Andrographis and medications.
Andrographis is in the Distil supplement database, evidence Grade B. The page below lists every medication we have explicitly assessed it against.
Andrographis is a herb standardised to andrographolides, taken at 200 to 400mg a day during illness or 100 to 200mg as prevention, and used mainly to shorten and soften upper respiratory infections through immune and anti-inflammatory effects. The Grade B evidence is fairly consistent for cold and respiratory symptoms, with reviews and trials showing it beats placebo for symptom relief, so it is one of the better-supported herbs in this space, though it is not a substitute for treating a serious infection. Several interaction points deserve real attention. Because it stimulates the immune system, it works against immunosuppressant medication and should be avoided with it. There is animal evidence of an anti-fertility effect, so it is best avoided when trying to conceive and during pregnancy. It also has a mild, reversible antiplatelet effect that becomes a consideration for people on anticoagulants or stacking several blood-thinning compounds. Very high doses have rarely raised liver enzymes. A solid short-term cold remedy, used in the right situation.
Below are the 7 documented pairs we have explicitly assessed for Andrographis: 7 amber. The pairs cluster around 3 mechanisms: Additive anticoagulation, Additive antiplatelet effect, and Immunosuppression caution. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not listed here is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by medication, and the missing-item form at the bottom of the page routes any uncatalogued medication into our next curation pass.
Documented interactions
Additive anticoagulation
Andrographis may raise the effect of acenocoumarol, both by a mild blood-thinning action of its own and by slowing how the body clears the drug. The direct evidence is from animal studies with a similar anticoagulant rather than from people taking acenocoumarol. If you take acenocoumarol, tell your anticoagulation clinic before starting andrographis and ask for an INR check a couple of weeks in.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Andrographis may slow how the body clears apixaban and could also have a mild blood-thinning action of its own, so in theory it might raise apixaban levels and bleeding risk. This has not been studied in people, so it is a cautious flag. If you take apixaban, tell your doctor or pharmacist before starting andrographis and watch for unusual bruising or bleeding.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Andrographis may raise warfarin's effect, both by mild blood-thinning of its own and by slowing how the body clears warfarin. The direct warfarin evidence so far is from animal studies rather than people. If you take warfarin, tell your anticoagulation clinic before starting andrographis and ask for an INR check a couple of weeks in.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Additive antiplatelet effect
Andrographis has a mild blood-thinning signal in laboratory studies, so in theory it could add to aspirin's effect on platelets and slightly raise bleeding risk. A small one-day study in healthy people found no clear change, so any real effect looks modest. If you take aspirin, it is worth telling your doctor or pharmacist before starting andrographis, and watch for easy bruising or unusual bleeding.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Andrographis has a mild blood-thinning signal in laboratory studies, so in theory it could add to clopidogrel's effect on platelets and slightly raise bleeding risk. A small one-day study in healthy people found no clear change, so any real effect looks modest. If you take clopidogrel, tell your doctor or pharmacist before starting andrographis, and watch for easy bruising or unusual bleeding.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Immunosuppression caution
Andrographis is taken to stimulate the immune system, which in theory works against a medicine like ciclosporin that is meant to calm it. There is also a separate concern that andrographis may slow how the body clears ciclosporin and push its blood levels up. The human evidence for both effects is thin, so for a narrow-window transplant medicine the safe route is to check with your transplant team before starting.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Andrographis is taken to stimulate the immune system, which in theory works against a medicine like tacrolimus that is meant to calm it. There is also a separate concern that andrographis may slow how the body clears tacrolimus and push its blood levels up. The human evidence for both effects is thin, so for a narrow-window transplant medicine the safe route is to check with your transplant team before starting.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope. Use the checker below to surface any medication, and submit a missing item if you take something we have not catalogued.
How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
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- the same graded, cited interaction check across your whole stack, not just the pairs you thought to type in
- where your current routine may be leaving you short of your goals
- the evidence-backed compounds worth adding, and the ones worth dropping
It's a paid report: £79, or £49 for the first 25 customers. The interactions check is one section of it, and you can read a real one in full before you buy.
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