Andrographis
Specifically for COVID-19
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Why it works for COVID-19:
Andrographis paniculata (the “king of bitters”) contains andrographolide, which has demonstrated antiviral, anti-inflammatory and immunomodulatory actions in lab studies and some clinical trials — and several countries (notably Thailand) have recommended short courses for mild early COVID-19.
Antiviral action (in vitro / in-silico). The main active constituent, andrographolide, has shown inhibition of SARS-CoV-2 replication and of viral proteins in laboratory and computer (in-silico) studies, suggesting potential to reduce viral replication or entry. SAGE Journals JAPSONLINE
(Examples: MDPI rapid review / in-silico summaries.) MDPI JAPSONLINE
Anti-inflammatory and immunomodulatory effects. Andrographolide can reduce inflammatory markers (e.g., CRP in some trials) and modulate immune responses — a plausible mechanism for reducing symptom severity in early disease. MDPI MedRxiv
Preclinical + early clinical signals. Animal, cell culture, and early human pilot trials in Thailand and elsewhere showed reduced symptom duration or reduced progression in some datasets, which motivated randomized trials and national pilot programs. herbalgram.org ศูนย์นวัตกรรมการแพทย์แผนไทย TTMIC
How to use for COVID-19:
Common trial dose (mild COVID-19): 60 mg andrographolide three times daily (total 180 mg andrographolide/day) for 5 days. This exact regimen was used in several Thai randomized trials. MedRxiv cdn1.get-qr.com
Example trial: A randomized trial in adults with mild COVID-19 gave 60 mg t.i.d. for 5 days (APE = Andrographis paniculata extract standardized by andrographolide). MedRxiv
Asymptomatic / very early guidance (Thailand Traditional Medicine): some Thai guidance documents suggested 60 mg/day (20 mg before meals ×3) for asymptomatic infected people, and 180 mg/day for people with mild symptoms — again for short courses (≈5 days). (See Thai Traditional Medical Innovation Center / Dept. recommendations.) ศูนย์นวัตกรรมการแพทย์แผนไทย TTMIC
Product / standardization note: extracts differ widely — many products specify the mg of andrographolide (active constituent) per capsule. Most clinical work uses standardized extracts (so check the label for andrographolide content). WebMD and trial reports stress using standardized extracts. WebMD cdn1.get-qr.com
Timing: trials and programs emphasized early use (ideally within 72 hours of symptom onset / early mild disease) for potential benefit. herbalgram.org MedRxiv
Scientific Evidence for COVID-19:
Randomized / controlled trials
- Efficacy and safety of Andrographis paniculata extract in patients with mild COVID-19: a randomized controlled trial (Thailand, medRxiv / preprint, 2021). RCT of APE (60 mg t.i.d. ×5 days) vs placebo in mild COVID-19; small sample, looked at symptom scores, CRP, PCR and pneumonia outcomes. MedRxiv
- Efficacy of Andrographis paniculata extract treatment in mild to … (clinical reports / journal articles summarizing trials in Thailand; several datasets published 2021–2023). These include randomized and open-label comparisons and often use the 180 mg/day (andrographolide) regimen. ScienceDirect Europe PMC
- Andrographis paniculata or favipiravir in Mild COVID-19: A randomized, double-blind trial (Thailand, 2025) — a recent randomized trial comparing AP vs favipiravir in mild COVID-19 (published 2025). ScienceDirect Mahidol University
Systematic reviews / meta-analyses / comprehensive reviews
- Frontiers systematic review & meta-analysis (2025) — pooled clinical and biological effects of A. paniculata extracts/derivatives for mild-to-moderate COVID-19; concludes there is signal of benefit but highlights heterogeneity and need for higher-quality large RCTs. Frontiers
- MDPI comprehensive review (2022) — reviews pharmacology, pharmacodynamics, safety and potential for COVID-19 drug discovery. Concludes andrographolide is a promising lead but more clinical evidence needed. MDPI
Regulatory / public-health actions
- Thailand: officially piloted and recommended short-course use (adult dosing guidance) in early/mild COVID-19 and included AP on essential medicines lists for that purpose — these government/pilot programs motivated much of the clinical work. (Thai Clinical Trials Registry entries and TTMIC pages.) Thai Clinical Trials Registry ศูนย์นวัตกรรมการแพทย์แผนไทย TTMIC
Specific Warnings for COVID-19:
Pregnancy & breastfeeding: avoid — andrographis has been associated with uterine stimulation and traditional cautions against pregnancy; safety in breastfeeding is not well established. Do not use in pregnancy unless advised by your obstetrician. Therapeutic Goods Administration (TGA)ShunChild
Autoimmune disease / immunomodulation: because andrographis can stimulate immune responses, people with autoimmune conditions (e.g., MS, SLE, rheumatoid arthritis) or on immunosuppressants should be cautious and consult their specialist. Biology Insights Survive & Thrive with Nicole Apelian
Bleeding / surgery: possible antiplatelet/anticoagulant effects have been reported — avoid before surgery and use caution if on anticoagulants (warfarin, DOACs) or antiplatelet drugs. WebMD Therapeutic Goods Administration (TGA)
Drug interactions: may interact with anticoagulants, antihypertensives (blood-pressure-lowering), immunosuppressants, and possibly some liver-metabolized drugs. Check with a pharmacist/doctor. WebMD Biology Insights
Allergic reactions & GI/neurological side effects: rash, urticaria, headache, GI upset have been reported in trials or post-marketing surveillance. The Australian TGA safety review documented rare allergic/adverse events. Therapeutic Goods Administration (TGA)WebMD
Quality / standardization risks: herbal products vary widely in strength and purity — clinical trials used standardized extracts (specified mg andrographolide). Over-the-counter products may not match trial preparations; choose products that state andrographolide content and buy from reputable manufacturers. cdn1.get-qr.com WebMD
General Information (All Ailments)
What It Is
Andrographis paniculata is a medicinal plant native to South and Southeast Asia, commonly known as the “King of Bitters.” It has been widely used in Ayurvedic, Traditional Chinese, and Thai medicine systems for centuries.
The main active compound in Andrographis is andrographolide, a diterpenoid lactone that is responsible for most of its biological activities. It also contains other compounds such as deoxyandrographolide, neoandrographolide, and andrograpanin.
Common names include:
- Kalmegh (India)
- Chuan Xin Lian (China)
- Green chiretta (English)
It is typically available as:
- Dried herb
- Capsules or tablets
- Liquid extracts or tinctures
- Standardized andrographolide supplements
How It Works
Andrographis works through several biological mechanisms that affect the immune system, inflammation, and microbial defense:
Immunomodulatory Effects
- Stimulates both innate and adaptive immune responses.
- Increases production of white blood cells (lymphocytes and macrophages) that help fight infections.
- Enhances the release of interferon-γ and antibodies, which strengthen antiviral defense.
Anti-inflammatory Activity
- Andrographolide inhibits NF-κB, a protein complex that regulates inflammation in the body.
- This results in decreased production of pro-inflammatory cytokines such as TNF-α, IL-1β, and IL-6.
Antiviral and Antimicrobial Effects
- Shows activity against a variety of viruses, including influenza, hepatitis, and even coronaviruses in some lab studies.
- Demonstrates antibacterial and antiparasitic properties, supporting its use for infections and fever.
Antioxidant and Hepatoprotective Properties
- Protects liver cells from toxins by boosting the activity of antioxidant enzymes like glutathione peroxidase.
- Reduces oxidative stress, helping maintain liver health.
Potential Anticancer Pathways (Experimental)
- In vitro studies suggest andrographolide may induce apoptosis (cell death) in certain cancer cells, though this is not yet confirmed in human studies.
Why It’s Important
Andrographis is considered important because of its broad therapeutic potential and natural immune support:
Cold and Flu Relief
- Clinical trials have shown it can reduce the severity and duration of upper respiratory tract infections.
- Often used as a natural alternative to conventional cold medicines.
Supports Immune System Function
- Regular use may enhance resistance to infections, especially in individuals prone to seasonal illnesses.
Liver Protection
- Acts as a natural hepatoprotective agent, helping to detoxify and support liver function.
Anti-inflammatory Benefits
- May help relieve symptoms of arthritis, fever, and inflammatory bowel conditions.
Adjunct in Chronic Conditions
- Some evidence supports its use in managing diabetes, hypertension, and autoimmune inflammation, although further research is needed.
Considerations
While Andrographis is generally safe when used properly, there are several important considerations to keep in mind:
Possible Side Effects
- Gastrointestinal discomfort (nausea, diarrhea)
- Headache or fatigue
- Allergic reactions or rash (rare)
- In high doses, may cause a temporary loss of taste
Contraindications
- Pregnancy and breastfeeding: May affect fertility and has potential uterine-stimulating effects.
- Autoimmune diseases: Can stimulate immune activity, possibly worsening conditions like lupus or multiple sclerosis.
- Surgery: Should be discontinued at least two weeks prior due to possible blood pressure or immune effects.
Drug Interactions
- May interact with:
- Immunosuppressants (reduces their effect)
- Anticoagulants or antiplatelet drugs (possible increased bleeding risk)
- Antihypertensives (may enhance their effect)
Dosage and Standardization
- Standardized extracts usually contain 30% andrographolide.
- Common dosage: 200–600 mg per day, divided into 2–3 doses.
- For acute infections, higher short-term doses are often used under professional guidance.
Quality Control
- Choose products from reputable brands that ensure standardized andrographolide content and third-party testing to avoid adulteration.
Helps with these conditions
Andrographis is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.
Detailed Information by Condition
Common Cold
The main active compound, andrographolide, shows anti-inflammatory, antiviral and immunomodulatory effects in lab studies. These actions can reduce in...
Flu
Andrographis works against influenza through multiple mechanisms. Andrographolide treatment inhibits viral invasion by binding with HA and NA so that...
COVID-19
Andrographis paniculata (the “king of bitters”) contains andrographolide, which has demonstrated antiviral, anti-inflammatory and immunomodulatory act...
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