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Andrographis (Andrographis paniculata) Be aware that the U.S. Food and Drug Administration does not strictly regulate herbs and dietary supplements. There is no guarantee of strength, purity or safety of products containing or claiming to contain andrographis. Decisions to use herbs or supplements should be carefully considered. Individuals using prescription drugs should discuss taking herbs or supplements with their pharmacists or health care providers before starting.
Scientists have studied andrographis for the following health problems: Familial Mediterranean fever | Familial Mediterranean fever is a genetic disorder mainly affecting ethnic groups around the Mediterranean. This disorder causes recurrent episodes of fever and inflammation of serous membranes. Based on early study, a combination product containing Andrographis paniculata, along with Eleutherococcus senticosus, Schizandra chinensis and Glycyrrhiza glabra may reduce duration, frequency and severity of attacks in children with familial Mediterranean fever. Further research is needed before a recommendation can be made. | Influenza | Historical data suggest that andrographis has been effective in the past as part of a regimen to treat influenza, fever and infectious illnesses in Asian medical systems. One clinical trial of andrographis reports a reduction in duration and severity of symptoms, as well as a decrease in time off from work, in patients treated for the flu with this herbal. More research is needed to confirm these results. | Upper respiratory tract infection | Based on the evidence from one clinical trial, andrographis may prevent upper respiratory tract infection during the winter months if taken on a daily basis. Other clinical trials, mostly done on the standardized product Kan Jang (Swedish Herbal Institute), suggest that this herb is effective in reducing symptom severity and duration in upper respiratory tract infections both in children and in adults if started within 36 to 48 hours of the onset of symptoms. There is a need for further studies carried out without the involvement of the manufacturer. It is also not clear if the combination product tested in some of the trials, which also contains Eleutherococcus, is more or less effective than using andrographis alone. |
Andrographis has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially very serious and even life-threatening. You should consult a health care provider before taking aloe for any unproven use. Allergies
Antioxidant
Atherosclerosis
Blood purifier
Cancer
Cholera
Diabetes
Dysentery
Dyspepsia
Fever
Gonorrhea
HIV
Increasing sperm count
| Inflammation
Jaundice
Liver protection
Malaria
Male contraception
Multiple sclerosis
Prevention of blood clots
Prevention of heart muscle injury
Prevention of blocked arteries after angioplasty
Shock
Snakebite
Urinary tract infection prevention after lithotripsy
Vitiligo |
Allergies Severe allergic (anaphylactic) reactions have been reported with andrographis. Side Effects Based on available research, andrographis at commonly recommended doses appears to be safe and well-tolerated. Adverse effects, as reported in clinical trials to date, are mild and do not occur very often. However, most trials have been short (two weeks or less), and the safety of long-term use remains unclear. Headache, dizziness, drowsiness, fatigue, chest discomfort, increased nasal discharge, "blocked nose," nausea, vomiting, abdominal discomfort, diarrhea, metallic, decreased sperm, decreased blood sugar and blood pressure, enlarged lymph glands and increased risk of bleeding may occur with andrographis use. Pregnancy And Breast-Feeding Avoid andrographis if you have fertility problems or are actively trying to become pregnant. Safety during breast-feeding is not known.
Interactions with drugs, supplements and other herbs have not been thoroughly studied. The interactions listed below have been reported in scientific publications. If you are taking prescription drugs, speak with your health care provider or pharmacist before using herbs or dietary supplements. Interactions With Drugs Andrographis may increase the risk of bleeding when taken with anticoagulant drugs, such as warfarin (Coumadin), or antiplatelet drugs, such as clopidogrel (Plavix). Your blood may need to be monitored carefully if you take these together. Nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil), should also be used cautiously with andrographis. Andrographis use should be stopped before some surgeries; discuss this with a health care professional. Andrographis may lower blood pressure. Patients taking blood pressure drugs should be monitored closely by a health care professional while using andrographis. Dosing adjustments may be necessary. Andrographis may lower blood sugar levels. Patients taking oral drugs for diabetes or using insulin should be monitored closely by a health care professional while using andrographis. Dosing adjustments may be necessary. Andrographis may have mast-cell stabilizing activity and may interact or add to the effects of other drugs used for some allergies or asthma. Anti-inflammatories, antineoplastics, antivirals and immunomodulators may interact with andrographis Interactions With Herbs And Dietary Supplements Andrographis may increase the risk of bleeding caused by anticoagulant or antiplatelet herbs or supplements such as ginkgo or horse chestnut seed extract. You should speak with a health care professional before taking andrographis with other herbs or supplements. Always read product labels carefully. Andrographis may lower blood pressure. People who are considering andrographis and are taking other herbs or supplements that may lower blood pressure, such as black cohosh (Cimicifuga racemosa) or hawthorn (Crataegus oxyacantha), should discuss therapy options with a health care professional. Andrographis may alter blood sugar levels. Patients taking other herbs or supplements that may affect blood sugar levels, such as bitter melon (Momordica charantia), should be monitored closely by a health care professional while taking andrographis. Anti-inflammatories, antineoplastics, antivirals and immunomodulators may interact with andrographis.
The doses listed below are based on scientific research, publications or traditional use. Because most herbs and supplements have not been thoroughly studied or monitored, safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients even within the same brand. Combination products often contain small amounts of each ingredient and may not be effective. The appropriate dosing should be discussed with a health care provider before starting therapy; always read the recommendations on a product's label. The dosing for unproven uses should be approached cautiously, because scientific information is limited in these areas. Adults (Aged 18 Or Older) Preparations containing 48 to 60 milligrams of the andrographolide constituents, divided into three or four daily doses, are in the range studied in most clinical trials for respiratory infections. For example, a 300-milligram Kan Jang tablet containing 4 percent andrographolides has been taken four times daily for cold treatment (for a total daily dose of 48 milligrams andrographolides). Lower doses have been evaluated for respiratory infection prevention; for example, a single 200- to 300-milligram standardized tablet has been taken daily. Use appears to be safe for up to two weeks. Higher doses may be unsafe and cause side effects. Long-term use of andrographis preparations (beyond two weeks) has not been well studied. Leaf: Doses of 500 to 3,000 milligram have been taken by mouth three times daily. Tea: For digestive problems, one teaspoon of herb per one cup of water, steeped for five to 10 minutes, has been taken with meals. Ayurvedic formulas: In India, the herb is known as Kalmegh, green chiretta, or Maha-tita ("king of bitters") and is the main ingredient of a common home remedy known as alui, which has been used for fever and as a "bitter" for digestive problems. Andrographis is also used in many Ayurvedic formulas, including SG-I Switradilepa, which is used for vitiligo. However, scientific evidence supporting these uses is lacking. Children (Younger Than 18) There is limited research in children. In one clinical trial in children between ages 4 and 11, a dose of two tablets three times daily (approximately 30 milligrams daily of andrographolide and deoxyandrographolide) was reported to be well tolerated for 10 days. Ayurvedic formulas: In India, leaves and juice are mixed with cardamom, clove and cinnamon. Such preparations have been used for colic and other stomach ailments in infants. However, these uses are not supported by scientific evidence.
Although andrographis has been suggested for many conditions, it has been most studied for familial Mediterranean fever, influenza and upper respiratory tract infections. Andrographis has not been proven for any other health condition. Andrographis may increase the risk of bleeding. Andrographis may also lower blood pressure or blood sugar levels. If you are taking anticoagulants, nonsteroidal anti-inflammatory drugs, blood pressure drugs, insulin or other diabetic drugs or if you are pregnant, you should speak with a health care professional or pharmacist before taking andrographis supplements. Consult a health care professional immediately if you experience side effects. The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.
- Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
- National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research
Selected Scientific Studies: Andrographis Natural Standard has reviewed all of the currently available medical literature to prepare the professional monograph from which this version was created. Some of the more recent articles are listed below: - Amaryan G, Astvatsatryan V, Gabrielyan E, et al. Double-blind, placebo-controlled, randomized, pilot clinical trial of ImmunoGuard: a standardized fixed combination of Andrographis paniculata Nees, with Eleutherococcus senticosus Maxim, Schizandra chinensis Bail. and Glycyrrhiza glabra L. extracts in patients with familial Mediterranean fever. Phytomedicine 2003;10(4):271-285.
- Calabrese C, Berman SH, Babish JG, et al. A phase I trial of andrographolide in HIV positive patients and normal volunteers. Phytother Res 2000;14(5):333-338.
- 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):293-298.
- Gabrielian ES, Shukarian AK, Goukasova GI, et al. A double blind, placebo-controlled study of Andrographis paniculata fixed combination Kan Jang in the treatment of acute upper respiratory tract infections including sinusitis. Phytomedicine 2002;9(7):589-597.
- Kligler B, Ulbricht C, Basch E, Kirkwood CD, Abrams TR, Miranda M, Singh Khalsa KP, Giles M, Boon H, Woods J. Andrographis paniculata for the treatment of upper respiratory infection: a systematic review by the natural standard research collaboration. Explore (NY). 2006 Jan;2(1):25-9.
- Kulichenko LL, Kireyeva LV, Malyshkina EN, Wikman G. A randomized, controlled study of Kan Jang versus amantadine in the treatment of influenza in Volgograd. J Herb Pharmacother 2003;3(1):77-93.
- Mandal SC, Dhara AK, Maiti BC. Studies on psychopharmacological activity of Andrographis paniculata extract. Phytother Res 2001;15(3):253-256.
- Melchior J, Spasov AA, Ostrovskij OV, et al. Double-blind, placebo-controlled pilot and phase III study of activity of standardized Andrographis paniculata Herba Nees extract fixed combination (Kan jang) in the treatment of uncomplicated upper-respiratory tract infection. Phytomedicine 2000;7(5):341-350.
- Natural Standard Research Collaboration, Chief Editors: Ulbricht C, Basch E, Natural Standard Herb and Supplement Reference - Evidence-Based Clinical Reviews, USA: Elsevier/Mosby, 2005.
- Poolsup N, Suthisisang C, Prathanturarug S, et al. Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract infection: systematic review of randomized controlled trials. J Clin Pharm Ther 2004;29(1):37-45.
- 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.
Last updated September 03, 2008
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