A meta-analysis found 7 double-blind, controlled efficacy trials, enrolling a total of 896 participants, evaluating the use of a proprietary oral andrographis extract (AP) for the treatment upper respiratory tract infection (URTI). The combined results indicate that AP is more effective than placebo for reducing symptoms. The studies included in this review used standardized AP alone or in combination with Eleutherococcus senticosus, except for one study. Herbal supplements were compared to either placebo or paracetamol (also known as acetaminophen or Tylenol). The daily dose of AP ranged from 48 to 360 mg/day in the efficacy review and from 11 mg/day to 10 mg/kg per day for 14 studies (n=1,235) included in the safety review. Significant differences in outcomes suggested that A. paniculata is superior to placebo in alleviating subjective symptoms of URTI. One study in HIV-positive patients and healthy volunteers, which used a high dose of AP (5 mg/kg and 10 mg/kg increasing every 3 weeks) was terminated early because of a large number of adverse events such as allergic reaction, fatigue, headache, pruritis/rash, diarrhoea, nausea, metallic taste, bitter taste, decreased/no taste, dry tongue, decreased sex drive, eyes sensitive to light, decreased short term memory, dizziness, heartburn, tender lymph nodes, lymphadenopathy. Side effects reported in other studies include unpleasant sensations in the chest, headache, urticarial, nausea, vomiting, abdominal discomfort, dizziness, drowsiness and malaise, increased nasal discharge and epigastric pain, blocked nose. However, AP was well tolerated among most participants. (5)
