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And8.5
Andrographis Research
Probably helpsModerate safety
29 peer-reviewed studies
What the evidence says
Probably helps
Andrographis helped in about half (4/7) of the studies that measured an effect — promising, but not unanimous.
Most evidence is from high-quality meta-analyses and randomised trials published 2005–2026 with a typical study size of 103 participants.
Based on 29 studies · 3 meta-analyses · 14 RCTs · 7,487 total participants
Confidence
High
What the studies found
4helped2unclear1didn't help· 22 more without graded effect data
By outcome
Immune supportReduced cold/flu severity and duration · 2-5 days when taken at onset
Probably helps23 studies
Therapeutic & clinical
Probably helps11 studies
Safety profile
Mostly mechanism / observational3 studies
Joint pain & arthritis
Too few graded studies2 studies
Energy & fatigue
Too few graded studies2 studies
Glucose & metabolic
Too few graded studies1 study
Heart & blood pressure
Too few graded studies1 study
By the numbers
Pulled from 22 studies with measurable effects
Likely real effects
67%
across studies
People studied
7,487
typical study: 103 people
Strongest designs
17
3 pooled, 14 randomised
Showed benefit
57%
4/7 studies
How long studies ran
Under a week
1
1–4 weeks
1
1–3 months
2
3+ months
1
Populations Studied
Patients taking Andrographis paniculata1
Adults and children with acute respiratory tract infections1
IBD patients (mean age 41, 50% female)1
Active ulcerative colitis patients1
Active research area
11 studies in the last 5 years · Latest meta-analysis: 2024
200520152026
1Incidence of adverse eventsMeta-AnalysisCited 22×n=1,000 · large study2021
Like other medicine, Andrographis paniculata can cause some AEs.
Worakunphanich W et al. · Pharmacoepidemiology and drug safety (2021)
No clear effect
← WorseNo effectBetter →
Incidence of serious AEs was very rare with the pooled incidence (95% CI) from RCTs of 0.02 per 1000 patients (0.0-0.5).
However, the incidence of nonserious AEs was considered very common with the pooled incidence (95% CI) from RCTs of 102.6 per 1000 patients (10.7-256.1), and the pooled incidence (95% CI) from intensive monitoring of 34.2 per 1000 patients (0.0-229.6).
Like other medicine, Andrographis paniculata can cause some AEs.
3IBD treatment with herbal therapySystematic ReviewCited 88×n=1,484 · large study2013
Randomised controlled trials of herbal therapy for the treatment of IBD show encouraging results but studies remain limited and heterogenous.
Ng SC et al. · Alimentary pharmacology & therapeutics (2013)
Twenty-one randomised controlled trials (14 UC; 7 CD) including a total of 1484 subjects (mean age 41, 50% female) were analysed.
Randomised controlled trials of herbal therapy for the treatment of IBD show encouraging results but studies remain limited and heterogenous.
Larger controlled studies with stricter endpoints and better-defined patient groups are required to obtain more conclusive results on the use of CAM therapies in IBD.
4Clinical response rates for ulcerative colitisMeta-AnalysisCited 16×2024
Research with larger scale and well-designed RCTs, manufacturing regulations, and education are needed.
Iyengar P et al. · Nutrients (2024)
Huge harm
← WorseNo effectBetter →
In pooled analyses, when compared with placebo, clinical response rates were significantly higher for Indigo naturalis (IN) (RR 3.70, 95% CI 1.97-6.95), but not for Curcuma longa (CL) (RR 1.60, 95% CI 0.99-2.58) or Andrographis paniculata (AP) (RR 0.95, 95% CI 0.71-1.26).
There was a significantly higher rate of clinical remission for CL (RR 2.58, 95% CI 1.18-5.63), but not for AP (RR 1.31, 95% CI 0.86-2.01).
Higher rates of endoscopic response (RR 1.56, 95% CI 1.08-2.26) and remission (RR 19.37, 95% CI 2.71-138.42) were significant for CL.
These studies indicate that andrographolide can hinder the cell cycle, suppress cell proliferation, alleviate oxidative stress, and induce apoptosis by prompting gastric cancer cells to undergo self-destruction, which is a crucial mechanism for controlling and eliminating cancerous growths.
Anis Amiera MA et al. · PeerJ (2024)
These studies indicate that andrographolide can hinder the cell cycle, suppress cell proliferation, alleviate oxidative stress, and induce apoptosis by prompting gastric cancer cells to undergo self-destruction, which is a crucial mechanism for controlling and eliminating cancerous growths.
6Therapeutic efficacy of andrographolide in cancerSystematic ReviewCited 123×n=139 · medium study2018
Among the model systems, cultured cell lines appeared as the most frequently (79.14%) used, followed by in vivo models using rodents, among others.
Islam MT et al. · Cancer letters (2018)
Among the model systems, cultured cell lines appeared as the most frequently (79.14%) used, followed by in vivo models using rodents, among others.
After careful consideration of the relevant evidence, we suggest that andrographolide can be one of the potential agents in the treatment of cancer in the near future.
7Antimicrobial activity of andrographolideSystematic ReviewCited 11×n=16 · very small study2024
This review highlights the need for further research on andrographolide's antifungal activity, mechanisms of action, clinical safety, toxicity, and potential applications in antimicrobial resistance strategies.
Dafur GS et al. · Journal of microbiology and biotechnology (2024)
The quality assessment revealed low bias risk in 11 out of 16 studies (78.57% to 92.86%), while the remaining five had medium bias risk (57.14% to 64.29%), indicating an overall acceptable quality of the studies.
Information on andrographolide's potential and effectiveness across various microorganisms is crucial.
Therefore, the purpose of this review was to synthesize the existing data on andrographolide's antimicrobial activity and assess its potential in combating antimicrobial resistance.
8Clinical and biological outcomes in multiple sclerosisSystematic ReviewCited 12×n=31 · small study2020
The existing literature provides preliminary support for the use of a number of nutraceutical interventions in MS.
Marx W et al. · Multiple sclerosis and related disorders (2020)
The existing literature provides preliminary support for the use of a number of nutraceutical interventions in MS.
However, sufficiently powered long-term trials are required to expand the currently limited literature and to investigate unexplored nutraceuticals that may target relevant pathways involved in MS such as the gut microbiome and mitochondrial dysfunction.
10Disease activity in inflammatory bowel diseaseSystematic ReviewCited 38×2016
In summary, attention to dietary factors such as curcumin, green tea and vitamins, including vitamins D and B12, appears to be beneficial and, if necessary, supplementation may be appropriate.
Rossi RE et al. · European journal of gastroenterology & hepatology (2016)
Zinc and iron should be supplemented in selected cases.
Probiotics (VSL#3) may reduce disease activity in IBD patients with pouchitis.
Complementary and alternative medicines are used by IBD patients and some studies have shown promising results.
Complementary and alternative therapies might be effective for the treatment of inflammatory bowel diseases; however, given the low number of trials and the heterogeneous methodological quality of trials, further in-depth research is necessary.
Langhorst J et al. · Journal of Crohn's & colitis (2015)
Complementary and alternative therapies might be effective for the treatment of inflammatory bowel diseases; however, given the low number of trials and the heterogeneous methodological quality of trials, further in-depth research is necessary.
13Resolution of upper respiratory tract infection symptomsRCTCited 3×n=331 · medium study2023
Participants in both the AP-Bio® dose groups showed positive tendency towards resolution of URTI symptoms when compared with placebo on Day-3 but not on Day-5 and Day-7.
Raj JP et al. · Complementary therapies in medicine (2023)
Noticeable benefit
← WorseNo effectBetter →
Likely real
AP-Bio® 400 mg group (Mean Difference - MD [Standard Error - SE] = -3.85 [1.52]; 95% CI = -6.85, - 0.85; adjusted p = 0.034) and 200 mg group (MD [SE] = -3.74 [1.51]; 95% CI = -6.73, - 0.76; adjusted p = 0.038) had significantly lower score than placebo.
Participants in both the AP-Bio® dose groups showed positive tendency towards resolution of URTI symptoms when compared with placebo on Day-3 but not on Day-5 and Day-7.
Overall, it can be concluded that ParActin® in 300 and 600 mg/day dosages were found to be effective and safe in reducing pain in individuals suffering from mild to moderate knee osteoarthritis.
Hancke JL et al. · Phytotherapy research : PTR (2019)
Patients treated with 300 or 600 mg/day of ParActin® showed a significant reduction in pain at days 28, 56, and 84 compared with a placebo group.
WOMAC stiffness scores, physical function score, and the fatigue score showed a significant improvement in both ParActin®-treated groups compared with the placebo group.
At the end of the study, the quality of life (SF-36 questionnaire) and Functional Assessment of Chronic Illness Therapy (FACIT) scores showed significant improvements in both ParActin®-treated groups compared with the placebo group.
The combination of Guanxin Danshen Dropping Pill and Andrographis tablet exert significant anti-inflammatory effect on UA patients, which is superior to single Guanxin Danshen Dropping Pill. (Registration No.
Ma XJ et al. · Chinese journal of integrative medicine (2021)
The combination of Guanxin Danshen Dropping Pill and Andrographis tablet exert significant anti-inflammatory effect on UA patients, which is superior to single Guanxin Danshen Dropping Pill. (Registration No.
16Palliative management of metastatic esophageal squamous cell carcinomaRCTCited 2×n=30 · small study2023
Phytotherapy Research
Chiu PW et al. · Phytotherapy research : PTR (2023)
The treatment effect of AP also contributed to the shift of the overall structure of gut microbiota for ESCC patients towards those of healthy individuals.
The significance of this study is the establishment of AP as a safe and effective palliative treatment for patients with squamous cell carcinoma of the esophagus.
To the best of our knowledge, this is the first clinical trial of AP water extract in esophageal cancer patients demonstrating its new medicinal use.
17Clinical response in active ulcerative colitisRCTCited 104×n=224 · medium study2013
Patients with mildly to moderately active ulcerative colitis treated with A. paniculata extract (HMPL-004) at a dose of 1,800 mg daily were more likely to achieve clinical response than those receiving placebo.
Sandborn WJ et al. · The American journal of gastroenterology (2013)
Huge benefit
← WorseNo effectBetter →
Likely real
In total, 45 and 60% of patients receiving A. paniculata 1,200 mg and 1,800 mg daily, respectively, were in clinical response at week 8, compared with 40% of those who received placebo (P=0.5924 for 1,200 mg vs. placebo and P=0.0183 for 1,800 mg vs. placebo).
In all, 34 and 38% of patients receiving A. paniculata 1,200 mg and 1,800 mg daily, respectively, were in clinical remission at week 8, compared with 25% of those who received placebo (P=0.2582 for 1,200 mg vs. placebo and P=0.1011 for 1,800 mg vs. placebo).
Adverse events developed in 60 and 53% of patients in the A. paniculata 1,200 mg and 1,800 mg daily groups, respectively, and 60% in the placebo group.
18Non-deterioration of WHO Clinical Progression Scale scoresRCTCited 7×n=19 · very small study2023
APE treatment did not demonstrate additional clinical and virological benefits in patients with mild to moderate COVID-19 being treated with favipiravir.
Siripongboonsitti T et al. · Phytomedicine : international journal of phytotherapy and phytopharmacology (2023)
No clear effect
← WorseNo effectBetter →
Could be chance
Non-deterioration of WHOCPS scores on day 4 was 98.63% versus 97.26% of patients in the APE-FPV and placebo-FPV groups (p = 1.000).
The oxygen supplemental was 4.11% in the placebo-FPV group.
APE treatment did not demonstrate additional clinical and virological benefits in patients with mild to moderate COVID-19 being treated with favipiravir.
19Pharmacokinetics of Andrographis paniculata extractRCTCited 17×2023
This rct examined the effects of Andrographis.
Songvut P et al. · Scientific reports (2023)
The disposition kinetics demonstrated that major diterpenoids could enter into systemic circulation, but they are mostly biotransformed (phase II) into conjugated glucuronide and sulfate metabolites.
These metabolites are predominantly found in plasma and then extremely eliminated, in part through urinary excretion.
The successful application of this analytical method supports its suitable uses in further clinical benefits after oral administration of A. paniculata.
20Fatigue reduction (FSS score)RCTCited 38×n=22 · very small study2016
A. paniculata was well tolerated in patients and no changes in clinical parameters were observed.
Bertoglio JC et al. · BMC neurology (2016)
Huge benefit
← WorseNo effectBetter →
Patients treated with A. paniculata showed a significant reduction in their FSS score as compared to the placebo, equivalent to a 44 % reduction at 12 months.
No statistically significant differences were observed for relapse rate, EDSS or inflammatory parameters, with a trend in reducing new lesions among the A. paniculata group.
A. paniculata was well tolerated in patients and no changes in clinical parameters were observed.