Kalmegh: Benefits, Evidence, Dosage & Safety

TL;DR

Kalmegh (Andrographis paniculata) is the same plant as our Bhunimba article: see there for full respiratory evidence and safety. This covers the classical Kalmegh entry: a bitter Ayurvedic herb for liver disorders, worms. Its human liver evidence: an uncontrolled 1982 series of kalmegh decoction in infective hepatitis plus a 2013 comparison against a control group; the rest is preclinical.

What it is

Kalmegh is the classical Ayurvedic name for Andrographis paniculata (Burm.f.) Nees, an intensely bitter annual herb of the Acanthaceae family: the "king of bitters." Its Sanskrit synonyms include Bhunimba, Kalamegha, Yavatikta ("bitter like barley"), and Kiratatikta (Ayurline review). The dried aerial parts (leaves and stems) are the medicinal portion, and its major bioactive constituents are the diterpene lactones, chiefly andrographolide (evidence review).

A note on our two articles: this plant appears on this site under two names. Our Bhunimba article covers the modern clinical evidence for respiratory infections (a 33-trial meta-analysis), the COVID-19 trial, dosing used in trials, and the serious anaphylaxis safety warning. This Kalmegh article covers the classical Ayurvedic entry: its traditional identity, liver-related uses, and the older clinical work on hepatitis. The two are companions, not duplicates.

Traditional use

In Ayurvedic materia medica, kalmegh is described as tikta rasa (bitter taste) with katu vipaka (pungent post-digestive effect) and ushna virya (hot potency), pacifying Kapha and Pitta. The Priyanighantu places it in the Shatpushpadi Varga (Ayurline review). It is classically used for yakrutroga (liver disorders), krimiroga (worm infestations), kushtha (skin disorders), and jvara (fever), and by tradition as a liver tonic, for jaundice, diarrhoea, and common cold (same review).

Its classical actions are summarized as jwarahara (fever-relieving), yakritshodhaka (liver-cleansing), krimighna (anthelmintic), deepana-pachana (digestive stimulant), and raktashodhaka (blood-purifying). In Ayurvedic practice it was used as a bitter tonic and general stomach remedy, said to increase appetite, strengthen digestion, and reduce flatulence and biliousness, and specifically for feverish stomach complaints in young children and for weak, convalescing patients regaining appetite after illness (Herbal Reality monograph). These are traditional claims, not clinical proof: the human evidence is assessed separately below.

What modern research says

Hepatitis (limited human studies)

The main human study of kalmegh for liver disease is a 1982 clinical series from the Institute of Medical Sciences, Banaras Hindu University, published in Ancient Science of Life. Patients with infective hepatitis were given kalmegh in decoction form, and results were assessed on clinical and biochemical parameters: the authors reported marked symptomatic improvement in most cases, statistically significant decreases in serum bilirubin, thymol turbidity, alkaline phosphatase, SGOT, SGPT, and serum globulin, with increased total serum protein and albumin: and an overall assessment of 80% "cured" and 20% "relieved" (Chaturvedi et al., 1982).

The caveats are decisive: this was an uncontrolled series, no comparison group, no stated sample size or decoction dose in the published abstract, from 1982, and infective hepatitis frequently resolves on its own. Recovery cannot be attributed to the herb. Treat this as a historical lead, not evidence of efficacy.

A second, smaller human data point: a 2013 clinical comparison in acute viral hepatitis, in which a kalmegh decoction improved liver function versus a control group: as reported in a review of kalmegh's hepatoprotective work (IJPS review). The primary 2013 paper was not accessible for this article, so no further details are drawn from it.

Liver protection (animal studies)

The bulk of the hepatoprotective evidence is animal: protection against diclofenac-induced liver toxicity in rats (restored antioxidant enzymes, reduced lipid peroxidation and liver enzymes), and protection against carbon tetrachloride, paracetamol, ethanol, and heavy-metal liver injury (IJPS review). Mechanistic studies link andrographolide to antioxidant and anti-inflammatory pathways, but these are laboratory findings, not proof of human benefit.

For respiratory infections and COVID-19 — see our Bhunimba article

To avoid duplicating evidence: the modern clinical trial literature on A. paniculata concerns respiratory infections, a 2017 meta-analysis of 33 RCTs (7,175 patients) on cough and sore throat, a 1991 trial versus paracetamol for pharyngotonsillitis, and a COVID-19 trial, and is covered in full in our Bhunimba article, along with the complete safety section. Nothing in those respiratory trials establishes a liver benefit.

What the evidence does not support (yet)

A hepatoprotective or jaundice-curing effect in humans. The traditional liver reputation rests on classical use plus one uncontrolled 1982 series, one small 2013 clinical comparison, and animal studies: well short of clinical proof.

Dosage

There is no established human dose for kalmegh as a liver remedy. The single human hepatitis study used a kalmegh decoction but did not report the dose. No pharmacopoeial dose was verified in the sources reviewed for this article. Do not infer a dose from traditional practice or from the respiratory trials covered in our Bhunimba article, which used different preparations.

Safety & contraindications

Because this is the same plant covered in our Bhunimba article, its safety section applies in full: read it there. The short version: Australia's TGA warns that Andrographis products can cause sudden, potentially life-threatening allergic reactions (anaphylaxis), including in people who previously used the herb without problems: reports rose sharply in 2019 and have stayed high, including a fatal case in June 2024, and in September 2026 the TGA removed Andrographis from the permissible-ingredients list for low-risk listed medicines (TGA safety advisory; TGA 2026 decision). Avoid in pregnancy (animal findings on reproductive effects are conflicting, and there are no adequate human data). Stop use and seek care immediately for any sign of allergic reaction.

FAQs

Is kalmegh the same as bhunimba?

Yes: both are names for Andrographis paniculata. On this site, our Bhunimba article covers the modern clinical evidence for respiratory infections plus full safety details, while this Kalmegh article covers the classical Ayurvedic entry (liver, fever, worms) and the older hepatitis work. Read both for the complete picture.

Is kalmegh good for the liver?

Traditionally it is the classic Ayurvedic liver herb (yakritshodhaka), but human proof is missing. The human liver evidence is an uncontrolled 1982 series of kalmegh decoction in infective hepatitis: no control group, so recovery cannot be credited to the herb (Chaturvedi et al., 1982): plus a small 2013 clinical comparison versus a control group. The rest of the liver evidence is animal studies.

What did the 1982 hepatitis study actually show?

Patients given kalmegh decoction showed improved liver-function tests (bilirubin, SGOT, SGPT, alkaline phosphatase) and symptomatic improvement, with 80% assessed as cured (Chaturvedi et al., 1982). Without a control group, this shows only that patients who took kalmegh got better: not that kalmegh caused it.

What is the right dose of kalmegh for the liver?

There is none established. The hepatitis study did not report its decoction dose, and no pharmacopoeial dose was verified in the sources reviewed. Do not guess a dose.

Is kalmegh safe?

See the full safety section in our Bhunimba article: the key warning is the risk of sudden severe allergic reactions (anaphylaxis), per Australia's TGA advisory, plus the standard cautions for pregnancy and medication interactions.

Can I take kalmegh for colds and cough?

That is the one area with real trial data: but it belongs to our Bhunimba article, which covers the 33-trial meta-analysis and the paracetamol-comparison trial in detail.

Sources

Disclaimer

This article is for educational purposes only and is not medical advice. Herbal products can interact with medications and are not suitable for everyone. Talk to a qualified healthcare practitioner before use — especially if you are pregnant, breastfeeding, managing a medical condition, or taking prescription medicines.