- Indian Echinacea
- Chuan Xin Lin
For Patients & Caregivers
Andrographis has been primarily studied for the treatment of colds, flu, and upper respiratory infections. It has also demonstrated possible anticancer effects in laboratory studies, but this has not been confirmed in humans.
Andrographis paniculata is used in traditional medicine to treat infectious diseases and fevers. Andrographis possesses antibacterial, antioxidant, anti-inflammatory, anticancer, and immunostimulating properties. Either alone, or in combination with other herbs, andrographis has been shown to reduce the duration and severity of upper respiratory infections such as those associated with the common cold or flu. Andrographis extract may benefit patients with ulcerative colitis. It also reduced symptoms of rheumatoid arthritis. However, patients should use caution before using this herb as it may interact with many drugs.
- Colds and Flu
Either alone or in combination with other herbs, andrographis may reduce the duration and severity of cold and flu symptoms in humans.
In a trial of patients infected with HIV, andrographolides, the active ingredients in andrographis were shown to increase the number of lymphocytes, suggestive of an improvement in immune function.
Studies done in animals have shown antioxidant activities. It is unclear if this herb has beneficial effects in human as cancer treatment.
- Rheumatoid Arthritis
A small clinical trial showed Andrographis extract relieved rheumatoid arthritis symptoms. However, further study is needed to confirm this effect.
- Ulcerative Colitis
A clinical trial showed that Andrographis extract achieved a clinical response or full remission of ulcerative colitis. However, further study is needed to confirm these effects.
- You are taking chemotherapy drugs (Andrographis has antioxidant effects and can interfere with actions of chemo drugs).
- You are taking drugs that are substrates of Cytochrome P450 (Andrographis may make some of these drugs less effective and may increase the risk of side effects of others).
- You are taking blood pressure reducing drugs (Andrographis may have additive hypotensive effects).
- You are taking anticoagulants and antiplatelet drugs (Andrographis may interfere with these drugs).
- You are taking drugs that are substrates of UDP-glucoronosyltransferase (UGT) 2B7: Andrographolide derivatives inhibit UGT2B7, and can increase the side effects of drugs metabolized by this enzyme.
For Healthcare Professionals
Andrographis paniculata is a bitter tasting annual plant prevalent in much of Asia. It is often used in combination with other herbs in traditional medicine to treat infectious diseases and associated fevers. It is also used in folk medicine to treat snakebites. Andrographis is promoted in supplemental form for cancer prevention, cancer treatment, and to counter the toxicity of chemotherapy in humans. Formulations containing standardized extracts of andrographis are also marketed for colds and flu.
In vitro and animal studies indicate that andrographis has antimicrobial (23), anti-inflammatory (26), antioxidant (27),anticancer (13)(18) and antimetastatic (15) properties.
Kan Jang, a standardized extract of Andrographis paniculata and Eleutherococcus senticosus, has been studied in manufacturer-sponsored clinical trials for relief of respiratory symptoms from cold and flu (1)(2)(3)(4).
An andrographis extract was found useful in treating the symptoms of upper respiratory infection (5); another study found it as effective as mesalamine in treating ulcerative colitis (6).
Andrographis extracts also reduced rheumatoid factors and relieved rheumatoid arthritis symptoms (7).
The active constituents of andrographis are diterpenoid lactones known as andrographolides (10)(11). They exhibit anti-inflammatory activity by inhibiting nitric oxide production and cyclooxygenase-2 expression (26). In mouse hepatocytes, andrographis induced mRNA expression of P450 subfamily members, CYP1A1 and CYP1A2, in a concentration-dependent manner (31). In other studies, andrographis extract demonstrated a calcium channel inhibition effect that can cause smooth muscle relaxation and a decrease in blood pressure and heart rate (32), as well as relaxation of uterus (33). It also showed antiplatelet effects by inhibiting thrombin (34) and platelet activating factor (35). When given orally to mice, andrographis extract was shown to neutralize snake venom (9). In addition, andrographolides inhibit HIV-induced dysregulation of cell cycle and increased CD4+ lymphocyte levels in HIV-1 patients (10).
Andrographolides also demonstrate anticancer effects. They inhibited IL-6 expression and IL-6-mediated signals in human prostate cancer cells, and suppressed tumor growth of DU145 human prostate tumors in mice (12); inhibited migration and invasion of human colorectal cancer Lovo cells through suppression of mRNA and matrix metalloproteinase (MMP)-7 protein levels (13); and MMP-2 activity in human HT29 colon cancer cells (14). An in vitro study found that andrographolide reduced the invasiveness of human A549 non small cell lung cancer (NSCLC) cells by suppressing the PI3K/Akt/AP-1 signaling pathway and inhibiting MMP-7 expression (15). Andrographolides were shown to cause apoptosis of human hepatoma cancer cells through the induction of c-Jun N-terminal kinase (16) and through the activation of caspases in vitro (17). They inhibited E-selection expression resulting in the decreased adhesion of gastric cancer cells to endothelial tissues (18); and also inhibited tumor cell growth by stimulating cytotoxic T-lymphocyte production through IL-2 and IFN-gamma secretion (19)(25). An in vitro study found that andrographolide enhanced doxorubicin-induced cell death in several human cancer cell lines, mainly through JAK-STAT suppression (20).
- Common adverse effects include headache, fatigue, hypersensitivity, lymphadenopathy, pain in the lymph nodes, nausea, diarrhea and altered taste (10)(11)(44).
- Acute kidney injury has been reported following intravenous infusion of andrographolide. Symptoms included flank pain, decreased urine output, and nausea or vomiting (41).
- Cytochrome P450 substrates: Andrographis extract inhibits 1A2, 2C9, 3A4 (37); some compounds of Andrographis were shown to induce CYP1A1 (39). These two properties can affect the intracellular concentration of drugs metabolized by these enzymes.
- Anticoagulants and antiplatelet drugs: Data from animal studies indicate possible inhibition of platelet aggregation (34)(35). But an animal study showed that andrographis extract does not interact with warfarin when used concomitantly (38). Patients taking anticoagulant or antiplatelet medications should use andrographis products with caution.
- Chemotherapy drugs: Andrographolide has antioxidant effects (21). This can interfere with the actions of some chemotherapy drugs.
- Blood pressure lowering drugs: Andrographis may have additive hypotensive effect (32).
- UDP-glucoronosyltransferase (UGT) 2B7: Andrographolide derivatives inhibit UGT2B7, and can increase the side effects of drugs metabolized by this enzyme (42).
- Aminophylline: Andrographis inhibits CYP1A2, which is involved in metabolizing aminophylline, resulting in increased risk of side effects from the drug (43).