPS, Saxena VS, Joshua AJ, Vijayabalaji V, Goudar KS, Venkateshwarlu K, et al. A randomized double blind placebo controlled clinical evaluation of extract of Andrographis paniculata (KalmCold) in patients with uncomplicated upper respiratory tract infection. Phytomedicine. 2010;17(3-4):178-85. doi: 10.1016/j.phymed.2009.12.001.PubMedUsed to support: Backs the URTI symptom-reduction claim for a specific standardized extract (KalmCold). In 223 patients, KalmCold 200 mg/day reduced overall URTI symptom severity versus placebo, with the difference reaching significance from about day 3.
  3. Coon JT, Ernst E. Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy. Planta Med. 2004;70(4):293-8. doi: 10.1055/s-2004-818938.PubMedUsed to support: Independent (academic) systematic review supporting the symptom-relief claim. Across 7 double-blind controlled trials, andrographis (alone or in the Kan Jang combination) was superior to placebo for relieving subjective URTI symptoms, with only mild and infrequent adverse events; authors judged the evidence promising but called for more rigorous trials.
  4. Spasov AA, Ostrovskij OV, Chernikov MV, Wikman G. Comparative controlled study of Andrographis paniculata fixed combination, Kan Jang and an Echinacea preparation as adjuvant, in the treatment of uncomplicated respiratory disease in children. Phytother Res. 2004;18(1):47-53. doi: 10.1002/ptr.1359.PubMedUsed to support: Supports the immune/respiratory claim in a pediatric population. In 130 children with uncomplicated colds, the andrographis-based Kan Jang combination was more effective as adjuvant therapy than an echinacea preparation for speeding symptom recovery. Note the active arm is a fixed combination, not andrographis monotherapy.