Andrographis: benefits, dosage, contraindications
Other name(s)
Andrographis paniculata, green chirette
Scientific name(s)
Andrographis paniculata
Family or group:
Plants
Active ingredients:
Andrographolides
Indications
Scoring methodology
EFSA approval.
ENT infections ✪✪✪✪✪
Andrographis paniculata has become popular as a treatment for upper respiratory tract infections. It is most often used in combination with other medicinal plants, particularly Siberian ginseng (Eleutherococcus), and sometimes echinacea. Clinical studies confirm that treatment with andrographis, alone or in combination with Siberian ginseng, is beneficial and provides some symptom relief within a few days; however, maximal effects appear by the fifth day. Clinical evidence indicates that andrographis treatment reduces cough, sputum production, nasal discharge, headaches, fever, sore throat, fatigue, sinus pain, and sleep disturbances. Other research shows that the combination of andrographis and Eleutherococcus (Siberian ginseng) relieves cold symptoms better than echinacea or placebo in children.
Posologie
Oral: leaf
200 mg
standardized extract in andrographolide, Kan Jang®, standardized extract, dry extract
Synergies
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
A randomized double blind placebo controlled clinical evaluation of extract of Andrographis paniculata (KalmCold) in patients with uncomplicated upper respiratory tract infection
A double blind, placebo-controlled study of Andrographis paniculata fixed combination Kan Jang in the treatment of acute upper respiratory tract infections including sinusitis
Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract infection: systematic review of randomized controlled trials
Andrographis paniculata (Chuān Xīn Lián) for symptomatic relief of acute respiratory tract infections in adults and children: A systematic review and meta-analysis
Comparative controlled study of Andrographis paniculata fixed combination, Kan Jang and an Echinacea preparation as adjuvant, in the treatment of uncomplicated respiratory disease in children
Common cold ✪✪✪✪✪
Andrographis may reduce the incidence of the common cold according to available evidence. Indeed, a randomized double-blind clinical study of 107 healthy schoolchildren found that a specific treatment combining green chiretta and eleuthero (100 mg standardized to 5.6 mg andrographolide per tablet) taken twice daily for 5 days a week over a period of 3 months reduced the risk of developing a cold by about 50% after 2 months compared with placebo.
Posologie
Oral: leaf
200 mg
Andrographolide-standardized extract, Kan Jang®, standardized extract, dry extract
Synergies
Prevention of common colds with Andrographis paniculata dried extract. A Pilot double blind trial
Controlled clinical study of standardized Andrographis paniculata extract in common cold - a pilot trial
A double‐blind study with a new monodrug Kan Jang: Decrease of symptoms and improvement in the recovery from common colds
Ulcerative colitis ✪✪✪✪✪
Some clinical research has found that andrographis treatment reduces the symptoms of mild to moderate ulcerative colitis but does not affect remission rates compared with placebo. Two different concentrations of andrographis (1200 mg or 1800 mg per day) were compared with placebo for 8 weeks. At the end of the treatment period, a clinical response was observed in 60% of patients receiving 1800 mg/day of green chiretta, compared with 45% for the 1200 mg dose and 40% for placebo. Therefore, only the 1800 mg/day dose was significantly superior to placebo.
Posologie
Oral: leaf
1200 - 1800 mg
andrographolide-standardized extract, standardized extract, dry extract
Rheumatoid arthritis ✪✪✪✪✪
Treatment with andrographis tablets (standardized to 30 mg andrographolide per tablet) three times daily for 14 weeks significantly reduced joint pain and the number of painful joints compared with placebo in a double-blind randomized clinical trial involving 60 patients with active rheumatoid arthritis. A reduction in IgA rheumatoid factor and C4 levels was also observed.
Posologie
Oral: leaf
90 mg
andrographolide-standardized extract, standardized extract, dry extract
A double-blind, randomized, placebo-controlled study to assess the efficacy of Andrographis paniculata standardized extract (ParActin®) on pain reduction in subjects with knee osteoarthritis
Pharyngitis ✪✪✪✪✪
A clinical benefit of andrographis in the treatment of pharyngitis was reported in an initial randomized clinical trial involving 152 volunteers. Symptoms of sore throat and fever were reduced at a dose of 6 g/day of a non-standardized green chiretta preparation after 3 days. nn
Posologie
Oral: leaf
3 - 6 g
standardized extract, dry extract
Osteoarthritis ✪✪✪✪✪
In patients with mild to moderate knee osteoarthritis, clinical research shows that taking andrographis extract at 300 mg and 600 mg per day for 12 weeks reduces pain and stiffness by approximately 40% and 46%, respectively, compared with changes of less than 10% with placebo.nn
Posologie
Oral: leaf
300 - 600 mg
andrographolide-standardized extract, standardized extract, dry extract
Properties
Immunomodulatory
A number of immunomodulatory actions have been identified with andrographis and its derivatives. One of the main constituents responsible for the immunostimulant activity is andrographolide, which affects the stimulation and proliferation of immunocompetent cells and the production of cytokines and key immune markers in vitro.
Usages associés
Antimicrobial
An aqueous extract of Andrographis paniculata has demonstrated antibacterial and antifungal activity in vitro. In various laboratory studies, activity has been demonstrated against Bacillus subtilis, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Candida albicans. An ethanolic extract of Andrographis paniculata showed strong inhibitory activity against Gram-positive and Gram-negative bacteria in an in vitro study. nn
Antiviral
The andrographolides from andrographis have shown antiviral activity against herpes simplex virus type 1 and dengue virus serotypes in vitro.nnAndrographis has in vitro activity against avian influenza A and human influenza A H1N1 viruses, possibly by preventing viral hemagglutinin from binding to cells.nn
Usages associés
Anti-inflammatory
The antipyretic activity of andrographis has been demonstrated in animal models. Anti-inflammatory activity has also been observed in vitro and in vivo with andrographis, which is mainly associated with andrographolide. Andrographolide has been shown to reduce the production of cytokines, chemokines, adhesion molecules, nitric oxide and lipid mediators as well as IL-1 beta, IL-6, prostaglandin E2 and thromboxane B2, and the allergic mediator leukotriene B4. nnSome in vitro data have shown that antioxidant mechanisms are likely to contribute to the plant's anti-inflammatory effect.nn
Usages associés
Anticancer
There is interest in using Andrographis as an anticancer agent. Andrographis extracts inhibit the proliferation of colon cancer cells in vitro. This activity has been attributed to the diterpene constituents andrographolide, deoxyandrographolide, and 14-deoxy-11,12-didehydroandrographolide. The constituent andrographolide also inhibits the proliferation of breast, brain, lung, skin, ovarian, prostate, and kidney cancer cells in vitro.
Cardiovascular
Research has shown that Andrographis inhibits human platelet aggregation induced by platelet-activating factor and also appears to confer additional antiplatelet activity, for which several mechanisms may be involved. A number of compounds appear to be involved in these actions, such as andrographolide and 14-deoxy-11,12-didehydroandrographolide.
Hypoglycemic
Andrographis is traditionally used for diabetes. Early data suggest that Andrographis has hypoglycemic effects, possibly by slowing intestinal glucose absorption or by stimulating insulin release.
Antiplatelet/Anticoagulant
Research has shown that Andrographis inhibits human platelet aggregation induced by platelet-activating factor and also appears to confer additional antiplatelet activity, for which several mechanisms may be involved. A number of compounds appear to be involved in these actions, such as andrographolide and 14-deoxy-11,12-didehydroandrographolide.
Safe dosage
Adults aged 15 years and over: 200 mg - 1800 mg
A dose of 100 mg twice daily of a standardized andrographis extract providing 60 mg of andrographolide per day is used for symptomatic treatment. nnEquivalent or higher doses of 5 mg/kg/day of the andrographolide constituent should be avoided due to a risk of significant adverse effects.nn
Children aged 6 to 15 years: 48 mg
Andrographis, in combination with other herbs, has been used with apparent safety in clinical trials at doses up to 48 mg per day in children aged 3 to 15 years for periods of up to one month. nn
Interactions
Médicaments
Antiplatelet agents/Anticoagulants: moderate interaction
Theoretically, andrographis may increase the risk of bleeding when used with anticoagulant or antiplatelet medications.
Immunosuppressants: moderate interaction
Theoretically, andrographis could increase the risk of hypotension when used with antihypertensive medications.
Immunosuppressants: moderate interaction
Laboratory research suggests that andrographolide has immunostimulant activity. Theoretically, andrographis could interfere with the effects of immunosuppressant medications.
Precautions
Breastfeeding women: avoid
Avoid use due to lack of information.
Autoimmune diseases: use with caution
Andrographis may have immunostimulant effects. Theoretically, andrographis could exacerbate autoimmune diseases by stimulating immune activity. Advise patients with autoimmune diseases such as multiple sclerosis, systemic lupus erythematosus, and rheumatoid arthritis to use andrographis with caution.
Bleeding disorder: use with caution
In vitro and in vivo evidence suggests that andrographis may inhibit platelet aggregation. Although this has not been observed in humans, theoretically andrographis may increase the risk of bleeding in patients with coagulation disorders. Use with caution.
Hypotension: use with caution
Animal studies suggest that andrographis may lower blood pressure. Although this has not been observed in clinical research, andrographis should be used with caution.
Contraindications
Pregnant women: contraindicated
Andrographis is thought to have abortifacient effects.
