Andrographis and Echinacea TGA Alert : Herb Information from Phytomed

Andrographis and Echinacea

Andrographis paniculata (Andrographis) is contraindicated for use in individuals with a history of allergic reactions, particularly severe allergic reactions.

Recent TGA monitoring analysis has highlighted a few instances of products, including practitioner-only supplements, containing Andrographis or a combination formula of Andrographis with Echinacea angustifolia or purpurea (Echinacea), that resulted in adverse reactions. Both herbs may cause allergic reactions which can include life-threatening anaphylaxis in some individuals.

For detailed information, refer to TGA’s safety advisory:

https://www.tga.gov.au/news/safety-alerts/medicines-containing-andrographis-paniculata-safety-advisory

Important note: If prescribing the use of Andrographis, particularly in combination with Echinacea, it is important to check for the possibility of an allergy or anaphylaxis reaction and advise the client of the allergy response that could potentially occur and what to do. We recommend before any prescription of Andrographis or Andrographis and Echinacea:

1. Check and assess the past allergy history of the client. This includes any allergy or sensitivity reaction to an ingredient, not just Andrographis.
2. Ask directly if the individual has used either Andrographis or Echinacea previously.
3. If the client has previously had symptoms of an allergic reaction after using a medicine containing Andrographis, or a combination of Andrographis and Echinacea, advise them to avoid using all medicines containing Andrographis.
4. Also, if past adverse reactions, highlight to the client the importance of “if their symptoms worsen or if breathing difficulty arises, to seek prompt medical attention without delay (call 111 for an ambulance)”. Symptoms may include difficult or noisy breathing, swelling of tongue, swelling or tightness in throat, wheeze or persistent cough, difficulty talking or hoarse voice, persistent dizziness or collapse.
5. Even if no adverse effects are mentioned or noted in the client’s history, inform the client of the potential for allergic reactions to an ingredient, to be vigilant and remind the client “if an adverse reaction occurs or if their symptoms worsen or if breathing difficulty arises, to seek prompt medical attention without delay (call 111 for an ambulance)”.

Andrographis is a powerful herb and has the potential to provide significant health benefits to individuals. Like all medicines, however, care should be taken.