Articles

Hempedu Bumi

Plant Part Used

Leaves, aerial part of the plant

Active Constituents

Andrographolide, andrographinin, neoandrographolide, isoandrographolide,14- deoxy-11,12-didehydroandrographolide, 14-deoxy-12-methoxyandrographolide, 14-deoxy-11,12-dihydoandrographolide, 14-deoxy-11,12-dihydroandrographiside, andropanoside, 12-epi-14-deoxy-12-methoxyandrographolide, andrographiside, 14-epi-andrographolide, 14-deoxyandrographolide, deoxyandrographiside, 6’-acetylneoandrographolide, bisandrographolide A, bisandrographolide B, bisandrographolide C, bisandrographolide D, 14-deoxy-12-hydroxy- andrographolide, 14-deoxy-15-isopropylidene-11,12-didehydroandrographolide, andrographidin C, andrographidin D, andrographidin E, andrographidin A, andrographidin B, andrographidin F, 5-hydroxy-7,8,2’,3’-tetramethoxyflavone, andrographin, 5-hydroxy-7,8-dimethoxyflavone, 5-hydroxy-7,8-dimethoxy- flavanone and 5-hydroxy-7,2’,6’-trimethoxyflavone. (1) , (2) , (3) , (4) , (5)

Introduction

A. paniculata is an annual shrub that can grow to one meter high, with sharp quadrangular branches. Its flowers are small, solitary in panicles and its fruit is approximately 2 cm long. The seeds are numerous and yellow-brown in color. The plant is distributed over tropical regions of Asia often in isolated patches and can be found in a variety of habitats such as hill slopes, wastelands, farms, dry or wet lands, sea shores, and even on roadsides. It is found in India, Sri Lanka, Indonesia, Malaysia, and Thailand. In India it is commonly found in tropical moist deciduous forests where it grows as an under storey plant.

In Malaysia, A. paniculata is widely referred to as 'hempedu bumi' or 'pokok cerita', and the locals often take the leaves orally to aid in diabetes and hypertension.

Dosage Info

Dosage Range

1.5 to 5 g in dry herb form
Doses as high as 1,000 to 2,000 mg, 3 times daily have been used in some studies. (6) Standardized extract of 150-200 mg containing 30-40% andrographolide has been prepared as an oral daily dose.

Most Common Dosage

A typical dosage of Andrographis paniculata dry herb is 400 mg 3 times a day.

Standardization

Andrographis paniculata is usually standardized to its andrographolide content of 4 to 6%. (7) Other standard profiles were documented in the Malaysian Herbal Monograph. (8)

Toxicities & Precautions

Introduction

A. paniculata is not toxic but since it has displayed contraceptive and abortifacient effects in experimental animals (9) , it should not be taken during pregnancy. Safety in young children, pregnant women or patients with severe liver or kidney disease has not been established.

Side Effects

Large doses of Andrographis paniculata may cause gastric discomfort, vomiting, and loss of appetite. (10)

Pregnancy/ Breast Feeding

Andrographis paniculata has produced contraceptive effects in mice and abortifacient effects in pregnant rabbits when fed this herb. (11) Although a similar effect has not been observed in humans, A. paniculata should not be taken during pregnancy or by women trying to conceive.

Age Limitations

Safety in young children and the elderly has not been established.

Pharmacology

Hepatoprotective and choleretic activity
A. paniculata and its major constituent, andrographolide, exhibited protective effects comparable to that of silymarin against liver damage in rats induced by various hepatotoxic agents such as carbon tetrachloride, t-butylhydroperoxide, galactosamine, and paracetamol. (12) , (13) , (14) , (15) In an in vitro study, andrographolide was found to be superior and more potent than silymarin in reversing the toxic effects of paracetamol on certain liver enzymes. (16) Another study has shown that an alcohol extract of A. paniculata, andrographolide, and neoandrographolide had a significant anti-hepatotoxic effect against Plasmodium berghei K173-induced hepatic damage of Mastomys natalensis. (17) Andrographolide has shown choleretic activity in the rat and guinea pig, increasing bile volume as well as the amount of bile salts and bile acids. (18) Other researchers have also reported the antioxidant and hepatoprotective action of A. paniculata in t-butylhydroperoxide-induced liver damage of mice. (19)

Anti-diabetic properties
A. paniculata was also reported to have anti-diabetic properties. A study reported that oral administration of the extract significantly reduced the fasting serum glucose levels of diabetic rats but not of normal rats when compared to metformin, a standard anti-diabetic drug. (20) Both andrographolide and A. paniculata extract accelerated intestinal digestion and absorption of carbohydrates by activating the brush border membrane bound hydrolases, e.g. lactase, maltase, and sucrase of the small intestine. (21)

Cardiovascular disorders
A crude aqueous extract of Andrographis paniculata as well as its semi-purified fractions were found to produce a significant dose-dependent fall in mean arterial blood pressure of rats. (22) Another study has shown that the aqueous extract of A. paniculata lowered systolic blood pressure by reducing circulating angiotensin-converting enzyme in the plasma. (23) Two of its diterpene lactones, 14-deoxyandrographolide and 14-deoxy-(11,12)-didehydroandrographolide (DDA), demonstrated hypotensive effects in isolated rat aorta. (24) DDA also significantly reduced mean arterial blood pressure and heart rate of anaesthetized rats in a dose-dependent manner. (25) Andrographolide inhibited PAF-induced human platelet aggregation in a dose-dependent manner, thus supporting its anti-thrombotic activity. (26)

Anti-inflammatory activity
Andrographolide was found to have a moderate anti-inflammatory effect in the rat when given orally at 30 to 300mg per kg of bodyweight, (27) but showed no adverse effects on the gastric mucosa in these studies. Other studies indicated that andrographolide inhibited the up-regulation of adhesion molecule expression caused by tumour necrosis factor-a (28) and prevented the reactive oxygen species (ROS) production and neutrophils adhesion, lending support that andrographolide has the potential to become an anti-inflammatory substance. (29) Neoandrographolide has been found to inhibit nitric oxide production both in vitro and ex vivo. (30)

Antipyretic and analgesic properties
In a study, (31) andrographolide reduced the rectal body temperature at doses of 30, 100, and 300 mg per kg of bodyweight. The 300mg/kg dose of andrographolide was as effective as the same amount of aspirin. However, the analgesic activity of andrographolide was weak compared to aspirin. In another study A. paniculata extracts were found to produce results comparable to 200 mg of aspirin. (32)

Antidiarrheal activity
The alcoholic extract of A. paniculata has been shown to have a significant effect against diarrhea associated with E. coli bacterial infection. Andrographolide and neoandrographolide, showed similar activity to loperamide, a common anti-diarrheal drug. (33)

Immunostimulant activity
The mechanism by which Andrographis paniculata exerts its effect in the prevention and treatment of the common cold is not known, but it appears that the immunostimulant activity rather than direct antimicrobial activity plays a key role. (34) An ethanolic extract of A. paniculata as well as its purified andrographolides have been shown to stimulate both antigen specific and non-specific immune responses in vivo. (35) Mice studies have shown that A. paniculata extract and andrographolide induced significant stimulation of the antibody and delayed hypersensitivity responses. (36)

Miscellaneous activity
A. paniculata demonstrated higher anti-malarial effects than Piper sarmentosum or Tinospora crispa. (37) A similar study has shown that A. paniculata produces a considerable inhibition of the multiplication of Plasmodium berghei. (38) A. paniculata was found to be a potential chemopreventive agent against chemotoxicity including carcinogenicity. (39) Andrographolide and neoandrographolide were found to possess anti-allergic activity in rats. (40) Psychopharmacological studies have shown that the Andrographis paniculata extract has a significant alteration in behaviour patterns and a reduction in spontaneous motility. (41)

Clinical Studies

Uncomplicated upper-respiratory tract infections
Two double blind, placebo-controlled studies were performed in Sweden, (42) where subjects were treated with a standardized extract of Andrographis paniculata for uncomplicated upper-respiratory tract infections. Both the total symptom and total diagnostic scores showed increased improvement in the treated group when compared with the placebo.

Uncomplicated common cold
Several clinical trials have been performed using a standardized hydro-ethanolic A. paniculata leaf extract. (43) , (44) The results of these clinical studies provided compelling evidence that a standardized extract of Andrographis paniculata could significantly reduce the symptoms and duration of the common cold.

Pharyngotonsilitis
A Thai research team (45) has shown that a high dose (2 g three times daily) of A. paniculata extract was significantly more effective to relieve a fever and sore throat than that of a low dose (1 g three times daily).

Atheroschelorotic arterial stenosis
In a study, the comparative effects of andrographolide and fish oils in a group of patients following angioplasty were investigated. (46) A follow-up angiography four weeks later showed that 57% in control group had severe restenosis, but in the andrographolide-treated group, there were only minor incidences of restenosis. The fish oil treated group had restenosis as severe as that of the control group. Andrographolide was found to be markedly superior to fish oils in alleviating arterial stenosis as well as restenosis following angioplasty.

HIV positive
In a recent Phase 1 dose-escalating clinical trial of andrographolide in HIV positive patients, (47) it was found that there was a significant rise in the mean CD4 lymphocyte level of HIV subjects after administration of andrographolide. Dehydroandrographolide succinic acid monoester (DASM) has been found to be an inhibitor against some strains of the HIV-1 and HIV-2 in vitro. (48)

Reported Uses:

Uses supported by clinical data
Possible prevention of the common cold. (49)
Symptomatic treatment of the common cold and pharyngotonsillitis. (50) , (51) , (52)

Uses reported in folk medicine, but not supported by clinical data

  • cardiovascular disease,
  • common cold,
  • convalescence,
  • debility,
  • diabetes mellitus,
  • diarrhoea,
  • digestive weakness,
  • dysentery,
  • dyspepsia,
  • flatulence,
  • gastrointestinal tract,
  • infestation hepatitis,
  • immune deficiency,
  • infections of the respiratory tract, skin, and liver,
  • liver insufficiency and toxicity

 

Read More

  1) Botanical Info

  2) Cultivation

  3) Western Herb

  4) Ayuverda

References

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  51. Caceras DD, Hancke JL, Burgos RA, Sandberg F, Wikman GK. Prevention of common colds with Andrographis paniculata dried extract. A pilot double blind trial. Phytomedicine. 1997;4:101-104.
  52. Caceras DD, Hancke JL, Burgos RA, Sandberg F, Wikman GK. Use of visual analogue scale measurements (VAS) to asses the effectiveness of standardized Andrographis paniculata extract SHA-10 in reducing the symptoms of common cold. A randomized double blind-placebo study. Phytomedicine. 1999;6:217-223.