AndrographisBotanical

• Respiratory infection symptomsLikely helps

  This is the best-studied use by a wide margin. A 2017 systematic review and meta-analysis of 33 randomized trials found andrographis improved acute respiratory tract infection symptoms, including shorter cough and sore-throat duration [2].
  
  A 2004 systematic review reached a compatible conclusion, calling it possibly safe and efficacious for symptom relief in uncomplicated infection [3].
  
  A 2021 pharmacology review catalogued 12 controlled trials, 2,008 participants — nine double-blind, eight placebo-controlled — generally favouring andrographis over placebo on symptoms [1]. ^[2]

• How solid is that respiratory evidence?Possibly helps

  ⚠ Not uniformly. Healthline cites a more recent 2023 study whose symptom improvement was not statistically significant [15].
  
  No formal Cochrane review on andrographis was located in this research — only non-Cochrane systematic reviews [2][3][15].
  
  So the meta-analytic signal is real, and it is not backed by the most conservative reviewing body in the field. ^[15]

• Catching fewer coldsPossibly helps

  A double-blind trial in 107 healthy 18-year-old students ran for 3 months [10].
  
  Colds occurred in 16 of 54 on andrographis versus 33 of 53 on placebo — roughly half the incidence [10]. That is one small trial in a narrow age group. ^[10]

• Sore throat and tonsillitis with feverPossibly helps

  At 6 g/day of dried herb, andrographis performed about as well as acetaminophen after 3 to 7 days [5][10].
  
  At 3 g/day it did not [5][10]. The dose difference is the finding. ^[5]

• Ulcerative colitisPossibly helps

  Two randomized, double-blind trials (n=120 and n=224) found A. paniculata extract performed about as well as the drug mesalazine [4].
  
  Healthline cites a 2012 RCT in which 34–38% of participants on andrographis reached remission at 8 weeks, against 25% on placebo [15]. ^[4]

• Knee osteoarthritisPossibly helps

  A double-blind RCT of 103 people used 150 or 300 mg twice daily of an extract standardized to 50% andrographolide, over 3 months [4].
  
  Pain, stiffness and WOMAC score all improved significantly against placebo [4][15]. ^[4]

• Rheumatoid arthritis — the references describe the same trial differentlyPossibly helps

  The trial is Burgos 2009: 60 participants, andrographolide 30 mg three times daily, 14 weeks [4][5].
  
  ⚠ Drugs.com describes improved swelling and tenderness plus reduced rheumatoid factor "compared with placebo" [4].
  
  RxList says the improvement held only against pretreatment baseline, and explicitly "not when compared to another group of people taking just a sugar pill" [5].
  
  That is a direct disagreement about whether the benefit beat placebo, and it is not resolved here. ^[5]

• Fatigue in relapsing multiple sclerosisPossibly helps

  A 12-month pilot RCT in 25 people with relapsing multiple sclerosis reported reduced fatigue [4].
  
  A 25-person pilot is a starting point, not a result to act on [4]. ^[4]

• TriglyceridesPossibly helps

  A small RCT of 60 people with modest hypertriglyceridemia used andrographolide at 120 mg/day [4].
  
  Triglycerides improved, but on a single small trial [4]. ^[4]

• Familial Mediterranean FeverPossibly helps

  A phase II pilot of the ImmunoGuard combination product, 24 participants, was reported as safe and efficacious [1].
  
  A 24-person phase II pilot of a multi-herb combination establishes very little on its own [1]. ^[1]

• Immune-cell countsPossibly helps

  In a 30-day open-label study, 21 of 30 healthy adults showed increased T-cell and lymphocyte counts after a standardized extract [4][15].
  
  Open-label with no placebo arm, and a change in cell counts is not the same as fewer illnesses [4]. ^[4]

• COVID-19Possibly helps

  Lab studies show antiviral activity against SARS-CoV-2 in cell culture [4].
  
  The one clinical data point found is a Thai retrospective cohort of hospitalized patients, where andrographolide at 180 mg/day for 5 days produced no difference in pneumonia rates versus conventional therapy [4].
  
  Cell-culture activity has not carried over into a demonstrated clinical benefit [4]. ^[4]

• Capsules and tabletsThe most common format and the one nearly all trials used .

  Elemental content

  Standardized extracts, commonly labeled 4–6% andrographolide, with commercial products ranging from about 10% up to 30%, 50% or even 98% [12]

  Absorption

  Poor oral bioavailability affects every conventional solid form, driven by andrographolide's poor water solubility [12]

  Best for

  The most common format and the one nearly all trials used [12].

• Liquid extracts and tincturesFlexible dosing, at a cost. Healthline notes tinctures are notably bitter, so taste-sensitive people tend to prefer cap…

  Elemental content

  Liquid extracts of the aerial parts, standardization varying by manufacturer [12]

  Absorption

  Shares the same solubility limitation; no head-to-head comparison against capsules was found [12]

  Best for

  Flexible dosing, at a cost. Healthline notes tinctures are notably bitter, so taste-sensitive people tend to prefer capsules [15].

• Dried herb teaThe traditional preparation. PeaceHealth describes sipping it before meals for indigestion .

  Elemental content

  Whole dried aerial parts, unstandardized [6]

  Absorption

  1 teaspoon (5 g) per 250 mL cup, steeped 10 to 15 minutes [6]

  Best for

  The traditional preparation. PeaceHealth describes sipping it before meals for indigestion [6].

• Nanoparticle, liposome and cyclodextrin formulationsLaboratories, not shelves. Semi-solid forms such as patches, creams and gels are essentially absent commercially despit…

  Elemental content

  Andrographolide carried in solubility-enhancing systems [12]

  Absorption

  An active research area aimed squarely at the bioavailability problem [12]

  Best for

  Laboratories, not shelves. Semi-solid forms such as patches, creams and gels are essentially absent commercially despite preclinical interest [12].

• Common effects

  Reported in trials: headache, fatigue, gastrointestinal upset (nausea, diarrhea, vomiting, appetite loss), skin rash, a bitter or metallic taste, runny nose and dizziness [4][5].
  
  One trial also reported decreased libido [15]. RxList rates appropriate short-term oral use "likely safe" [5]. ^[4]

• Anaphylaxis — a signal two regulators are tracking

  This is the serious one. Australia's TGA has received more than 300 anaphylaxis and hypersensitivity reports for andrographis-containing medicines since 2005, over 200 of them since 2019 [8][14].
  
  That total includes one reaction with a fatal outcome, reported in June 2024 [14].
  
  More than 80% of the reports involved multi-ingredient products combining andrographis with Echinacea species [8].
  
  The TGA advises anyone who reacts to such a combination product to avoid medicines containing either ingredient afterwards [8].
  
  New Zealand's Medsafe issued its own alert on the same risk back in 2017 [9]. ^[8]

• Liver enzymes

  A Phase 1 HIV trial dosing andrographolide at 10 mg/kg body weight saw elevated liver enzymes, severe enough to contribute to the trial being interrupted [4][7].
  
  A Thai cross-sectional study of 810 patients found users had a median ALT change of +2 U/L against 0 in non-users [16].
  
  The adjusted odds ratio for an ALT rise above 3 U/L was 1.62 (95% CI 1.02–2.57) [16].
  
  ⚠ Those are two different kinds of evidence — a high-dose causal design versus a low-dose observational association with small average changes [4][16].
  
  What that means at ordinary consumer doses stays uncertain, and people with existing liver disease are advised caution [15][16]. ^[16]

• Autoimmune disease

  Lupus, multiple sclerosis, rheumatoid arthritis, Crohn's disease, Graves' disease and Hashimoto's are the named conditions [5][10].
  
  The advice is avoidance, on the reasoning that immune stimulation could worsen symptoms [5]. ^[5]

• Pregnancy and breastfeeding

  Drugs.com cites documented abortifacient effects, and RxList rates andrographis "possibly unsafe" in pregnancy [4][5].
  
  Breastfeeding has not been studied adequately, so the standing advice there is avoidance as a precaution [5]. ^[4]

• Fertility

  Animal studies show reduced sperm count and motility, and impaired fertility, at high doses [4].
  
  One human trial of a Kan Jang plus ginseng combination found no adverse effect on male fertility measures [10]. Animal and human data point different ways. ^[4]

• Gallbladder disease

  Andrographis stimulates gallbladder contraction [10].
  
  EBSCO advises against using it without physician supervision if you have gallbladder disease [10]. ^[10]

• Children

  RxList rates it "possibly safe" for short-term use in children, based on studies of herb combinations used for up to one month [5].
  
  Broader pediatric safety data is limited, so cautious use under guidance is the reasonable read [5]. ^[5]

• What's on the label may not be in the bottle

  ⚠ A 2025 phytochemical analysis of 27 commercial supplements found andrographolide content per daily serving ranging from 0 mg to 309 mg [13].
  
  The American Botanical Council's Botanical Adulterants Monitor found the majority of tested products delivered only 0–20% of the andrographolide their labels claimed [17].
  
  That makes every dose figure on this page approximate in practice, and a product's stated standardization worth verifying independently [13][17]. ^[13]

• Blood-pressure medication

  Andrographis has shown hypotensive effects in some studies, which could add to a blood-pressure drug's action [5][7].
  
  EBSCO extends the same caution to people who already run low blood pressure [10]. ^[5]

• Immunosuppressants

  Cyclosporine, tacrolimus and corticosteroids are the named examples [5][7].
  
  Andrographis's immune-stimulating action could work against what those drugs are prescribed to do [7]. ^[7]

• Anticoagulants and antiplatelets

  Aspirin, warfarin, clopidogrel, NSAIDs and heparins all come up [5][7][10].
  
  Andrographis may slow blood clotting, raising the risk of bruising and bleeding in combination [5]. ^[5]

• Aminophylline

  Memorial Sloan Kettering advises against combining the two, based on preclinical pharmacokinetic evidence of increased side-effect risk [7]. ^[7]

• CYP450 and UGT2B7 substrate drugs

  Laboratory enzyme-inhibition studies suggest andrographis could affect drugs metabolized by these pathways [7].
  
  The clinical significance of those lab findings is unclear [7]. ^[7]

• How many of these interactions are real? Sources disagree

  ⚠ Drugs.com's clinical monograph states, under Interactions, "None well documented" [4].
  
  RxList, Memorial Sloan Kettering and EBSCO each list several moderate-risk interactions instead [5][7][10].
  
  The split is about evidentiary bar — confirmed human case reports versus plausible mechanism and preclinical data — rather than a factual contradiction. ^[4]

Not a food. Andrographis paniculata is an annual herb whose aerial parts are harvested specifically as a bitter medicinal ingredient — capsules, tablets, tinctures or dried-herb tea [4][12].

There is no meaningful dietary source of andrographolide outside the plant itself and products made from it [12].

No source found here gives a morning-versus-evening or fasted-versus-fed rule for andrographis — that is a genuine gap, not an oversight [6].

What every studied protocol does share is divided dosing: two to four doses a day rather than one [4][5][6].

For an active cold, timing against the illness matters more than time of day. Multiple sources advise starting as soon as symptoms appear, ideally within about 72 hours [5][6].

Trials dosed participants through the first days of illness, with improvement seen as early as day 2 and most symptoms settled by day 4 or 5 [10][15].

If it upsets your stomach, PeaceHealth advises lowering the dose or taking it with meals [6]. Its dried-herb tea is traditionally sipped before meals for indigestion — the only food-timing guidance located [6].