Andrographis: benefits, dosage, contraindications
Other name(s)
Andrographis paniculata, Green chiretta
Scientific name(s)
Andrographis paniculata
Family or group:
Plants
Active ingredients:
Andrographolides
Indications
Rating methodology
EFSA approval.
ENT infections ✪✪✪✪✪
Andrographis paniculata has become popular as a treatment for upper respiratory infections. It is most often used in combination with other medicinal plants, particularly Siberian ginseng (Eleuthero) and sometimes echinacea. Clinical studies confirm that treatment with andrographis, alone or in combination with Siberian ginseng, is beneficial and provides some relief of symptoms within a few days; however, maximum effects appear by the fifth day. Clinical evidence indicates that treatment with andrographis reduces cough, expectoration, nasal discharge, headaches, fever, sore throat, fatigue, sinus pain, and sleep disturbances. Other research shows that the combination of andrographis and eleuthero relieves cold symptoms better than echinacea or placebo in children.
Posologie
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
Cold ✪✪✪✪✪
Andrographis can reduce the incidence of colds according to available evidence. Indeed, a randomized double-blind clinical study on 107 healthy schoolchildren revealed that a specific treatment combining green chiretta and eleuthero (100 mg standardized to 5.6 mg andrographolide/tablet) taken twice daily for 5 days one week for a period of 3 months reduced the risk of developing a cold by about 50% after 2 months compared to placebo.
Posologie
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 treatment with andrographis reduces the symptoms of mild to moderate ulcerative colitis, but does not affect remission rates, compared to placebo. Two different concentrations of andrographis (1200 mg, or 1800 mg per day) were compared to a placebo over 8 weeks. At the end of the treatment period, the clinical response was observed in 60% of patients receiving 1800 mg/day of green chiretta, compared to 45% for the 1200 mg dose and 40% for the placebo. Consequently, only the 1800 mg/day dose was significantly superior to placebo.
Posologie
Rheumatoid Arthritis ✪✪✪✪✪
Treatment with andrographis in tablets (standardized to 30 mg andrographolide/tablet) three times a day for 14 weeks significantly reduced joint pain and the number of tender joints compared to placebo, in a double-blind, randomized clinical trial involving 60 patients with active rheumatoid arthritis. A reduction in IgA and C4 rheumatoid factors was also observed.
Posologie
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 early 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 chirette preparation after 3 days.
Posologie
Osteoarthritis ✪✪✪✪✪
In patients with mild to moderate knee osteoarthritis, clinical research shows that taking andrographis extract 300 mg and 600 mg per day for 12 weeks reduces pain and stiffness by approximately 40% and 46%, respectively, compared to changes of less than 10% with a placebo.
Posologie
Properties
Immunomodulatory
A number of immunomodulatory actions have been identified with andrographis and its derivatives. One of the major 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 shown antibacterial and antifungal activity in vitro. In various laboratory studies, activity was demonstrated against Bacillus subtilis, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Candida albicans. An ethanolic extract of Andrographis paniculata showed powerful inhibitory activity against Gram-positive and Gram-negative bacteria according to an in vitro study.
Antiviral
Andrographolides from andrographis have shown antiviral activity against herpes simplex virus type 1 and dengue serotype virus, in vitro. Andrographis has in vitro activity against avian influenza A viruses and human influenza A H1N1 viruses, possibly by preventing the binding of viral hemagglutinin to cells.
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, primarily associated with andrographolide. It has been shown that andrographolide reduces 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. Some in vitro data have shown that antioxidant mechanisms may contribute to the plant's anti-inflammatory effect.
Usages associés
Anticancer
There is an 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 andrographolide constituent 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 seem 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 the absorption of glucose by the intestine or 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 seem to be involved in these actions, such as andrographolide and 14-deoxy-11,12-didehydroandrographolide.
Safety dosage
Adult from 15 years: 200 mg - 1800 mg
A dose of 100 mg twice a day of a standardized andrographis extract providing 60 mg of andrographolide per day is used for symptomatic treatment. Equivalent or higher doses of 5 mg/kg/day of the andrographolide component should be avoided due to the risk of significant adverse effects.
Child from 6 to 15 years: 48 mg
Andrographis, in combination with other plants, 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 a period of up to one month.
Interactions
Médicaments
Antiplatelet/Anticoagulant drugs: moderate interaction
Theoretically, andrographis may increase bleeding risk when used with anticoagulant or antiplatelet medications.
Immunosuppressant: moderate interaction
Theoretically, andrographis could increase the risk of hypotension when used with antihypertensive medications.
Immunosuppressant: moderate interaction
Laboratory research suggests andrographolide has immunostimulant activity. Theoretically, andrographis could interfere with the effects of immunosuppressant drugs.
Precautions
Breastfeeding women: avoid
Avoid use due to lack of information.
Autoimmune diseases: use with caution
Andrographis could have immunostimulant effects. Theoretically, andrographis could worsen autoimmune diseases by stimulating immune activity. Advise patients with autoimmune diseases like multiple sclerosis, systemic lupus erythematosus, rheumatoid arthritis to use andrographis cautiously.
Bleeding disorders: use with caution
In vitro and in vivo evidence suggests that andrographis may inhibit platelet aggregation. Although not seen in humans, theoretically, andrographis may increase bleeding risk in patients with bleeding disorders. Use cautiously.
Hypotension: use with caution
Animal research suggests andrographis might reduce blood pressure. Although this has not been observed in clinical research, andrographis should be used with caution.
Contraindications
Pregnant women: prohibited
Andrographis is believed to have abortifacient effects.