Andrographis paniculata · herb
Evidence tier: moderate
Shortens the duration and reduces the severity of upper respiratory infections and colds through direct antiviral and immune stimulating action
Andrographolide is understood to inhibit NF-kB signalling, dampening pro inflammatory cytokines while stimulating innate immune activity. That single mechanism is the leading laboratory explanation for BOTH its cold symptom effect and its immunostimulant contraindication in autoimmune disease, which is why the selling point and the safety warning are the same fact.
Genuinely reasonable, and better evidenced than most things sold for colds, but ONLY for symptomatic relief of acute upper respiratory infections. The largest synthesis is a 2017 systematic review and meta analysis (PMID 28783743, Hu 2017, PLoS One) covering 33 randomised trials in 7,175 patients. It found andrographis improved cough (standardised mean difference -0.39, 95 percent CI -0.67 to -0.10) and sore throat (SMD -1.13, 95 percent CI -1.37 to -0.89) versus placebo, improved overall cold symptoms versus placebo, usual care and other herbals, and shortened the duration of cough, sore throat and sick leave versus usual care. The same review states that the methodological quality of the included trials was overall poor and that the findings should be interpreted cautiously owing to poor study quality and heterogeneity, which is why the honest ceiling is MODERATE and not strong. An earlier review of 4 studies (PMID 14748896, Poolsup 2004) reached the same direction. For the other uses (general immune support, sinusitis, allergies, fever, Lyme) no comparable trial evidence was located: treat those as unproven. Safety is NOT gentle and is the reason this ingredient earns hard guardrails. It is an immune stimulant, so it clashes with autoimmune disease and with immunosuppressants (ciclosporin, tacrolimus, post transplant). Severe allergic reactions are real, regulator flagged and occasionally fatal: Australia's TGA has received more than 300 reports of anaphylaxis or hypersensitivity to andrographis containing medicines since 2005, more than 200 of them since 2019, including a report of FATAL ANAPHYLAXIS in June 2024, and now mandates a label warning; New Zealand's Medsafe issued a matching alert; a Thai pharmacovigilance study (PMID 25539642) characterised 13 serious hypersensitivity cases including anaphylactic shock, with onset from 5 minutes to 1 day at doses of 352 to 1,750 mg. Avoid in pregnancy (traditional abortifacient use, animal antifertility data).
In the trials, standardised extracts are dosed at roughly 400 to 600 mg twice daily (standardised to andrographolide content, often about 10 percent), taken as a short course of about 5 to 7 days at the onset of symptoms. It is an acute, short use herb, not a daily long term immune tonic.
Take at the first sign of symptoms. Use for no more than 7 to 10 consecutive days. Typical dose: 400mg standardised extract (containing 10mg andrographolide) three times daily during acute illness.
Generally well tolerated at standard doses for short term use. Avoid in pregnancy due to potential uterotonic and abortifacient activity. May affect fertility at high doses.
Pregnancy: avoid
Breastfeeding: avoid
Active compounds: andrographolide, diterpenoid lactones, neoandrographolide
Remedies using Andrographis · Browse by body system · Check it against what you take
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.