Andrographis paniculata or favipiravir in Mild COVID-19: A randomized control trial

Background: The COVID-19 pandemic led to an urgent search for effective treatments. Andrographis paniculata (AP), a traditional herbal medicine, has shown potential due to its antiviral and anti-inflammatory properties. This study aimed to compare the efficacy and safety of AP capsules with favipira...

Full description

Saved in:
Bibliographic Details
Main Authors: Rujipas Sirijatuphat, Navin Horthongkham, Chutikarn Chaimayo, Patimaporn Wongprompitak, Wuttikrai Kongsankum, Phornnapa Charoenkij, Titchaphorn Palo, Suthatip Mahajaroensiri, Nalinthika Nathananwanit, Sansanee Senawong, Wannee Kantakamalakul, Pravit Akarasereenont, Chairat Permpikul
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Phytomedicine Plus
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2667031325001290
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849232634998161408
author Rujipas Sirijatuphat
Navin Horthongkham
Chutikarn Chaimayo
Patimaporn Wongprompitak
Wuttikrai Kongsankum
Phornnapa Charoenkij
Titchaphorn Palo
Suthatip Mahajaroensiri
Nalinthika Nathananwanit
Sansanee Senawong
Wannee Kantakamalakul
Pravit Akarasereenont
Chairat Permpikul
author_facet Rujipas Sirijatuphat
Navin Horthongkham
Chutikarn Chaimayo
Patimaporn Wongprompitak
Wuttikrai Kongsankum
Phornnapa Charoenkij
Titchaphorn Palo
Suthatip Mahajaroensiri
Nalinthika Nathananwanit
Sansanee Senawong
Wannee Kantakamalakul
Pravit Akarasereenont
Chairat Permpikul
author_sort Rujipas Sirijatuphat
collection DOAJ
description Background: The COVID-19 pandemic led to an urgent search for effective treatments. Andrographis paniculata (AP), a traditional herbal medicine, has shown potential due to its antiviral and anti-inflammatory properties. This study aimed to compare the efficacy and safety of AP capsules with favipiravir (FV) in treating mild COVID-19 patients. Methods: This randomized, double-blind trial was conducted at Siriraj Hospital, Thailand. This study was in the Thai Clinical Trials Registry register, which number is TCTR20240802007. The study included patients aged 18–59 who were diagnosed with mild COVID-19. Participants were randomly assigned to receive either AP capsules (180 mg/day) or FV for five days, with a 10-day follow-up period. Primary outcomes included changes in viral load, pneumonia incidence, and symptom improvement. Secondary outcomes focused on viral clearance and adverse events. Results: A total of 190 participants (95 per group) were enrolled. By day 10, none had developed pneumonia. Both AP and FV effectively reduced viral load, with the Mann-Whitney U-test showing statistical significance (p < 0.05). The AP group showed greater improvement in specific symptoms, particularly in phlegm (1.15 ± 1.58 vs. 1.9 ± 2.04, p = 0.004) and headache (0.15 ± 0.51 vs. 0.47 ± 1.25, p = 0.033), compared to the FV group. Adverse events were minimal and similar between the two groups. Conclusion: Both AP and FV effectively reduced symptoms and viral load with minimal side effects. However, AP showed superior improvements in phlegm and headaches. Consequently, physicians may regard AP as an appropriate option for COVID-19 patients to alleviate symptoms.
format Article
id doaj-art-8dcd61d8c0454674a5f0b76a0e884587
institution Kabale University
issn 2667-0313
language English
publishDate 2025-08-01
publisher Elsevier
record_format Article
series Phytomedicine Plus
spelling doaj-art-8dcd61d8c0454674a5f0b76a0e8845872025-08-21T04:17:42ZengElsevierPhytomedicine Plus2667-03132025-08-015310085810.1016/j.phyplu.2025.100858Andrographis paniculata or favipiravir in Mild COVID-19: A randomized control trialRujipas Sirijatuphat0Navin Horthongkham1Chutikarn Chaimayo2Patimaporn Wongprompitak3Wuttikrai Kongsankum4Phornnapa Charoenkij5Titchaphorn Palo6Suthatip Mahajaroensiri7Nalinthika Nathananwanit8Sansanee Senawong9Wannee Kantakamalakul10Pravit Akarasereenont11Chairat Permpikul12Department of Medicine, Faculty of medicine Siriraj Hospital, Mahidol University, Thailand 10700Department of Microbiology, Faculty of medicine Siriraj Hospital, Mahidol University, Thailand 10700Department of Microbiology, Faculty of medicine Siriraj Hospital, Mahidol University, Thailand 10700Department of Immunology, Faculty of medicine Siriraj Hospital, Mahidol University, Thailand 10700Department of Immunology, Faculty of medicine Siriraj Hospital, Mahidol University, Thailand 10700Department of Pharmacology, Faculty of medicine Siriraj Hospital, Mahidol University, Thailand 10700Department of Pharmacology, Faculty of medicine Siriraj Hospital, Mahidol University, Thailand 10700Center of Applied Thai traditional medicine, Faculty of medicine Siriraj Hospital, Mahidol University, Thailand 10700Center of Applied Thai traditional medicine, Faculty of medicine Siriraj Hospital, Mahidol University, Thailand 10700Department of Immunology, Faculty of medicine Siriraj Hospital, Mahidol University, Thailand 10700Department of Microbiology, Faculty of medicine Siriraj Hospital, Mahidol University, Thailand 10700Department of Pharmacology, Faculty of medicine Siriraj Hospital, Mahidol University, Thailand 10700; Center of Applied Thai traditional medicine, Faculty of medicine Siriraj Hospital, Mahidol University, Thailand 10700Department of Medicine, Faculty of medicine Siriraj Hospital, Mahidol University, Thailand 10700; Corresponding author at: Department of Medicine, Faculty of medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road Bangkoknoi, Bangkok 10700, ThailandBackground: The COVID-19 pandemic led to an urgent search for effective treatments. Andrographis paniculata (AP), a traditional herbal medicine, has shown potential due to its antiviral and anti-inflammatory properties. This study aimed to compare the efficacy and safety of AP capsules with favipiravir (FV) in treating mild COVID-19 patients. Methods: This randomized, double-blind trial was conducted at Siriraj Hospital, Thailand. This study was in the Thai Clinical Trials Registry register, which number is TCTR20240802007. The study included patients aged 18–59 who were diagnosed with mild COVID-19. Participants were randomly assigned to receive either AP capsules (180 mg/day) or FV for five days, with a 10-day follow-up period. Primary outcomes included changes in viral load, pneumonia incidence, and symptom improvement. Secondary outcomes focused on viral clearance and adverse events. Results: A total of 190 participants (95 per group) were enrolled. By day 10, none had developed pneumonia. Both AP and FV effectively reduced viral load, with the Mann-Whitney U-test showing statistical significance (p < 0.05). The AP group showed greater improvement in specific symptoms, particularly in phlegm (1.15 ± 1.58 vs. 1.9 ± 2.04, p = 0.004) and headache (0.15 ± 0.51 vs. 0.47 ± 1.25, p = 0.033), compared to the FV group. Adverse events were minimal and similar between the two groups. Conclusion: Both AP and FV effectively reduced symptoms and viral load with minimal side effects. However, AP showed superior improvements in phlegm and headaches. Consequently, physicians may regard AP as an appropriate option for COVID-19 patients to alleviate symptoms.http://www.sciencedirect.com/science/article/pii/S2667031325001290Andrographis paniculatafavipiravirCOVID-19traditional herbal medicinesymptom reliefpneumonia
spellingShingle Rujipas Sirijatuphat
Navin Horthongkham
Chutikarn Chaimayo
Patimaporn Wongprompitak
Wuttikrai Kongsankum
Phornnapa Charoenkij
Titchaphorn Palo
Suthatip Mahajaroensiri
Nalinthika Nathananwanit
Sansanee Senawong
Wannee Kantakamalakul
Pravit Akarasereenont
Chairat Permpikul
Andrographis paniculata or favipiravir in Mild COVID-19: A randomized control trial
Phytomedicine Plus
Andrographis paniculata
favipiravir
COVID-19
traditional herbal medicine
symptom relief
pneumonia
title Andrographis paniculata or favipiravir in Mild COVID-19: A randomized control trial
title_full Andrographis paniculata or favipiravir in Mild COVID-19: A randomized control trial
title_fullStr Andrographis paniculata or favipiravir in Mild COVID-19: A randomized control trial
title_full_unstemmed Andrographis paniculata or favipiravir in Mild COVID-19: A randomized control trial
title_short Andrographis paniculata or favipiravir in Mild COVID-19: A randomized control trial
title_sort andrographis paniculata or favipiravir in mild covid 19 a randomized control trial
topic Andrographis paniculata
favipiravir
COVID-19
traditional herbal medicine
symptom relief
pneumonia
url http://www.sciencedirect.com/science/article/pii/S2667031325001290
work_keys_str_mv AT rujipassirijatuphat andrographispaniculataorfavipiravirinmildcovid19arandomizedcontroltrial
AT navinhorthongkham andrographispaniculataorfavipiravirinmildcovid19arandomizedcontroltrial
AT chutikarnchaimayo andrographispaniculataorfavipiravirinmildcovid19arandomizedcontroltrial
AT patimapornwongprompitak andrographispaniculataorfavipiravirinmildcovid19arandomizedcontroltrial
AT wuttikraikongsankum andrographispaniculataorfavipiravirinmildcovid19arandomizedcontroltrial
AT phornnapacharoenkij andrographispaniculataorfavipiravirinmildcovid19arandomizedcontroltrial
AT titchaphornpalo andrographispaniculataorfavipiravirinmildcovid19arandomizedcontroltrial
AT suthatipmahajaroensiri andrographispaniculataorfavipiravirinmildcovid19arandomizedcontroltrial
AT nalinthikanathananwanit andrographispaniculataorfavipiravirinmildcovid19arandomizedcontroltrial
AT sansaneesenawong andrographispaniculataorfavipiravirinmildcovid19arandomizedcontroltrial
AT wanneekantakamalakul andrographispaniculataorfavipiravirinmildcovid19arandomizedcontroltrial
AT pravitakarasereenont andrographispaniculataorfavipiravirinmildcovid19arandomizedcontroltrial
AT chairatpermpikul andrographispaniculataorfavipiravirinmildcovid19arandomizedcontroltrial