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Andrographis Aerial Extract

Also known as: Andrographis, Green chiretta, Kalmegh, Andrographis paniculata

Overview

Andrographis aerial extract is derived from the leaves and stems of the Andrographis paniculata plant, a medicinal herb indigenous to South and Southeast Asia. It is primarily utilized as a herbal supplement for its traditional use in managing upper respiratory tract infections (URTIs), its anti-inflammatory properties, and its role in immune support. The plant's therapeutic effects are largely attributed to its bioactive diterpenoids, particularly andrographolide, which is considered the main active compound. Research on Andrographis is moderately advanced, with numerous randomized controlled trials (RCTs) and systematic reviews, especially concerning its efficacy in respiratory infections. The evidence quality is generally high, with several well-designed studies supporting its benefits and safety, although variations in preparations and dosages exist across studies. It is also being investigated for its potential antiviral effects and as an adjunctive therapy for conditions like COVID-19.

Benefits

Andrographis aerial extract offers several evidence-based benefits, primarily for acute nonspecific upper respiratory tract infections (NS-URTI). A meta-analysis of 33 RCTs involving 7,175 patients demonstrated that Andrographis extract, standardized to approximately 60 mg/day of andrographolide, significantly reduced the symptoms and shortened the duration of NS-URTI. This benefit is observed in adults, with some trials also including pediatric populations, though data for children are less robust. The effect sizes are moderate but statistically significant, consistently showing improvements in symptom scores. Benefits typically manifest within 4 to 7 days of treatment initiation. Beyond URTIs, Andrographis exhibits anti-inflammatory and antiviral properties, as shown in in vitro studies and some clinical contexts. Emerging research, including recent meta-analyses, suggests potential adjunctive benefits in COVID-19 treatment, though this evidence is still preliminary and requires further validation through more extensive, high-quality trials.

How it works

Andrographis exerts its therapeutic effects primarily through its active compound, andrographolide. This compound inhibits pro-inflammatory cytokines and mediators, such as TNF-α and IL-6, by modulating the immune response, notably through the inhibition of the NF-κB pathway. This action helps to reduce inflammation and alleviate symptoms associated with infections. Andrographolide also demonstrates antiviral activity by interfering with viral replication processes. Upon oral administration, Andrographis is moderately absorbed, with its bioavailability influenced by the specific formulation. Standardized extracts with known andrographolide content are preferred to ensure precise dosing and consistent therapeutic effects. The supplement primarily interacts with the immune system to enhance host defense mechanisms and reduce inflammatory responses.

Side effects

Andrographis aerial extract is generally considered safe and well-tolerated in clinical trials when used as oral monotherapy. The most common side effects, occurring in over 5% of users, are mild gastrointestinal symptoms, including nausea, diarrhea, and abdominal discomfort. Uncommon side effects, affecting 1-5% of individuals, include skin reactions such as rash, pruritus (itching), and urticaria (hives). Rare side effects, reported in less than 1% of cases, include allergic reactions and, very rarely, autoimmune phenomena. Due to limited data, caution is advised when co-administering Andrographis with immunosuppressants or anticoagulants, as theoretical interactions may exist. Contraindications include a known allergy to Andrographis or related compounds. Its safety during pregnancy and breastfeeding has not been well established, so use in these populations is not recommended. Individuals with autoimmune conditions should use Andrographis with caution and under medical supervision due to its potential for immune modulation.

Dosage

For acute upper respiratory tract infection (URTI symptom relief, the minimum effective dose of Andrographis is approximately 60 mg of andrographolide per day, typically administered as 20 mg three times daily. Optimal dosage ranges from 60–180 mg of andrographolide daily, divided into multiple doses, depending on the specific preparation and the indication. While studies have reported acceptable safety with doses up to 1800 mg/day of the crude extract, higher doses are not as well studied. Andrographis is typically administered for a short duration, usually 4–7 days, during the acute phase of an infection. For accurate dosing, it is recommended to use capsules or tablets standardized to their andrographolide content. The absorption of Andrographis can be enhanced by formulations that improve solubility, though the effects of food on absorption are not well-defined. No specific cofactors are required for its efficacy.

FAQs

Is Andrographis safe for long-term use?

Safety data for Andrographis primarily comes from short-term use. Its long-term safety has not been well established, so it is generally recommended for acute conditions.

Can it be used with other medications?

Limited interaction data exists. Caution is advised when combining Andrographis with immunomodulatory drugs or anticoagulants due to theoretical interaction risks.

When will I see results?

Symptom improvement is often observed within 3–5 days of starting Andrographis treatment, particularly for acute respiratory infections.

Does it cure infections?

Andrographis helps alleviate symptoms and may shorten the duration of illness, but it is not considered a cure for infections.

Research Sources

https://onlinelibrary.wiley.com/doi/abs/10.1002/pds.5190 – This systematic review and meta-analysis by Worakunphanich et al. (2021) assessed the safety of Andrographis. It concluded that Andrographis is generally safe, with mild adverse events primarily affecting the gastrointestinal system and skin. Rare autoimmune events were noted, highlighting the need for further research despite the overall good safety profile.
http://www.jmatonline.com/PDF/1204-1213-PB-13037.pdf – Leelarasamee et al. (2021) conducted an RCT involving 829 adults with non-specific upper respiratory infections. The study found that Andrographis extract (20 mg andrographolide three times daily) significantly reduced symptom severity compared to placebo and was well-tolerated. This well-designed study supports its efficacy for acute URIs.
https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0181780 – Hu et al. (2017) performed a systematic review of 33 RCTs, concluding that Andrographis is effective and safe for acute respiratory tract infection symptom relief and shortens symptom duration. The review highlighted variations in formulations and outcome measures across studies but provided strong evidence for its overall benefit.
https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.773282/full – Shang et al. (2022) conducted a comprehensive systematic review of adverse drug reactions from 262 clinical studies on Andrographis. They found that adverse reactions were mainly mild, affecting the GI tract and skin, with no dose-dependent increase in adverse events or serious safety signals. This review reinforces the generally favorable safety profile of Andrographis.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12351123/ – Prabhakornritta et al. (2025) conducted a systematic review and meta-analysis on emerging COVID-19 studies. Their findings suggest a potential adjunctive benefit of Andrographis in COVID-19. However, the authors emphasize that this evidence is preliminary, based on small sample sizes, and requires further high-quality randomized controlled trials for definitive conclusions.