Andrographis
Also sold as: Andrographis paniculata · King of bitters · Kalmegh
A bitter herb whose standardized extracts are studied for acute respiratory symptoms. Product-specific clinical findings do not establish daily immune enhancement in healthy people.
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Research
- Energy: A small 12-month relapsing-remitting multiple sclerosis pilot reported less fatigue; this does not establish general energy enhancement in healthy adults.
REALITY CHECK // Respiratory-symptom trials and reviews suggest relief, but products and study quality vary and combination studies cannot isolate Andrographis. A small multiple-sclerosis fatigue pilot is not a general energy claim. Allergy and anaphylaxis reports, reproductive uncertainty and theoretical drug interactions matter despite short-term trial tolerability.
Levels: how we grade evidence. Grey = evidence of no benefit; amber = evidence it makes this goal worse.
Ratings are self-reported by a self-selected group of users: how it felt, not proof that it works.
Check your bottle
Compare what your label says with what was used in trials. This is a trial range, not a personal prescription.
Enter the amount from your label to see the result.
How it was studied
UPPER LIMIT // No numerical EFSA or NIH/IOM UL is established in the supplied dossier. Research doses are product- and indication-specific; absence of a formal UL does not mean unlimited safe intake. Current regulatory status was not independently checked.
Summary
Respiratory-symptom trials and reviews suggest relief, but products and study quality vary and combination studies cannot isolate Andrographis. A small multiple-sclerosis fatigue pilot is not a general energy claim. Allergy and anaphylaxis reports, reproductive uncertainty and theoretical drug interactions matter despite short-term trial tolerability.
Mechanism
Andrographolides have immunomodulatory and anti-inflammatory effects mainly characterized in preclinical models. This does not establish prevention of infection or immune enhancement in healthy humans.
Typical studied dose
The source describes about 200 mg/day of KalmCold extract for short-term respiratory studies. HMPL-004 at 1,200–1,800 mg/day was investigated for active UC under clinical supervision and is not interchangeable with that respiratory extract. Marker standardization is commonly 10–30%, with about 30% specified for the respiratory reference.
Upper limit
No numerical EFSA or NIH/IOM UL is established in the supplied dossier. Research doses are product- and indication-specific; absence of a formal UL does not mean unlimited safe intake. Current regulatory status was not independently checked.
Popular stacks with Andrographis
Not enough stack data yet. A combination with Andrographis appears here once 5 people rate the same set.
Forms and label traps
| Form on label | Active content | Studied range / day | Absorption & GI tolerance | Verdict |
|---|---|---|---|---|
| Standardized respiratory extract, about 30% andrographolides Best for: Comparing mass with the supplied respiratory reference. |
Extract weight · ~30% marker | 200–200 mg | Oral andrographolide availability is low with rapid metabolism; clinical evidence belongs to specified extracts. Generally tolerated short term; GI discomfort occurs. |
Studied standard [REFERENCE // TRIAL_CONTEXT] 200 mg is extract mass, about 60 mg marker at 30% assay. It does not equal 200 mg isolated andrographolide or establish interchangeability with HMPL-004. |
| Andrographis plus eleuthero fixed combination Best for: Recognizing combination-product evidence. |
Unstandardized: active content unknown | no comparable trial range | Effects cannot be assigned to isolated Andrographis. Generally tolerated in the cited short-term studies. |
Avoid / not comparable [AVOID // SAFETY_OR_COMPARABILITY] No exact preparation-matched mass range is supplied. Zero bounds mean no comparison; single-herb equivalence and synergy are not established. |
| Raw herb, powder or tincture without assay Best for: Identifying absent standardization. |
Unstandardized: active content unknown | no comparable trial range | Constituent levels and exposure are variable. Very bitter; larger quantities may irritate the GI tract. |
Avoid / not comparable [AVOID // SAFETY_OR_COMPARABILITY] Without an andrographolide assay and matching extract specification no confident trial comparison is possible. Zero bounds mean unavailable comparator. |
Common label traps
- TRAP_01 // A daily immune booster
Clinical evidence concerns symptoms of acute respiratory infection. Preclinical immunomodulation is not proof of long-term prevention in healthy people. - TRAP_02 // More milligrams means better results
Extract mass, marker assay and formulation differ. High-dose UC research cannot validate arbitrary high-dose respiratory use. - TRAP_03 // Natural means harmless
Hypersensitivity surveillance includes anaphylaxis; pregnancy safety and long-term healthy-user safety are inadequate.
Other outcomes studied
Outside the five leaderboard goals. Same evidence levels as above.
- ACUTE RESPIRATORY SYMPTOMS Moderate · benefit
A 33-RCT review (7,175 patients overall) found cough SMD -0.39 (95% CI -0.67 to -0.10; n=596) and sore throat -1.13 (-1.37 to -0.89; n=314) versus placebo. Product quality and standardization reporting varied; not every pooled participant contributed to each outcome.
PMID 28783743 PMID 15095142 PMID 14748896 PMID 36842634 PMID 20092985 PMID 37821383 - FIXED COMBINATIONS Limited · benefit
Older Kan Jang RCTs reported symptom reduction, but Andrographis plus eleuthero cannot establish single-herb efficacy. The SHA-10 study is a separate extract trial.
PMID 11081985 PMID 12487322 PMID 10589439 - RHEUMATOID ARTHRITIS Limited · benefit
A 60-person 14-week trial did not reach significance on primary pain intensity; secondary tender joints (-0.13/week, p=0.001) and swollen joints (-0.15/week, p=0.02) improved. This does not establish monotherapy.
PMID 19408036 - ACTIVE ULCERATIVE COLITIS Limited · benefit
In 224 adults, 1,800 mg/day HMPL-004 produced week-8 response in 60% versus 40% (p=0.018); 1,200 mg/day did not significantly improve response (45% versus 40%). Remission was nonsignificant at both doses.
PMID 23044768 PMID 21114791 PMID 38612967 - MULTIPLE-SCLEROSIS FATIGUE Limited · benefit
A small 12-month placebo-controlled RRMS pilot reported about 44% lower fatigue severity; it is hypothesis-generating and not general healthy-user energy evidence.
PMID 27215274 - COVID-19 ADJUNCT Limited · no benefit
The APFaVi trial added extract to favipiravir and did not establish a clear hard-clinical-outcome advantage; this is not evidence for a stand-alone COVID treatment.
PMID 37625206 - HEALTHY IMMUNE ENHANCEMENT No established evidence
Mechanistic and preclinical immunomodulation does not establish a clinical benefit or prevention endpoint in healthy people.
PMID 38731500
Reader questions
Can I take it every day for immune protection?
The best-supported context is short-term respiratory-symptom relief with particular extracts. Long-term prevention trials and healthy-user safety data are inadequate.
Which form best matches the trials?
A named extract with a stated andrographolide assay and matching preparation is more informative than an unstandardized herb weight. Brand reputation alone does not prove equivalence.
Is it safe with medicines or in pregnancy?
Pregnancy and breastfeeding safety is inadequate, and reproductive concerns come from animal data. Immunosuppression, anticoagulants, glucose- or pressure-lowering treatment require individual review because direct interaction evidence is limited.
Does starting at the first throat symptom guarantee a shorter cold?
No. Trials support symptom relief under specific protocols; the supplied extraction does not establish a universal optimal start time or guaranteed reduction in illness duration.
Stack interactions
- Caution Immunosuppressive medicines [CAUTION // CLINICAL_REVIEW]
Possible antagonism is mechanistic/preclinical, not a proven clinical interaction. Transplant and autoimmune treatment require specialist review.
PMID 38731500 - Caution Anticoagulants and antiplatelet drugs [CAUTION // CLINICAL_REVIEW]
Additive bleeding risk is a preclinical/theoretical concern here; no quantified human interaction is established. - Caution Diabetes or blood-pressure treatment [CAUTION // CLINICAL_REVIEW]
Possible additive lowering is based mainly on preclinical mechanisms. Clinical importance and effect magnitude are uncertain. - Caution Eleuthero and other immune-active herbs [CAUTION // CLINICAL_REVIEW]
Fixed-combination trials cannot isolate the contribution of each ingredient, and stacking echinacea or other herbs has no established additional benefit.
PMID 11081985 PMID 12487322
Red flags: interactions and who should avoid it
Interactions
Immunosuppressant antagonism and additive bleeding, glucose-lowering or blood-pressure effects are mainly theoretical or preclinical here. Eleuthero combinations have clinical studies but cannot prove synergy or isolate the herb. Other immune-active herbs add uncertainty rather than a demonstrated advantage.
Avoid or ask a doctor first if
Avoid unsupervised use in pregnancy, breastfeeding, transplantation or immunosuppression, autoimmune disease, bleeding disorders or before procedures. Human pregnancy safety is absent; reproductive concerns derive from animal studies, not proven human infertility. Hypersensitivity surveillance includes anaphylaxis: breathing difficulty or swelling needs emergency care. Liver-injury assertions in the source lack a verified specific citation and remain an unresolved precaution.
Sources (PubMed, 16)
- Andrographis paniculata (Chuān Xīn Lián) for symptomatic relief of acute respiratory tract infections in adults and children: A systematic review and meta-analysis.
PMID 28783743 · 2017 · Meta-analysisA 33-RCT review (7,175 patients overall) found cough SMD -0.39 (95% CI -0.67 to -0.10; n=596) and sore throat -1.13 (-1.37 to -0.89; n=314) versus placebo. Product quality and standardization reporting varied; not every pooled participant contributed to each outcome.
- Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy.
PMID 15095142 · 2004 · Systematic reviewA 33-RCT review (7,175 patients overall) found cough SMD -0.39 (95% CI -0.67 to -0.10; n=596) and sore throat -1.13 (-1.37 to -0.89; n=314) versus placebo. Product quality and standardization reporting varied; not every pooled participant contributed to each outcome.
- Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract infection: systematic review of randomized controlled trials.
PMID 14748896 · 2004 · Systematic reviewA 33-RCT review (7,175 patients overall) found cough SMD -0.39 (95% CI -0.67 to -0.10; n=596) and sore throat -1.13 (-1.37 to -0.89; n=314) versus placebo. Product quality and standardization reporting varied; not every pooled participant contributed to each outcome.
- Efficacy and safety of AP-Bio®(KalmCold®) in participants with uncomplicated upper respiratory tract viral infection (common cold) - A phase III, double-blind, parallel group, randomized placebo-controlled trial.
PMID 36842634 · 2023 · Randomized controlled trialA 33-RCT review (7,175 patients overall) found cough SMD -0.39 (95% CI -0.67 to -0.10; n=596) and sore throat -1.13 (-1.37 to -0.89; n=314) versus placebo. Product quality and standardization reporting varied; not every pooled participant contributed to each outcome. Form or pharmacokinetic context: 200 mg is extract mass, about 60 mg marker at 30% assay. It does not equal 200 mg isolated andrographolide or establish interchangeability with HMPL-004.
- A randomized double blind placebo controlled clinical evaluation of extract of Andrographis paniculata (KalmCold) in patients with uncomplicated upper respiratory tract infection.
PMID 20092985 · 2010 · Randomized controlled trialA 33-RCT review (7,175 patients overall) found cough SMD -0.39 (95% CI -0.67 to -0.10; n=596) and sore throat -1.13 (-1.37 to -0.89; n=314) versus placebo. Product quality and standardization reporting varied; not every pooled participant contributed to each outcome. Form or pharmacokinetic context: 200 mg is extract mass, about 60 mg marker at 30% assay. It does not equal 200 mg isolated andrographolide or establish interchangeability with HMPL-004.
- Efficacy of Andrographis paniculata spray in acute pharyngitis: A randomized controlled trial.
PMID 37821383 · 2023 · Randomized controlled trialA 33-RCT review (7,175 patients overall) found cough SMD -0.39 (95% CI -0.67 to -0.10; n=596) and sore throat -1.13 (-1.37 to -0.89; n=314) versus placebo. Product quality and standardization reporting varied; not every pooled participant contributed to each outcome.
- 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.
PMID 11081985 · 2000 · Randomized controlled trialOlder Kan Jang RCTs reported symptom reduction, but Andrographis plus eleuthero cannot establish single-herb efficacy. The SHA-10 study is a separate extract trial. Form or pharmacokinetic context: No exact preparation-matched mass range is supplied. Zero bounds mean no comparison; single-herb equivalence and synergy are not established. Fixed-combination trials cannot isolate the contribution of each ingredient, and stacking echinacea or other herbs has no established additional benefit.
- A double blind, placebo-controlled study of Andrographis paniculata fixed combination Kan Jang in the treatment of acute upper respiratory tract infections including sinusitis.
PMID 12487322 · 2002 · Randomized controlled trialOlder Kan Jang RCTs reported symptom reduction, but Andrographis plus eleuthero cannot establish single-herb efficacy. The SHA-10 study is a separate extract trial. Form or pharmacokinetic context: No exact preparation-matched mass range is supplied. Zero bounds mean no comparison; single-herb equivalence and synergy are not established. Fixed-combination trials cannot isolate the contribution of each ingredient, and stacking echinacea or other herbs has no established additional benefit.
- Use of visual analogue scale measurements (VAS) to asses the effectiveness of standardized Andrographis paniculata extract SHA-10 in reducing the symptoms of common cold. A randomized double blind-placebo study.
PMID 10589439 · 1999 · Randomized controlled trialOlder Kan Jang RCTs reported symptom reduction, but Andrographis plus eleuthero cannot establish single-herb efficacy. The SHA-10 study is a separate extract trial.
- Efficacy of an Andrographis paniculata composition for the relief of rheumatoid arthritis symptoms: a prospective randomized placebo-controlled trial.
PMID 19408036 · 2009 · Randomized controlled trialA 60-person 14-week trial did not reach significance on primary pain intensity; secondary tender joints (-0.13/week, p=0.001) and swollen joints (-0.15/week, p=0.02) improved. This does not establish monotherapy.
- Andrographis paniculata extract (HMPL-004) for active ulcerative colitis.
PMID 23044768 · 2013 · Randomized controlled trialIn 224 adults, 1,800 mg/day HMPL-004 produced week-8 response in 60% versus 40% (p=0.018); 1,200 mg/day did not significantly improve response (45% versus 40%). Remission was nonsignificant at both doses.
- Randomised clinical trial: herbal extract HMPL-004 in active ulcerative colitis - a double-blind comparison with sustained release mesalazine.
PMID 21114791 · 2011 · Randomized controlled trialIn 224 adults, 1,800 mg/day HMPL-004 produced week-8 response in 60% versus 40% (p=0.018); 1,200 mg/day did not significantly improve response (45% versus 40%). Remission was nonsignificant at both doses.
- Herbal Medicines for the Treatment of Active Ulcerative Colitis: A Systematic Review and Meta-Analysis.
PMID 38612967 · 2024 · Meta-analysisIn 224 adults, 1,800 mg/day HMPL-004 produced week-8 response in 60% versus 40% (p=0.018); 1,200 mg/day did not significantly improve response (45% versus 40%). Remission was nonsignificant at both doses.
- Andrographis paniculata decreases fatigue in patients with relapsing-remitting multiple sclerosis: a 12-month double-blind placebo-controlled pilot study.
PMID 27215274 · 2016 · Randomized controlled trialA small 12-month placebo-controlled RRMS pilot reported about 44% lower fatigue severity; it is hypothesis-generating and not general healthy-user energy evidence.
- Efficacy of Andrographis paniculata extract treatment in mild to moderate COVID-19 patients being treated with favipiravir: A double-blind, randomized, placebo-controlled study (APFaVi trial).
PMID 37625206 · 2023 · Randomized controlled trialThe APFaVi trial added extract to favipiravir and did not establish a clear hard-clinical-outcome advantage; this is not evidence for a stand-alone COVID treatment.
- Systematic Review of Chemical Compounds with Immunomodulatory Action Isolated from African Medicinal Plants.
PMID 38731500 · 2024 · Systematic reviewMechanistic and preclinical immunomodulation does not establish a clinical benefit or prevention endpoint in healthy people. Possible antagonism is mechanistic/preclinical, not a proven clinical interaction. Transplant and autoimmune treatment require specialist review.
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