Andrographis Overview

Andrographis is a shrub found throughout India and other Asian countries that is sometimes called "Indian echinacea." It has been used historically in epidemics, including the Indian flu epidemic in 1919 during which andrographis was credited with stopping the spread of the disease. ¹

Reducing Cold Symptoms

A meta-analysis (statistically rigorous review of studies) published in 2004 found seven reasonable quality double-blind, controlled trials, enrolling a total of 896 participants, evaluating the use of a proprietary andrographis extract for the treatment of acute respiratory infections. ² The combined results indicate that this andrographis extract is more effective than placebo for reducing symptoms.

For example, a 4-day, double-blind, placebo-controlled study of 158 adults with colds found that treatment with this andrographis significantly reduced cold symptoms. ³ Participants were given either placebo or 1,200 mg daily of an andrographis extract standardized to contain 5% andrographolide. The results showed that by day 2 of treatment, and even more by day 4, individuals who were given the actual treatment experienced significant improvements in symptoms compared to participants in the placebo group. The greatest response was seen in earache, sleeplessness, nasal drainage, and sore throat, but other cold symptoms improved as well.

Three other double-blind, placebo-controlled studies, enrolling a total of about 400 people, evaluated a related proprietary herbal combination treatment containing both andrographis and [Eleutherococcus senticosus][5] . ⁴ (This proprietary combination is sold under the name, “Kan Jang." The manufacturer regards this combination as more effective than andrographis alone.) Another study found this combination more effective than echinacea for colds in children. ⁵ A different formulation of andrographis has been compared to acetaminophen (Tylenol). In a double-blind study of 152 adults with sore throat and fever, participants received andrographis (in doses of 3 g per day or 6 g per day, for 7 days) or acetaminophen. ⁶ The higher dose of andrographis (6 g) decreased symptoms of fever and throat pain to about the same extent as acetaminophen, but the lower dose of andrographis (3 g) was not as effective. There were no significant side effects in either group.

A Russian study of questionable quality apparently found andrographis extract approximately as effective as the drug amanditine for influenza infections. ⁷

Preventing Colds

According to one double-blind, placebo-controlled study, andrographis may increase resistance to colds. ⁸ A total of 107 students, all 18 years old, participated in this 3-month-long trial that used the same proprietary extract of andrographis mentioned above. Fifty-four of the participants took two 100-mg tablets standardized to 5.6% andrographolide daily—considerably less than the 1,200 to 6,000 mg per day that has been used in studies on treatment of colds. The other 53 students were given placebo tablets with a coating identical to the treatment. Then, once a week throughout the study, a clinician evaluated all the participants for cold symptoms.

By the end of the trial, only 16 people in the group using andrographis had experienced colds, compared to 33 of the placebo-group participants. This difference was statistically significant, indicating that andrographis reduces the risk of catching a cold by a factor of two as compared to placebo.

A typical dosage of andrographis is 400 mg 3 times a day. Doses as high as 1,000 to 2,000 mg 3 times daily have been used in some studies. Andrographis is usually standardized to its content of andrographolide, typically 4% to 6%. Note that virtually all published studies of andrographis have involved a single proprietary product. It is not clear that the results of these studies apply to products using different andrographis sources, or different methods of extraction.

1. Hancke J, Burgos R, Caceres D, et al. A double-blind study with a new monodrug Kan Jang: decrease of symptoms and improvement in the recovery from common colds. Phytother Res. 1995;9:559-562.
2. Caceres DD, Hancke JL, Burgos RA, et al. Use of visual analogue scale measurements (VAS) to assess the effectiveness of standardized Andrographis paniculata extract SHA-10 in reducing the symptoms of common cold. A randomized double blind-placebo study. Phytomedicine. 1999;6:217-223.
3. Caceres DD, Hancke JL, Burgos RA, et al. Use of visual analogue scale measurements (VAS) to assess the effectiveness of standardized Andrographis paniculata extract SHA-10 in reducing the symptoms of common cold. A randomized double blind-placebo study. Phytomedicine. 1999;6:217-223.
4. Melchior J, Spasov AA, Ostrovskij OV, et al. 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. Phytomedicine. 2000;7:341-350.
5. Spasov AA, Ostrovskij OV, Chernikov MV, et al. Comparative controlled study of Andrographis paniculata fixed combination, Kan Jang(R) and an echinacea preparation as adjuvant, in the treatment of uncomplicated respiratory disease in children. Phytother Res. 2004;18:47-53.
6. Thamlikitkul V, Dechatiwongse T, Theerapong S, et al. Efficacy of Andrographis paniculata (Nees) for pharyngotonsillitis in adults. J Med Assoc Thai.1991;74:437-442.
7. Kulichenko LL, Kireyeva LV, Malyshkina EN, et al. A randomized, controlled study of Kan Jang versus amantadine in the treatment of influenza in Volgograd. J Herb Pharmcother. 2003;3:77-92.
8. Caceres DD, Hancke JL, Burgos RA, et al. Prevention of common colds with Andrographis paniculata dried extract: a pilot double blind trial. Phytomedicine 1997;4:101-104.