Andrographis paniculata Kalmegh Green Chiretta

• The extract of whole plant is useful in jaundice, liver troubles, bronchitis and diabetes.
• Many household medicines known as "AIvi" is prepared from the leaves and is given to children suffering from stomach complaints.
• A decoction of plant is considered a blood purifier and its extract or infusion is reportedly used to relieve fever.
• The dried leaves and tender shoots constitute the well known drug 'Kalmegh' or 'green chiretta' used as bitter tonic and febrifuge.

Source: Medicinal Plants in the Indian Arid Zone, March 2005, Director Central Arid Zone Research Institute Jodhpur 342 003

Andrographis paniculata (Burm. f.) Wall. ex Nee Chirayta Acanthaceae Respiratory disorder

Andrographis paniculata (Burm.f.) Nees Nelavemu Acanthaceae Leaf Edema, viral fever, typhoid

Andrographis paniculata (Burm. f.) Nees King of Bitter, Bhuineem Acanthaceae Herb Leaf Andrographolide, Kalmeghin

Andrographis paniculata (Burm. f.) Nees Herb Whole plant To treat malaria and malaria-like symptoms; dyspepsia; dysentery; diabetes; itches; piles and jaundice; snake bite and scorpion sting; wound; skin disease; fever; Liver disease; hangover symptoms; warts; asthma; cancer; cholera General; children Padal et al. 2014, Raju 2008, Ram et al. 2004, Rao et al. 2006, Suneetha 2011

Andrographolides are the active chemical constituents found in the plant Andrographis paniculata, commonly known as "Kalmegh" or the "King of Bitters." They have gained attention due to their diverse pharmacological activities and potential therapeutic uses in various conditions. Below is a detailed overview of the medical properties, medicinal activity, contraindications, drug-drug interactions, posology, and related information.

Medical Properties of Andrographolides

Andrographolides possess several key properties, including:

• Anti-inflammatory: They inhibit inflammatory pathways, including the NF-κB and COX pathways, helping in conditions such as arthritis and inflammatory bowel disease.
• Antioxidant: Andrographolides reduce oxidative stress by neutralizing free radicals, supporting overall cellular health.
• Antipyretic (Fever-reducing): Widely used in traditional medicine for fever management, especially in viral and bacterial infections.
• Immunomodulatory: They enhance immune function by stimulating the production of immune cells and reducing excessive immune reactions.
• Antiviral: Effective against certain viral infections, such as the common cold, flu, dengue, and possibly COVID-19 due to its ability to inhibit viral replication.
• Hepatoprotective: Andrographolides protect the liver from damage, making them useful in conditions like viral hepatitis and toxin-induced liver damage.
• Anticancer: Some studies suggest potential antitumor activity due to their ability to inhibit cancer cell proliferation and induce apoptosis (programmed cell death).
• Antidiabetic: These compounds show hypoglycemic effects, helping to regulate blood sugar levels in diabetic conditions.
• Antimicrobial: Andrographolides have antibacterial properties, effective against pathogens like Staphylococcus aureus, E. coli, and other common bacteria.

Medicinal Activity of Andrographolides

1. Respiratory Infections: Andrographolides have traditionally been used to treat respiratory tract infections, including common cold, bronchitis, and sinusitis, due to their anti-inflammatory, antiviral, and immune-boosting properties.
2. Gastrointestinal Disorders: These compounds are effective in managing conditions like dysentery, diarrhea, and indigestion, partly due to their antimicrobial and digestive-stimulating properties.
3. Hepatoprotective Uses: Andrographolides are often prescribed in cases of jaundice, fatty liver disease, and as adjuncts in liver conditions such as viral hepatitis.
4. Fever and Infections: They have been commonly used as part of traditional remedies for fever, especially in malaria, typhoid, and viral fevers like dengue.
5. Anti-Cancer Potential: In vitro and animal studies suggest that andrographolides may suppress tumor growth and enhance the effects of chemotherapy.

Contraindications

• Pregnancy and Lactation: Andrographolides may not be safe during pregnancy and breastfeeding due to their potential to stimulate uterine contractions and lack of sufficient safety data.
• Autoimmune Diseases: Due to their immunostimulatory properties, andrographolides may exacerbate conditions such as lupus, multiple sclerosis, and rheumatoid arthritis.
• Allergic Reactions: Individuals allergic to plants in the Acanthaceae family or to Andrographis paniculata itself should avoid its use.

Possible Drug-Drug Interactions

1. Immunosuppressants: Andrographolides can potentially reduce the efficacy of immunosuppressive drugs (e.g., cyclosporine, tacrolimus), which are used in autoimmune diseases and organ transplants, as they stimulate the immune system.
2. Anticoagulants (Blood Thinners): Caution is advised when using andrographolides alongside anticoagulant drugs (e.g., warfarin, aspirin, clopidogrel), as they may increase the risk of bleeding due to their antiplatelet and blood-thinning effects.
3. Antihypertensive Drugs: There may be additive effects when andrographolides are combined with blood pressure-lowering medications, possibly leading to hypotension.
4. Hypoglycemic Drugs: Andrographolides may enhance the effects of antidiabetic drugs, increasing the risk of hypoglycemia.

Posology (Dosage)

• Standardized Extract (usually containing 10-30% andrographolides):
  • Acute Respiratory Infections/Cold: 300-600 mg per day, divided into 2-3 doses.
  • Fever and Mild Infections: 400-800 mg daily, for 5-7 days, or as advised by a healthcare professional.
  • Chronic Conditions (e.g., Liver Support): 200-400 mg daily for 2-4 weeks, under medical supervision.
  • Adjunct to Cancer Treatment: 100 mg to 200 mg daily, but always consult with a specialist before use in cancer therapy.

Dosage can vary depending on the standardized content of andrographolides in the product being used.

Side Effects

• Common side effects of andrographolides may include gastrointestinal discomfort, headache, and fatigue.
• High doses may cause nausea, diarrhea, and a bitter aftertaste.

Other Relevant Information

• Forms Available: Andrographolides are available in various forms, including capsules, tablets, tinctures, and as part of polyherbal formulations.
• Traditional Use: In Ayurvedic and Traditional Chinese Medicine, Andrographis paniculata has been used for centuries for detoxification and immune support.

Conclusion

Andrographolides are valuable due to their wide range of therapeutic properties, including anti-inflammatory, antiviral, and hepatoprotective activities. However, it is important to use them with caution in specific populations (such as pregnant women and those on immunosuppressive therapies) and to be aware of possible drug interactions, especially with blood thinners and immunosuppressive drugs. Always consult a healthcare provider for personalized dosage recommendations and safety.