Why the TGA Took Andrographis Out of Listed Medicines
Andrographis paniculata, the king of bitters, its andrographolide diterpenoids, and the anaphylaxis signal that led the TGA to remove it from the ingredients allowed in Australian listed medicines on 17/09/2026.
The episode reads the Institute's 2026 monograph and literature review. Andrographis is a knee-high annual of the Acanthaceae from southern India and Sri Lanka, naturalised as a weed in parts of Queensland, with square stems, narrow hairless leaves and small white flowers marked with violet. The trade name green chiretta is shared with Swertia chirayita, a gentian with a different chemistry, so only the full binomial on the raw material identifies it. Edward John Waring's 1868 Pharmacopoeia of India listed it as a bitter tonic and doubted its credit, since his patients also got stronger remedies.
The second half follows the TGA safety review to 31/12/2025: 287 Australian anaphylaxis reports, 130 hospital admissions, 105 people given adrenaline and one death in June 2024. Of those reactions, 74% began within 30 minutes, over half the people had no allergy history, and 71% came on first use or after earlier uneventful use. Combination products with echinacea made up about 98% of supply. Single-ingredient andrographis was 0.14% of supply and 0.74% of cases, echinacea without andrographis drew 10 reports over the same period, and Thai VigiBase data showed the same signal for andrographis taken alone. Label warnings from 2020 did not bring reports down. The closing sections cover what the removal means for listed medicines and for practitioner-compounded supply, warfarin and immunosuppressants, pregnancy, who should stop or avoid it, and the signs of anaphylaxis with the first aid: call triple zero, lie the person flat, and give adrenaline if in doubt.
In this episode: (00:00) The medicine cabinet; (02:41) The Institute's sources; (04:58) From king of bitters to regulatory action; (05:27) A knee-high weed with square stems; (08:20) Many names, and the chiretta trap; (10:36) Traditional use across South Asia and China; (12:26) Waring's footnote, 1868; (14:39) What tradition can and cannot tell us; (16:09) Andrographis in Australian cold products; (17:41) Three different doses; (22:22) Does it shorten a cold?; (23:40) Tier B, and why; (25:51) COVID-19 trials in Thailand; (27:51) Ulcerative colitis, stopped for futility; (29:39) A modest benefit, summed up; (30:53) The TGA adverse event data; (31:55) What anaphylaxis does to the body; (33:05) 287 reports to December 2025; (34:19) Fast reactions in people with no allergy history; (36:42) How a first dose can react; (38:49) Was echinacea to blame?; (40:00) Supply data and single-herb products; (42:03) The Thai VigiBase signal; (43:36) Label warnings from 2020; (45:30) Why the labels failed; (48:52) Cofactors: anti-inflammatories, alcohol, exercise; (49:57) Removal from listed medicines, 17/09/2026; (51:48) The practitioner compounding exemption; (53:36) Screening, interactions and the first dose; (56:16) Is it worth prescribing?; (56:57) Check your cabinet; (58:00) Who should stop or avoid it; (59:41) Pregnancy and breastfeeding; (1:00:35) Signs of anaphylaxis; (1:02:05) First aid: triple zero, lie flat, adrenaline; (1:04:18) The arc of the story; (1:05:47) Closing thought.
Read more in the Institute's Journal: https://www.australian-pharmacognosy.org/pharmacopoeia/andrographis-paniculata/
Nothing in this episode is a prescription or a dose. If you want to use a herb, consult a degree-qualified herbalist with competencies and adequate training in pharmacognosy.
Dr Luke Iggulden, Chief Scientific Officer, made the episode from the Institute's Journal and monograph material. Jesse Kirby, Head of Community Outreach, wrote the show notes and chapters from the episode transcript.
The Herbarium Hour, from the Australian Institute of Pharmacognosy, Cardwell, Queensland.