Andrographis
In short
Summary of findings for quick reference
Andrographis, the King of Bitters, is an Asian medicinal herb, not a European one. It is documented in Ayurveda as Kalmegh, in Siddha as Nilavembu, in traditional Chinese medicine as Chuan Xin Lian, in Thai practice as Fah Talai Jone, and in Indonesian Jamu as sambiloto. These traditions converge on the same picture: a strongly bitter aerial herb taken for fever and cold-season complaints. The honest scope is also clear. There is no Greco-Roman or Old World European antiquity here, and the firmly text-anchored written record begins with the sixteenth-century Bhavaprakasha Nighantu, which is why this entry sits in the established rather than the highest tier.
The clinical picture is cautious and needs one careful distinction. Reviews of Andrographis taken on its own, by Coon and Ernst in 2004 and by Hu and colleagues in 2017, describe a small body of trials with mostly modest reductions in upper respiratory symptom duration, variable trial quality, and standardised preparations that differ between studies. Much of the most positive published evidence, summarised by Kligler and colleagues in 2003, is for a fixed combination of Andrographis with Eleutherococcus senticosus, which is the combination preparation and not Andrographis alone. The same care applies to the multi-herb Siddha and Chinese formulas; their effects are not attributable to Andrographis by itself.
On safety, treat Andrographis as a short course rather than a daily habit, and be clear about who should avoid it. There is no EMA HMPCEuropean Medicines Agency, Committee on Herbal Medicinal Products (HMPC) monograph; the European regulator assessed the leaf in 2014 and declined to establish one, and there is no permitted EFSA health claim. Pregnancy is a clear contraindication, since the traditional Ayurvedic literature lists it and animal studies document uterine activity, and the same caution applies if you are trying to conceive. Use it for four to eight weeks at a time and then take a break. If you take blood thinners or are treated for high blood pressure, or if you are pregnant or breastfeeding, talk with your doctor or midwife first.
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 herb native to India and Sri Lanka and widely cultivated across South and Southeast Asia. In Ayurveda it is known as Kalmegh, the King of Bitters, and the leaf and aerial parts are among the most extreme bitter remedies in the materia medica. The same plant is part of traditional Chinese medicine and of Indonesian Jamu. Modern preparations are almost always standardized extracts in capsule form rather than the raw tea, simply because the bitterness is hard to drink.
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
In Ayurveda Andrographis has the name Kalmegh, which translates roughly as dark cloud, and the epithet King of Bitters. Classical Indian sources describe its use during the rainy season and at the onset of fever and respiratory complaints. In traditional Chinese medicine the herb is known as Chuan Xin Lian and used in formulas addressing what the tradition calls heat and damp conditions in the respiratory and digestive systems. In Indonesian Jamu it remains a familiar bitter ingredient in household preparations. The colloquial English name Indian Echinacea is a marketing import, not a botanical or traditional designation.
In modern Europe the herb came into wider use through a different route. From the late twentieth century onward, Scandinavian and Russian phytotherapy adopted a fixed combination of Andrographis with Eleutherococcus, originally developed and trialled in Sweden. Most of the European clinical research on Andrographis to date sits inside that combination-preparation line of trials. The plant is not part of Austrian Hausmittel tradition; it remains an Asian medicinal herb that has been formally tested in a Northern European clinical setting.
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.
Modern clinical work on Andrographis has focused on the duration and severity of upper respiratory tract symptoms during the cold season. Coon and Ernst published a 2004 systematic review of Andrographis for upper respiratory tract infections, and Hu and colleagues published a more recent systematic review in 2017 covering the same indication. Both reviews described a body of work that is small in scale, with mostly modest improvements in symptom duration compared with placebo, and noted that trial quality varies and the standardised preparations differ between studies.
A separate strand of evidence comes from the fixed combination of Andrographis with Eleutherococcus. Kligler and colleagues summarised this line of work in a 2003 review and the combination trials are consistently the most positive in the literature on Andrographis. This matters for interpretation: most of the strongest published signals are for the combination preparation, not for Andrographis monotherapy. The herb has no permitted EFSA health claim and there is no EMA HMPCEuropean Medicines Agency, Committee on Herbal Medicinal Products (HMPC) monograph, so the responsible framing is traditional use plus an emerging evidence base, not a clinical treatment.
Evidence
| Outcome | Class | Grade | Effect | Studies | Refs |
|---|---|---|---|---|---|
| Upper respiratory tract symptom duration (Andrographis monotherapy)Coon and Ernst 2004 systematic review and Hu et al. 2017 systematic review and meta-analysis describe a small body of trials of Andrographis monotherapy for upper respiratory tract infections, with mostly modest reductions in symptom duration compared with placebo. Trial quality varies and the standardised preparations differ between studies.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 combinationKligler et al. 2003 review summarised trials of a fixed Andrographis and Eleutherococcus combination preparation. The combination shows the most consistent positive signals in the published literature on Andrographis, distinct from the monotherapy evidence.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 almost always taken as a standardized extract in capsule form rather than as a tea. The reason is practical: the leaf is intensely bitter, intensely enough that the colloquial name King of Bitters is a description rather than a flourish, and most people cannot drink a useful dose of the infusion. Standardised extracts are typically expressed as a percentage of andrographolides; a common specification is around 30 percent andrographolides on the label. Take the capsule with food and a glass of water. Taking it on an empty stomach is possible but can leave a long bitter aftertaste in the throat that some people find unpleasant. Tincture and unstandardised loose herb are also available; if you use a tincture, dilute it well in water before drinking. Andrographis is best used as a short course, not a long term daily supplement.
Dosage
Across the published trials, daily doses providing roughly 200 to 400 milligrams of andrographolides per day in divided doses are the typical research range. This is what gets compared to placebo in the upper respiratory trials. Doses on the lower end are common in maintenance use; the higher end shows up in short symptomatic courses. Read the label carefully: dosing is expressed in milligrams of andrographolides, not milligrams of crude extract. Use Andrographis as a short course of four to eight weeks at a time and then take a break. There is no published evidence supporting open ended daily use. Take the capsules with food and a glass of water; this mitigates the bitter aftertaste in the throat and the occasional reports of stomach upset on an empty stomach.
Safety
Look-alikes
FAQs
What is the Andrographis and Eleutherococcus combination preparation?
It is a fixed combination herbal preparation that pairs Andrographis with Eleutherococcus senticosus (Siberian ginseng). It was originally developed and trialled in Sweden and is the form of Andrographis with the most published clinical research. When you read positive trials on Andrographis for cold season symptoms, the majority studied this combination rather than Andrographis monotherapy.
How does Andrographis taste?
Extremely bitter. The Ayurvedic name Kalmegh translates loosely as dark cloud and the epithet King of Bitters is descriptive rather than poetic. Even a single chewed leaf is intensely bitter. This is why most modern preparations are capsules of standardized extract rather than a tea. If you take the tincture, dilute it well in water and have something to drink afterwards.
Can I take Andrographis during pregnancy?
No. The traditional Ayurvedic literature lists Andrographis as contraindicated in pregnancy, and animal studies have documented uterine activity. This is a clear avoid. The same caution applies if you are trying to conceive. Talk with your doctor or midwife before using any new herbal preparation during pregnancy or breastfeeding.
How long can I take Andrographis?
Andrographis is best used as a short course of four to eight weeks at a time, not as an open ended daily supplement. The clinical trials are short and there is no published evidence supporting continuous long term use. Stop after the course, take a break, and reassess before starting another one.
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 tract infection: a systematic review by the Natural Standard Research Collaboration. 2003.
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