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Herb library · Herb · Andrographis paniculata

Kalmegh (andrographis)

A very bitter shrub of India and Southeast Asia, sold worldwide as andrographis for colds and sore throats. Many small trials suggest it may ease cough and sore throat, but their quality is poor, and it can cause serious allergic reactions.

Serious warning

Serious allergic reactions, including anaphylactic shock, have been reported with andrographis products, according to a study of Thailand's national drug-safety reports (PubMed 25539642).

Traditional use

Dutt's 1877 compilation from Sanskrit medical works records that the shrub was well known in Bengal as kálmeg, where the juice of its leaves, with cardamoms, cloves and cinnamon, was the main ingredient of a household medicine for infants called álui, given for griping and loss of appetite. Dutt doubted that it had been used in classical Sanskrit medicine at all, since its supposed Sanskrit name appeared in no prescription he knew. It is also a Chinese herbal medicine (chuān xīn lián), used in Indian and Chinese practice for cough, cold and influenza, and today it is one of the most widely used herbal medicines in the world, sold mostly as tablets and capsules.

What studies show

  • Limited

    Colds, sore throat and other acute respiratory infections: a 2017 review of 33 randomized trials (7,175 people) found it eased cough and sore throat compared with placebo and shortened symptoms, but the reviewers call the trials' quality poor overall and ask for better ones.

  • Limited

    Ulcerative colitis: in one 8-week trial in 224 adults with mild to moderate disease, an extract at 1,800 mg a day brought more people a clinical response than placebo; the lower dose did not, and remission rates did not differ significantly.

  • Insufficient

    COVID-19: a 2025 analysis of 6 randomized trials in 660 adults with mild to moderate illness found no significant difference in how quickly fever or cough resolved compared with antivirals or supportive care.

Be careful of

Cautions

  • AllergySerious allergic reactions have been reported. Thailand's national drug-safety database recorded anaphylactic shock, anaphylaxis and swelling of the face and throat (angioedema) in people taking andrographis alone, beginning from 5 minutes to 1 day after a dose. Get emergency care for trouble breathing or swelling.
  • NoteMilder side effects are common: a 2021 safety review found stomach and gut upset and skin reactions in roughly 1 in 10 people in trials. Raised liver enzymes were reported in some COVID-19 trials.
  • PregnancyNCCIH advises talking with your clinician before using Ayurvedic products while pregnant or nursing.
  • NoteSome Ayurvedic preparations include metals. The FDA warns that this makes some Ayurvedic products potentially harmful, and a 2015 survey found high lead or mercury levels in some of the supplements tested.
  • Ask a clinicianTalk with a clinician or pharmacist before using this if you take prescription medicines, are pregnant or breastfeeding, or are giving it to a child.

From the old books

What herbals and dispensaries of the past printed. History, in their words.

“This bitter shrub is well-known in Bengal under the name of kálmeg and is the principal ingredient of a domestic medicine for infants called A’lui.”
Udoy Chand Dutt, The Materia Medica of the Hindus (1877), p. 216. See the page of The Materia Medica of the Hindus, p. 216 (opens in a new tab) · Read the full passage from The Materia Medica of the Hindus, p. 216
“yavatikta has not been noted by me as having occurred in any prescription, so that I am inclined to think Andrographis paniculata was not used in Sanskrit medicine.”
Udoy Chand Dutt, The Materia Medica of the Hindus (1877), p. 216. See the page of The Materia Medica of the Hindus, p. 216 (opens in a new tab) · Read the full passage from The Materia Medica of the Hindus, p. 216

Sources

  1. Andrographis paniculata (Chuān Xīn Lián) for symptomatic relief of acute respiratory tract infections in adults and children: A systematic review and meta-analysis (2017) (opens in a new tab) · NIH · read September 25, 2026
  2. Andrographis paniculata extract (HMPL-004) for active ulcerative colitis (2013) (opens in a new tab) · NIH · read September 25, 2026
  3. Exploring the clinical effects of Andrographis paniculata-derived compounds, its extract, or derivatives for the treatment of COVID-19: a systematic review and meta-analysis (2025) (opens in a new tab) · NIH · read September 25, 2026
  4. Safety of Andrographis paniculata: A systematic review and meta-analysis (2021) (opens in a new tab) · NIH · read September 25, 2026
  5. Characterization of hypersensitivity reactions reported among Andrographis paniculata users in Thailand using Health Product Vigilance Center (HPVC) database (2014) (opens in a new tab) · NIH · read September 25, 2026
  6. Ayurvedic Medicine: In Depth (opens in a new tab) · NCCIH · read September 25, 2026

Reviewed September 25, 2026.