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Kalmegh

Andrographis paniculata

Also calledKing of bitters, chiretta · Chuan xin lian (Chinese) · Fa tha lai jone (Thai) · Sambiloto (Indonesian) · Senshinren (Japanese) · Xuyên tâm liên (Vietnamese)

In older monographsJusticia paniculata Burm.f., Justicia latebrosa Russ., Justicia stricta Lam. ex Steud., Herba Andrographidis (drug name)

An intensely bitter herb of tropical Asia and India, the 'king of bitters', used in Ayurveda for the liver, in Chinese medicine to clear heat and fever, and in Thailand for sore throat and colds. Many trials, mostly of poor quality, suggest it eases cold and sore-throat symptoms; the EU declined to issue a monograph for lack of adequate data.

What it is used for

  • Common cold
    Moderate

    A 2017 meta-analysis of 33 trials (7175 patients) found andrographis, alone or in mixtures, improved overall symptoms of acute respiratory infections and shortened their duration compared with placebo or usual care; trial quality was generally poor. In one WHO-cited trial in 61 adults with colds, 1200 mg extract daily reduced sore throat, tiredness and aches by day 4. For prevention, a 3-month trial in 107 schoolchildren found 200 mg extract daily reduced colds only in the third month (30% vs 62%).3,1

  • Sore throat
    Moderate

    In the same meta-analysis andrographis improved sore throat compared with placebo (SMD -1.13, 314 patients). WHO cites a 152-patient trial in which 6 g daily of the powdered herb relieved pharyngotonsillitis about as well as paracetamol. Its use for sore throat has a long history in Thailand.3,1,2

  • Cough
    Limited

    Cough improved modestly compared with placebo (SMD -0.39, 596 patients) in the 2017 meta-analysis.3

  • Diarrhoea
    Limited

    WHO lists acute diarrhoea and bacillary dysentery among uses supported by clinical data or pharmacopoeias, based on older trials.1

  • Liver health
    Traditional

    A main ingredient of at least 26 Ayurvedic formulations for liver disorders; WHO lists hepatitis among pharmacopoeial uses. No good clinical trials.2,1

  • Fever
    Traditional

    Used in Chinese medicine and in Thailand to bring down fever; WHO records a decoction of 3 g twice daily for fever.2,1

How it is prepared

powder

Powdered dried aerial parts in capsules or tablets.

WHO monograph: for the common cold, 1.5–3 g powdered herb three times daily after meals and at bedtime.

Common cold · Sore throat

decoction

Dried herb simmered in water.

WHO monograph: for fever, a decoction of 3 g twice daily; for diarrhoea, a decoction of 3–9 g as needed.

Fever · Diarrhoea

dry extract / capsule

Standardised extracts (in trials, often 4% andrographolides).

In WHO-cited cold trials: 1020–1200 mg extract daily for about 5 days.

Common cold

Amounts are as recorded by the named source, not a recommendation.

Safety

Pregnancy
Avoid
Breastfeeding
Avoid
Children
EMA: safety not evaluated in children and adolescents; WHO cites a prevention trial in schoolchildren.

Interactions with medicines

  • isoniazidMinorPossible synergistic effect (WHO).
Interaction checker →

Do not use if

  • Pregnancy and breastfeeding (WHO)
  • Allergy to plants of the Acanthaceae family
  • Injection of crude extracts (anaphylaxis)

Side effects

  • Gastric discomfort, vomiting and loss of appetite with large doses (attributed to the bitterness)
  • Skin reactions including urticaria; non-serious side effects in about 1 in 10 trial patients, serious ones very rare
  • An anaphylactic reaction stopped a high-dose andrographolide trial in HIV patients

In the healing traditions

  • Ayurveda

    Kalmegh (bhunimba, mahatikta)

    A bitter for liver disorders and fevers, in at least 26 Ayurvedic formulations; ancient Ayurvedic literature also mentions it for tumours. The Indian Materia Medica gives the dried leaves with black pepper, a compound infusion with orange peel and coriander, and pills of the leaf juice with cumin, anise, cloves and cardamom.

    Dey & Mair, Indigenous Drugs of India (1896); Indian Materia Medica (1976); Indian Pharmacopoeia

  • Traditional Chinese Medicine

    Chuan xin lian

    A decoction with a 'cold' property, used as a blood purifier to clear body heat, bring down fever and dispel toxins, and for colds, sore throat, bronchitis, urinary infections, diarrhoea and dermatitis.

    Pharmacopoeia of the People's Republic of China (2005)

  • Southeast Asian (Jamu, Thai, Philippine…)

    Fa tha lai jone (Thai); sambiloto (Indonesian)

    In Thailand a long-established remedy for sore throat, fever and diarrhoea and as a tonic; WHO lists Indonesian and Malay names (sambiloto, akar cerita bidara).

Active compounds

andrographolide
bitter diterpene lactone; the main active and marker compound
neoandrographolide and 14-deoxyandrographolides
related diterpene lactones

History

Kalmegh appears in Dey and Mair's 'Indigenous Drugs of India' (1896), and its fresh and dried leaves and juice became official drugs of the Indian Pharmacopoeia. It is equally established in Chinese medicine as chuan xin lian and in Thai medicine as fa tha lai jone, and standardised extracts have since been tested in controlled trials for colds and sore throat.

Sources

  1. 1.WHO monographs on selected medicinal plants, vol. 2 (2002): Herba Andrographidis
  2. 2.EMA/HMPC: Assessment report on Andrographis paniculata Nees, folium (2013)
  3. 3.Hu XY et al. Andrographis paniculata (Chuān Xīn Lián) for symptomatic relief of acute respiratory tract infections: systematic review and meta-analysis. PLoS One 2017
  4. 4.Worakunphanich W et al. Safety of Andrographis paniculata: a systematic review and meta-analysis. Pharmacoepidemiol Drug Saf 2021
  5. 5.EMA/HMPC: Public statement on Andrographis paniculata Nees, folium (2013)

Reference, not prescription. Nothing here is medical advice. Herbs can interact with medicines and be dangerous in pregnancy; tell your doctor or pharmacist about anything you take.