The ASCIA FAQ for patients and carers on Adverse Reactions to Complementary and Alternative Medicine has been updated to include information about Andrographis paniculata. This herb is commonly used in Indian and Chinese medicine and is known as the 'king of bitters'.

Since 2019, the Therapeutic Goods Administration (TGA) has received more than 200 reports of severe allergic reactions (anaphylaxis) and/or hypersensitivity reactions to medicines containing andrographis, including a report of fatal anaphylaxis in June 2024. More information is available on the TGA website.  

Andrographis may be present in multi-ingredient herbal medicine products that are often used for relief of cold and flu symptoms, and is commonly marketed to boost immunity. Around 100 medicines listed in the Australian Register of Therapeutic Goods (ARTG) contain andrographis.

More than 80% of the adverse events reported to the TGA for andrographis are for multi-ingredient medicines that contain both andrographis and Echinacea species (echinacea) together with other ingredients. Echinacea is another herbal ingredient often used in medicines for relief of cold and flu symptoms and immune support. Echinacea has also been reported to cause allergic reactions, including anaphylaxis. 

This news item was issued on 4 July 2024 by Jill Smith, CEO of ASCIA, the peak professional body for clinical immunology and allergy in Australia and New Zealand.