Andrographis
Natural Standard evidence-based flashcard. Copyright © 2008 (www.naturalstandard.com). Commercial distribution prohibited. This flashcard is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions. 		Image
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Summary:
The leaves of Andrographis paniculata, an annual herb, were commonly used in Indian folk medicine and Ayurveda for centuries. The herb is also used in Chinese and Thai herbal medicine, where it is known for its "bitter" properties as a treatment for digestive problems. Today, this herb is popularly used in Scandinavia to treat upper respiratory infection (URI) and the flu.

Uses
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Grade*
Upper respiratory tract infection: treatment (URI) A
Familial Mediterranean fever C
Flu (influenza) C
Upper respiratory tract infection: prevention C
*Key to grades: A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

Safety:
Three cases of anaphylactic reactions, including one case of shock, have been reported to the World Health Organization Collaborating Center for International Drug Monitoring as of June 2003. Avoid with infertility or patients actively trying to conceive. Use cautiously with diabetes, bleeding disorders, and high or low blood pressure. Use cautiously with blood sugar-altering medications, warfarin or other blood thinning medications, and blood pressure-altering medications. Avoid if pregnant or breastfeeding.

Possible side effects:
"Blocked nose," chest pain, decreased sperm (infertility), diarrhea, dizziness, drowsiness, enlarged lymph glands, fatigue, headache, increased risk of bleeding, lowered blood pressure, lowered blood sugar, nasal discharge, nausea, stomachache, vomiting.

Possible interactions:
Allergy medications, anticoagulants and anti-platelets (blood thinners), antidiabetic agents (blood sugar-altering medications, insulin), antihypertensives (blood pressure medications), anti-inflammatory agents, antineoplastic (anticancer) agents, antiviral agents, fertility agents, immunomodulators, and herbs and supplements with similar effects.

Dosing:

Adult (18 years and older):
In India, the andrographis herb is known as Kalmegh, green chiretta, or Maha-tita ("King of bitters") and is the main ingredient of a common home remedy known as alui, which is used for fever and as a "bitter" for digestive problems. Andrographis is also used in many Ayurvedic formulas, including SG-I Switradilepa, which is used to treat vitiligo. Although not well substantiated in clinical trials, typical amounts of leaf preparation are 500-3,000 milligrams taken three times daily. For digestive problems, a typical dose of tea is one teaspoon of herb per one cup of water, steeped for 5-10 minutes, taken with meals.

Children (younger than 18 years):
There is limited research in children. In one study, children between ages 4-11, a dose of two tablets three times daily (approximately 30 milligrams daily of andrographolide and deoxyandrographolide) was well-tolerated for 10 days.
Ayurvedic formulas: In India, leaves and juice are mixed with cardamom, clove and cinnamon, and are used for colic and other stomach problems in infants.
Natural Standard Monograph (www.naturalstandard.com)
Copyright © 2008 Natural Standard Inc. Commercial distribution or reproduction prohibited.
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.