Andrographis
Andrographis paniculata
An intensely bitter Ayurvedic and Traditional Chinese Medicine herb, often called 'King of Bitters', with reasonably good trial evidence for shortening colds and other upper respiratory infections.
At a Glance
- Best known for
- Shortens duration and severity of upper respiratory infections, Immune-modulating and anti-inflammatory activity, Studied for ulcerative colitis symptoms
- Evidence
- Moderate
- Typical dose
- 300–400 mg extract 3x daily
- Type
- Herb
What is Andrographis?
Andrographis paniculata is an annual herb in the Acanthaceae family native to India and Sri Lanka and widely cultivated across Southeast Asia. Known as kalmegh in Ayurveda and chuan xin lian in Traditional Chinese Medicine, it has been used for centuries for fevers, infections, and digestive complaints. Its extreme bitterness earned it the nickname 'King of Bitters'. The aerial parts (leaves and stems) are the medicinal portion, and modern extracts are standardized to andrographolide content. It is one of the better-studied herbal remedies for the common cold, with commercial products such as Kan Jang (a combination with Siberian ginseng) used in Scandinavia since the 1990s.
Known Health Benefits
How It Works
Andrographolide is the principal active diterpenoid. It inhibits NF-κB signaling, reducing production of pro-inflammatory cytokines such as TNF-α, IL-6, and IL-1β, and it down-regulates COX-2 and inducible nitric oxide synthase. It appears to modulate rather than simply stimulate immunity, enhancing phagocytosis and natural killer cell activity while damping excessive inflammation. In vitro, andrographolide shows direct antiviral activity against influenza and other respiratory viruses, partly by interfering with viral replication and host cell signaling. It also has antipyretic activity in animal models and inhibits platelet aggregation through effects on thromboxane synthesis.
What Research Says
Andrographis has more clinical evidence than most cold remedies, though trial quality varies. A 2004 systematic review (Coon and Ernst) of seven double-blind trials involving nearly 900 people concluded it was superior to placebo for uncomplicated upper respiratory tract infection symptoms. A larger 2017 systematic review and meta-analysis of 33 trials (over 7,000 participants) found andrographis improved cough and sore throat compared with usual care and shortened symptom duration, but noted most trials were of low or moderate quality and many were conducted in China with a single commercial product. A pilot double-blind RCT in ulcerative colitis found an andrographis extract comparable to mesalazine over 8 weeks, and a later 224-person trial showed higher response rates than placebo at 1,800 mg daily. Small trials have also explored rheumatoid arthritis and familial Mediterranean fever. Overall the respiratory evidence is moderate; other uses remain preliminary.
Active Compounds
Andrographolide and related diterpene lactones (neoandrographolide, 14-deoxy-11,12-didehydroandrographolide), flavonoids
Forms & Bioavailability
Andrographolide is absorbed orally but has low bioavailability (estimated around 2–3%) owing to poor water solubility and rapid metabolism; peak plasma levels occur about 1.5–2 hours after dosing. Standardized extracts deliver far more consistent andrographolide than crude powder. Newer formulations (phospholipid complexes, solid dispersions) aim to improve absorption. Clinical effects are documented despite the low bioavailability, suggesting active metabolites or local immune effects.
Dosage Guidance
| Use Case | Dosage |
|---|---|
| Acute cold / URTI (adults) | 300–400 mg extract 3x daily |
| Cold prevention (seasonal) | 200 mg extract daily |
| Kan Jang combination | 4 tablets 3x daily (per label) |
| Ulcerative colitis (adjunct) | 1,200–1,800 mg extract daily |
| Tincture | 2–4 mL 1:5 tincture 3x daily |
Always consult a healthcare provider for personalized dosing.
Natural Food Sources
- Not found in food in meaningful amounts; used as a medicinal herb only
- Occasionally brewed as an extremely bitter tea in South Asia
Potential Side Effects
Bitter taste, nausea, loss of appetite, headache; rare allergic reactions and urticaria; elevated liver enzymes reported rarely
Who Should Avoid It
- Pregnancy (animal studies suggest abortifacient and anti-fertility effects)
- Autoimmune disease (theoretical immune stimulation — use with caution)
- Bleeding disorders or upcoming surgery (antiplatelet effects — stop 2 weeks before)
- Known allergy to Acanthaceae plants or previous reaction to andrographis
- Gallbladder disease (bitters stimulate bile flow)
Pregnancy & Lactation
Avoid in pregnancy. Animal studies report anti-fertility and abortifacient effects, and andrographis has traditional use as a contraceptive in some regions. There are no adequate human safety data for use while breastfeeding, so it is best avoided during lactation as well.
Known Drug Interactions
May add to anticoagulant and antiplatelet drugs; may lower blood pressure and blood glucose additively; may counteract immunosuppressants; inhibits several CYP450 enzymes in vitro
Evidence Classification
Supported by cohort studies, case-control studies, or multiple observational studies with consistent findings.
Frequently Asked Questions
Does andrographis really help with colds?
The evidence is better than for most cold remedies. Multiple randomized trials and two systematic reviews suggest it reduces symptom severity and may shorten the illness by roughly a day when started early. That said, many trials are small, of modest quality, or sponsored by manufacturers, so the benefit is likely real but not dramatic. It will not prevent every cold.
How does andrographis compare with echinacea?
Andrographis has more consistent trial results for treating existing colds, while echinacea evidence is mixed and seems to lean toward modest prevention. The two work differently: andrographis is strongly anti-inflammatory via NF-κB inhibition, whereas echinacea is thought to stimulate innate immune cells. Some people use them together, but there is no strong evidence that the combination is better than either alone.
Why does it taste so bitter, and does the bitterness matter?
Andrographolide and related diterpene lactones are among the most bitter plant compounds known, which is why capsules are the preferred form. In traditional medicine the bitterness itself was considered therapeutic for digestion and fever. For modern use, the bitterness is simply something to work around; capsules and coated tablets avoid it entirely.
Is it safe to take long term?
Most trials have lasted a few days to three months. Short courses for acute infection are well tolerated; the main complaints are nausea, loss of appetite, and headache. Rare allergic reactions and isolated reports of liver enzyme elevation mean it is sensible to use it in courses rather than continuously, and to stop if you develop a rash, hives, or unexplained fatigue.
References
- Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy. Coon JT, Ernst E. Planta Med (2004)View study
- Andrographis paniculata (Chuān Xīn Lián) for symptomatic relief of acute respiratory tract infections in adults and children: A systematic review and meta-analysis. Hu XY, Wu RH, Logue M, et al.. PLoS One (2017)View study
- Andrographis paniculata extract (HMPL-004) for active ulcerative colitis. Sandborn WJ, Targan SR, Byers VS, et al.. Am J Gastroenterol (2013)
- Andrographis paniculata. Examine.comView study
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