Andrographis paniculata

Andrographis has been studied in acute viral bronchitis as symptomatic therapy. The Saxena 2010 RCT with KalmCold extract 200 mg/day × 5 days in 223 patients with uncomplicated upper-respiratory URI with cough showed significant cough intensity and sore throat reduction by day 3-5 vs placebo. The Hu 2017 systematic review confirmed cough effect in a subgroup. EMA HMPC 2013 lists traditional use for «cough associated with cold». Acute viral bronchitis (>90% of cases) per AAFP and SEIMC is managed symptomatically (dextromethorphan, guaifenesin for dry cough, acetylcysteine); antibiotics are not indicated. Andrographis may be considered as adjunct to symptomatic therapy in adults without red flags (febrile fever >38.5 °C >3 days, purulent sputum, bronchospasm).

Andrographis is one of the adaptogens with relatively more convincing evidence in the common cold. The Hu 2017 systematic review of 33 RCTs in 7175 participants showed moderate reduction in cold symptom duration and severity (cough, sore throat, nasal congestion) with andrographis extracts 1200-6000 mg/day for 5-7 days. The Cáceres 1999 RCT in 152 cold patients showed significant symptom reduction by day 4-5 with SHA-10 vs placebo. The Saxena 2010 RCT in 223 patients with KalmCold showed symptom reduction by day 2-3. Evidence quality is limited by product heterogeneity, varied andrographolide standardisation and potential publication bias. EMA HMPC 2013 recognises «traditional use». AAFP 2019 and SEIMC 2020 for the common cold list symptomatic therapy first-line; andrographis is in the «evidence limited» category.