Andrographis
In short
Summary of findings for quick reference
Andrographis is a strongly bitter herb from the Indian subcontinent. It is known as Kalmegh in Ayurveda, Nilavembu in Siddha medicine, Chuan Xin Lian in traditional Chinese medicine, Fah Talai Jone in Thailand and Sambiloto in Indonesian Jamu. These traditions use the aerial herb for conditions including fever and respiratory complaints. Early textual references cannot always be securely assigned to the modern botanical species.
The preparation matters when reading the studies: Andrographis alone, its fixed combination with Eleutherococcus senticosus and other multi-herb formulas need to be distinguished. The reviews by Coon and Ernst (2004) and Hu and colleagues (2017) include different preparations. They suggest relief of some respiratory symptoms, but study quality prevents firm general conclusions.
Andrographis can cause severe allergic reactions, including anaphylaxis, even after previous use without problems. It should not be used during pregnancy or breastfeeding. Seek medical advice before use if trying to conceive or taking medication. Respiratory trials do not establish a general four-to-eight-week course; most studied only a few days. The EMA has not established an HMPC monograph for the leaf.
Clinical evidence ↔ Historical significanceWe display two separate evidence categories: clinical evidence from modern trials and historical significance from documented healing tradition. Both are valuable, but they answer different questions.Read more
In every encyclopedia entry we evaluate two distinct categories of evidence. Clinical evidence as used in trials meets a narrower but scientifically essential bar. At the same time, the hundreds of thousands of plant species worldwide have only partially been captured and tested in modern studies.
Alongside the trial picture our researchers compile a comprehensive overview of where and since when a plant has been used across different traditions of natural medicine. When a plant has been used as a medicinal plant in many cultures across many generations, that historical significance deserves to be visible too.
Our position: a truly informative overview emerges only when both categories sit side by side. We communicate transparently what counts as what.
Overview
Andrographis (Andrographis paniculata) is an annual native to the Indian subcontinent and cultivated in Southeast Asia. Known as Kalmegh in Ayurveda, it is valued for its strongly bitter taste. The aerial parts are used. The plant also features in traditional Chinese medicine and Indonesian Jamu. Preparations include standardized extracts in capsule form.
The most studied bioactives are the andrographolides, a family of diterpene lactones. Andrographolide is the principal compound; neoandrographolide is also commonly cited. Modern clinical research has focused on upper respiratory tract symptoms during the cold season, and a substantial share of the trial evidence comes from a fixed combination of Andrographis with Eleutherococcus senticosus rather than from Andrographis on its own. There is no EMA HMPCEuropean Medicines Agency, Committee on Herbal Medicinal Products (HMPC) monograph for Andrographis and no permitted EFSA health claim; the framing here stays with traditional use and emerging research.
History
Andrographis is known as Kalmegh in Ayurveda. Its common name “King of Bitters” reflects the herb’s intense taste. Traditional uses include fever and respiratory complaints. In traditional Chinese medicine it is called Chuan Xin Lian and is used in formulas for so-called heat and dampness patterns. It is also known as a bitter remedy in Indonesian Jamu. The English comparison name Indian Echinacea does not imply a botanical relationship with Echinacea.
European research has included a Swedish-developed combination of Andrographis and Eleutherococcus, with studies also conducted in Russia. Andrographis alone has also been studied. Results need to be interpreted according to the preparation tested.
Mechanism
The most studied bioactives in Andrographis are the andrographolides, a family of diterpene lactones present in the leaf and aerial parts. Andrographolide is the principal compound and is the marker substance used in standardized extracts. Laboratory work has examined andrographolide for effects on Toll-like receptor signalling and on cytokine pathways involved in the inflammatory response, and the herb is one of the named bitter principles studied in modern phytochemistry.
How these laboratory observations translate to a felt effect during a short course at typical extract doses is not fully understood. The clinical trials have measured symptom outcomes rather than mechanistic endpoints, and the mechanistic literature should be read as preliminary. Bitterness itself has long traditional use in herbal medicine as a digestive cue, but it is not a substitute for clinical evidence on a specific outcome.
Clinical research on Andrographis has focused mainly on respiratory symptoms. The reviews by Coon and Ernst (2004) and Hu and colleagues (2017) include both single-herb and combination preparations. Hu and colleagues found evidence of improvement in some symptoms, including cough and sore throat. Generally poor study quality and variation in preparations limit confidence in the findings.
One studied combination contains Andrographis and Eleutherococcus senticosus. Kligler and colleagues published their review of Andrographis for respiratory infection in 2006. Findings from combination products cannot be attributed to Andrographis alone. The herb has no authorized EFSA health claim. The EMA has not established an HMPC monograph for the leaf. Existing studies do not justify a general treatment recommendation.
Evidence
| Outcome | Class | Grade | Effect | Studies | Refs |
|---|---|---|---|---|---|
| Respiratory symptoms (Andrographis monotherapy)The reviews by Coon and Ernst (2004) and Hu and colleagues (2017) include both single-herb and combination preparations. There are indications of relief of some respiratory symptoms. Poor study quality and differences between preparations limit conclusions about monotherapy.Adults during the cold season | EmergingEmerging research. Early small trials suggest an effect but await replication. | CEvidence quality grade C. Mixed or limited evidence. Small trials, signals, or traditional use under an EMA HMPC traditional-use monograph. This is an evidence rating, not a product endorsement. | Modest Improvement | [1][2] | |
| Upper respiratory tract symptoms with the Andrographis and Eleutherococcus fixed combinationStudies have also examined a fixed combination of Andrographis and Eleutherococcus. The results apply to that preparation and do not establish general superiority over Andrographis alone. The linked review by Kligler and colleagues was published in 2006.Adults during the cold season | EmergingEmerging research. Early small trials suggest an effect but await replication. | CEvidence quality grade C. Mixed or limited evidence. Small trials, signals, or traditional use under an EMA HMPC traditional-use monograph. This is an evidence rating, not a product endorsement. | Modest Improvement | [3] | |
| Traditional Ayurvedic and TCM useLong-standing use in Ayurveda as Kalmegh (King of Bitters), in TCM as Chuan Xin Lian, and in Indonesian Jamu. Traditional indications cluster around bitter digestive use and respiratory and fever support during seasonal transitions. | TraditionalTraditional use. Long-standing folk practice or EMA HMPC traditional-use monograph. | CEvidence quality grade C. Mixed or limited evidence. Small trials, signals, or traditional use under an EMA HMPC traditional-use monograph. This is an evidence rating, not a product endorsement. | Traditional Use | ||
| In vitro anti-inflammatory and immunomodulatory activityAndrographolide has been studied in laboratory work for effects on Toll-like receptor signalling and cytokine pathways. Preclinical only; mechanistic literature should be read as preliminary and not as evidence of clinical effect. | EmergingEmerging research. Early small trials suggest an effect but await replication. | DEvidence quality grade D. Preliminary signal. A single small trial, pilot result, or laboratory or animal model. Clinical relevance unclear. This is an evidence rating, not a product endorsement. | Preliminary Signal |
Usage
Forms and preparation
Andrographis is available in forms including standardized extract capsules. Capsules avoid direct contact with the strongly bitter herb. Extract labels may state the andrographolide content. This percentage describes composition and is not a dosage recommendation. Take capsules with water according to the product instructions. Tinctures and dried herb are also available; they are not directly interchangeable with standardized extracts. Follow the specific preparation’s instructions on whether and how to dilute a tincture.
Dosage
The studies do not establish a single dose because extracts and their andrographolide content differ. One trial by Saxena and colleagues tested 200 milligrams of a specific extract per day. This meant 200 milligrams of extract, not 200 milligrams of andrographolides. Do not transfer such doses to other preparations; follow product-specific instructions and medical or pharmaceutical advice. In respiratory trials, treatment most often lasted five to seven days. This does not support a recommendation for four-to-eight-week courses or indefinite daily use. Follow the instructions for the specific preparation. Seek medical advice if symptoms persist or worsen.
Safety
Look-alikes
FAQs
What is the Andrographis and Eleutherococcus combination preparation?
The fixed herbal combination pairs Andrographis with Eleutherococcus senticosus, also known as eleuthero. It has been studied clinically for respiratory complaints. Results apply to the combination and cannot be attributed to Andrographis alone.
How does Andrographis taste?
Andrographis tastes intensely bitter, hence the name “King of Bitters”. Capsules avoid direct contact with the herb. For tinctures, follow the preparation’s dilution and usage instructions.
Can I take Andrographis during pregnancy?
No. The WHO monograph advises against Andrographis during pregnancy and breastfeeding. Safety is insufficiently established, and animal evidence concerning reproductive risks is mixed. Seek medical advice before use if trying to conceive.
How long can I take Andrographis?
Respiratory trials most often studied use for five to seven days. They do not establish a general recommendation for four-to-eight-week courses. There is no reliable basis for indefinite use. Follow the specific product instructions and seek medical advice for persistent symptoms.
3 sources.
- Coon JT, Ernst E. Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy. 2004.
- Hu XY, Wu RH, Logue M, Blondel C, Lai LYW, Stuart B, Flower A, Fei YT, Moore M, Lewith G, Liu JP. Andrographis paniculata (Chuan Xin Lian) for symptomatic relief of acute respiratory tract infections in adults and children: A systematic review and meta-analysis. 2017.
- Kligler B, Ulbricht C, Basch E, Kirkwood CD, Abrams TR, Miranda M, Khalsa KPS, Giles M, Boon H, Woods J. Andrographis paniculata for the treatment of upper respiratory infection: a systematic review by the natural standard research collaboration. 2006.
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