“Read Medicine Labels” – How to Safely Use Green Chiretta Against COVID-19

Chula Pharmaceutical Science points out the benefits and cautious use of green chiretta to better understand the drug, urging consumers to pay attention to “medicine labels” to choose and use green chiretta effectively and safely.

Since the herb “Green chiretta” (Andrographis paniculate) known in Thai as “Fah Talai Jone” became more popularly known during the COVID-19 pandemic especially when the Ministry of Public Health announced it could be used to treat COVID-19, there was a surge in the demand, causing the product to be in short supply.  Stories and news about the herb flooded social media, some with claims that it could cure COVID-19 while some said it only helped relieve the symptoms.  There were also warnings that it might be harmful to the liver, and so on.  All the conflicting information brought about confusion among consumers and could lead to misuse and harm.   

Dr. Kitiyot Yotsombut, lecturer of the Faculty of Pharmaceutical Sciences, Chulalongkorn University has prepared information on the green chiretta to enable us to learn about its benefits as well as how to safely use the product whether during the crisis or as a general remedy.  

What is green chiretta?

Green chiretta or Fah talai jone (Scientific name: Andrographis paniculata (Burm.f.) Wall. ex Nees) is an annual herbaceous plant that is native to India.  The stem is square in cross-section with longitudinal furrows and wings along the angles.  The oval or lance-shaped leaves have hairless blades that are dark green in color, and the small flowers are arranged in lax spreading racemes or panicles.  The plant grows to about 30-60 centimeters and lives between 3-5 years and is commonly found.  Because they bear fruit that is a capsule containing many yellow-brown seeds they are easily propagated.  In Thailand, they have long been found in kitchen gardens. 

Usually, all plants have hundreds of phytochemicals in them.  The green chiretta contains Andrographolides which are effective in inhibiting viral replication, and also has anti-inflammatory qualities which is why it is often used to treat and relieve common cold and diarrhea symptoms.    

The efficacy of green chiretta

According to ancient Thai traditional medicine recipes, green chiretta is effective mainly in reducing fever, treating mild forms of inflammation, and reducing contractions of the intestines.  In Thailand, it is often used to treat colds and non-inflammatory diarrhea though it has many other properties, depending on the usage, since it contains numerous phytochemicals that are beneficial.      

“In traditional medicine recipes in other countries, green chiretta is promoted and used for a wide range of symptoms such as to treat heartburn, chest pains, coughs, diabetes or even for external use like boils and burns and in some cases are also used to produce cosmetics.”  Dr. Kitiyot enumerated on the green chiretta and its benefits, yet he also underscored the awareness one should have regarding the usage of this type of drug. 

“The general public may not need to understand the drug in great depth but it is important that they are aware of its qualities.  They should realize that although they are all green chiretta the process that goes into its manufacturing differs from one pharmaceutical company to another.  This means that the level of the main active ingredient might be different resulting in different forms of side effects.” 

For this reason, reading the “label” becomes crucial in order to prevent dangerous side effects that might occur.

Can green chiretta really be used to treat COVID-19?

“When COVID-19 occurred, as a new disease it was treated like one would the flu, treating it according to its symptoms.”  Dr. Kitiyot recalled the early days of COVID-19.   

“When a new disease occurs, coming up with a new drug to treat it as soon as possible is most difficult.  The best way to test a drug is to see whether or not it can kill germs,” Dr. Kitiyot further explained.     

Tests conducted by the Department of Medical Sciences found that green chiretta showed direct inhibitory activity against the virus and virus multiplication but without the ability to prevent inflammation.  This is similar to the research conducted by the Department of Thai Traditional and Alternative Medicine, Ministry of Public Health that studied the use of extracts of green chiretta with andrographis at the level of 180 milligrams per day for a period of 5 days.   In patients with mild cases of COVID-19, it was found that green chiretta could prevent a slight level of COVID-19 from progressing to pneumonia.    

One could say that during the recent pandemic, many of the medicines that are widely mentioned like Favipiravir are those that have been around before that time.  The green chiretta had been chosen for the test because of its known ability to inhibit viruses and there is already considerable information available.  For this reason, even if the results of the studies have not been able to confirm that green chiretta can cure COVID-19, at least it can reduce the flu symptoms, and therefore it became one of the medications that was popularly used.      

How to use green chiretta safely and effectively

Dosage  

• For the common cold, 20 milligrams of green chiretta three times a day or 60 milligrams per day.     
• For the treatment of COVID-19, a higher dosage of andrographis is needed, therefore 60 milligrams three times a day, or 180 milligrams per day.    

The green chiretta can also be used in those with slight symptoms, but not recommended for those with more severe symptoms, and the 608 at-risk group (those aged 60 years and above with the seven diseases like chronic respiratory syndrome, heart and blood vessels diseases, chronic kidney failure, strokes, obesity, cancer and diabetes) as well as pregnant women since there has yet to be research to certify the results. 

Making it easier to read the labels  

Some brands of green chiretta do not indicate the amount of andrographolides.  Some of the labels, printed information, or what we read on social media present information that can be misleading which might be intentional or due to the ignorance of the seller.   Worse still, some brands register their product not as medicines but as food supplements and may not have green chiretta in it as an ingredient.    

Dr. Kitiyot’s advice is what to bear in mind when looking at the label of green chiretta products “If the label does not show the level of andrographolides, then it should not be taken.”    

When buying the product, consumers should make sure they study the label to find out the level of androphapholides it contains, and most importantly to check the FDA registration number.  Green chiretta is classified as an herbal product and the label must have a registration number starting with the letter “G”. 

Consumers can check for faulty green chiretta products from the FDA website at Food and Drug Administration 

Cautions for green chiretta products

Allergies to the medicine  

Despite being an herbal medicine, it can still cause allergies in the same way as modern medicines.  Those who have had allergies display symptoms of rashes and in severe cases will find swelling in the windpipe that can sometimes be fatal.  If one doesn’t know whether they might be allergic, they should watch out for possible symptoms from the first time they take the medicine.   

Avoid using it with other medicines  

Since green chiretta has many phytochemicals that have the ability to treat a large number of symptoms as indicated earlier, if taken with other medicines like those for blood pressure, liver, or anti-viral medicines it would cause what is known as drug interaction.  In such cases, one might experience fainting or heart palpitations resulting from low blood pressure or sugar levels dropping or other severe forms of side effects.     

Avoid taking the medicine for long durations   

The Ministry of Public Health specifies 5 days as the maximum as side effects can occur like muscle weakness or numbness in hands and feet.  In cases where the herb has been used for 3-5 days and one does not feel better, they should consult the doctor for further diagnosis.   

“There are always two sides to the same coin, whatever has advantages will also have disadvantages.  Herbal medicine is a good alternative but one needs to have adequate information in order to be confident about its use and avoid unwanted allergies and side effects.  The best thing is probably to consult with a doctor or pharmacist beforehand.”  Dr. Kitiyot concluded with some words of caution.    

References:

1. https://www.dtam.moph.go.th/index.php/th/dtam-news/dn/8165-dn0073.html
2. https://thaicam.go.th/wp-content/uploads/2021/07/%E0%B8%81%E0%B8%B2%E0%B8%A3%E0%B9%83%E0%B8%8A%E0%B9%89%E0%B8%A2%E0%B8%B2%E0%B8%9F%E0%B9%89%E0%B8%B2%E0%B8%97%E0%B8%B0%E0%B8%A5%E0%B8%B2%E0%B8%A2%E0%B9%82%E0%B8%88%E0%B8%A3%E0%B9%83%E0%B8%99%E0%B8%9C%E0%B8%B9%E0%B9%89%E0%B8%9B%E0%B9%88%E0%B8%A7%E0%B8%A2%E0%B9%82%E0%B8%A3%E0%B8%84%E0%B9%82%E0%B8%84%E0%B8%A7%E0%B8%B4%E0%B8%94-19.pdf

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