Andrographis paniculata

Consumers and health professionals are advised that products containing the herb Andrographis paniculata (Andrographis) may be associated with changes in the sense of taste (also known as taste disturbance), including complete loss of taste.

Andrographis is a herbal ingredient permitted for use in low-risk medicines in Australia. Approximately 100 medicines listed in the Australian Register of Therapeutic Goods (ARTG) contain Andrographis.

Andrographis is a herb commonly used in Indian and Chinese medicine and is known as the 'King of bitters'. It is commonly used to support immune function and to relieve symptoms of:

• mild fever
• common cold
• sore throat

Since mid-2019, the TGA has identified a significant increase in the number of adverse event reports involving Andrographis and the development of taste disturbance. Most of these reports have been associated with a multi-ingredient product called Armaforce, which contains Andrographis. The TGA has worked with the sponsor of Armaforce to implement a label warning for this product. However, our investigation of this issue indicates that Andrographis is likely to be responsible for these effects on the sense of taste.

The onset of taste disturbance frequently occurs after about two weeks of use of Andrographis products, but may also occur in a shorter timeframe. Based on the reports received by the TGA, it can take up to several weeks after you stop using the product for taste to return to normal. In addition, at the time of reporting, not all individuals had regained a normal sense of taste.

Information for consumers

You should be aware that using products that contain Andrographis is associated with the possibility of changes to the sense of taste, including the potential for complete loss of taste.

Andrographis may be present in multi-ingredient herbal medicine products, typically used for relief of cold and flu symptoms, or for immune support.

If you develop any of the following symptoms while you are taking a product containing Andrographis, stop taking the product as soon as possible and seek medical advice:

• loss of taste
• metallic or soapy taste
• altered taste
• loss of appetite

You should discuss any concerns or questions you have about this issue with your health professional.

If you suspect you have had an adverse effect to a product containing Andrographis, please report it to the TGA.

Information for health professionals

Consumers should be warned at the time of purchase of the possibility of developing taste disturbances when using Andrographis products.

If you are treating a patient who has presented complaining of reduced or altered taste or loss of taste functions of the tongue, you should consider whether a product containing Andrographis could be involved.

Please report any suspected adverse reactions involving taste disorders and Andrographis containing products to the TGA.

Information for sponsors

You are reminded of your obligation to report all serious adverse events to the TGA within required timeframes. Loss of taste and taste disturbance is medically significant, particularly when prolonged. Possible consequences include loss of appetite that may be associated with weight loss and malnutrition.

Reporting problems

Consumers and health professionals are encouraged to report problems with medicines or vaccines. Your report will contribute to the TGA's monitoring of these products.

The TGA cannot give advice about an individual's medical condition. You are strongly encouraged to talk with a health professional if you are concerned about a possible adverse event associated with a medicine or vaccine.