Drug & supplement interaction

Andrographis + Mesalamine

Mesalamine brand names: Pentasa, Asacol, Canasa, Rowasa, Lialda, and others.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Andrographis and Mesalamine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Mesalamine states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Andrographis and Mesalamine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Mesalamine and Andrographis in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Andrographis safety at a glance

Andrographis overall Use caution Often well tolerated short-term, but quality of products and long-term safety are not well established.
Pregnancy Possibly Unsafe When used orally. Andrographis is thought to have abortifacient effects; avoid using. Read the full pregnancy detail
Breastfeeding Avoid Not enough safety information, so avoid use while breastfeeding.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Mesalamine and Andrographis? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Mesalamine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Mesalamine is filed under a single classification — oral drugs. Andrographis has documented interactions with 6 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), antihypertensive drugs (moderate) and immunosuppressants (moderate) — and none of Mesalamine’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Andrographis Does Interact With Other Medications

Andrographis has 408 moderate, 5 minor known drug interactions in our database — Mesalamine isn’t one of them. If you take anything else, check it against the full list below.

Moderate 408 Minor 5 No known interaction 2,417 (incl. Mesalamine)
Taking anything else?

Check Another of Your Medications Against Andrographis

Covers the 2,830 medications we’ve checked against Andrographis. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Andrographis and Mesalamine May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 2 of them are worth acting on rather than waiting out — marked below.

  • Liver problems Worth acting on Additional detail

    Andrographis

    “Orally, there is one case report of hepatitis associated with andrographis use.”

    Andrographis · Natural Medicines adverse-effect record, reported in hepatitis.

    1 source cited
    1. 91841. Suwankesawong W, Saokaew S, Permsuwan U, et al. Characterization of hypersensitivity reactions reported among Andrographis paniculata users in Thailand using Health Product Vigilance Center (HPVC) database. BMC Complement Altern Med. 2014; 14:515. PubMed

    Mesalamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Mesalamine. Read the label on DailyMed ›

  • An allergic reaction Worth acting on Additional detail

    Andrographis

    “Orally, andrographis is generally well tolerated. Adverse effects are more likely when doses reach or exceed 5-10 mg/kg of andrographolide content and when treatment duration exceeds 14 days.

    Most Common Adverse Effects:

    Orally: Abdominal discomfort, altered taste, diarrhea, dizziness, fatigue, headache, nausea and vomiting, pruritus, rash, and urticaria.

    Serious Adverse Effects (Rare):

    Orally: Severe allergic reacti…”

    Andrographis · Natural Medicines adverse-effect record, reported in cluster headache.

    Mesalamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Mesalamine. Read the label on DailyMed ›

  • Bloating or gas Additional detail

    Andrographis

    “Orally, andrographis has been reported to cause nausea, vomiting, diarrhea, dyspepsia, flatulence, altered or metallic taste, and abdominal discomfort. Andrographis intake has also been reported to cause epigastric pain, ulcerative stomatitis, melena, dry mouth, and dry lips.

    Parenterally, there have been reports of diarrhea, nausea, vomiting, and abdominal discomfort with the use of andrographolide derivative inject…”

    Andrographis · Natural Medicines adverse-effect record, reported in diarrhea.

    6 sources cited
    1. 6767. Calabrese C, Berman SH, Babish JG, et al. A phase I trial of andrographolide in HIV positive patients and normal volunteers. Phytother Res 2000;14:333-8. PubMed
    2. 31213. Kligler, B., Ulbricht, C., Basch, E., Kirkwood, C. D., Abrams, T. R., Miranda, M., Singh Khalsa, K. P., Giles, M., Boon, H., and Woods, J. Andrographis paniculata for the treatment of upper respiratory infection: a systematic review by the natural standa
    3. 2748. Thamlikitkul V, Dechatiwongse T, Theerapong S, et al. Efficacy of Andrographis paniculata, Nees for pharyngotonsillitis in adults. J Med Assoc Thai 1991;74:437-42.
    4. 13016. Coon JT, Ernst E. Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy. Planta Med 2004;70:293-8.
    5. 31220. Burgos, R. A., Hancke, J. L., Bertoglio, J. C., Aguirre, V., Arriagada, S., Calvo, M., and Caceres, D. D. Efficacy of an Andrographis paniculata composition for the relief of rheumatoid arthritis symptoms: a prospective randomized placebo-controlled tria
    6. 31222. Saxena, R. C., Singh, R., Kumar, P., Yadav, S. C., Negi, M. P., Saxena, V. S., Joshua, A. J., Vijayabalaji, V., Goudar, K. S., Venkateshwarlu, K., and Amit, A. A randomized double blind placebo controlled clinical evaluation of extract of Andrographis pa

    Mesalamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Mesalamine. Read the label on DailyMed ›

  • Diarrhea / Vomiting Additional detail

    Andrographis

    Recorded for Andrographis in the same Natural Medicines adverse-effect record shown under An allergic reaction above.

    Mesalamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Mesalamine. Read the label on DailyMed ›

  • Headache Additional detail

    Andrographis

    “Orally, andrographis has been reported to cause headache, fatigue, anorexia, somnolence, insomnia, lethargy, malaise, and drowsiness. Headache and fatigue occurred more often with high doses of the andrographolide constituent (5-10 mg/kg daily) in one clinical trial.”

    Andrographis · Natural Medicines adverse-effect record, reported in anorexia.

    6 sources cited
    1. 2748. Thamlikitkul V, Dechatiwongse T, Theerapong S, et al. Efficacy of Andrographis paniculata, Nees for pharyngotonsillitis in adults. J Med Assoc Thai 1991;74:437-42.
    2. 5784. Melchoir J, Spasov AA, Ostrovskij OV, et al. Double-blind, placebo-controlled pilot and phase III study of activity of standardized Andrographis paniculata Herba Nees extract fixed combination (Kan Jang) in the treatment of uncomplicated upper-respirator
    3. 6767. Calabrese C, Berman SH, Babish JG, et al. A phase I trial of andrographolide in HIV positive patients and normal volunteers. Phytother Res 2000;14:333-8. PubMed
    4. 10795. Gabrielian ES, Shukarian AK, Goukasova GI, et al. A double blind, placebo-controlled study of Andrographis paniculata fixed combination Kan Jang in the treatment of acute upper respiratory tract infections including sinusitis. Phytomedicine 2002;9:589-97 PubMed
    5. 12380. Poolsup N, Suthisisang C, Prathanturarug S, et al. Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract infection: systematic review of randomized controlled trials. J Clin Pharm Ther 2004;29:37-45. PubMed
    6. 13016. Coon JT, Ernst E. Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy. Planta Med 2004;70:293-8.

    Mesalamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Mesalamine. Read the label on DailyMed ›

Reported for Andrographis but not commonly for Mesalamine: a severe skin reaction, stomach upset, sweating and a severe allergic reaction.

Effects for Mesalamine come from the ADVERSE REACTIONS section of its FDA label; effects for Andrographis come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Andrographis in Pregnancy & Breastfeeding

Pregnancy Possibly Unsafe

When used orally. Andrographis is thought to have abortifacient effects; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Mesalamine Products Have a Food Rule — Andrographis Should Not Break It

At least one FDA label for a product containing Mesalamine says to take it with food. If you take Andrographis on an empty stomach out of habit, keep them separate — and take Mesalamine with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Mesalamine products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

( 2 ) Administer mesalamine delayed-release tablets with food.

From the Dosage and Administration section of the FDA label we read for Mesalamine — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Overlapping uses

What Mesalamine Is Prescribed For, and What Andrographis Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Mesalamine is a prescription medicine with approved uses on its FDA label. Andrographis is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Mesalamine is prescribed for: Mesalamine is used to treat mildly to moderately active ulcerative colitis — a condition where the lining of the large intestine becomes inflamed and ulcerated. Depending on the product and formulation, it can be used to bring the disease under control (induction of remission) and/or to keep it from coming back (maintenance of remission). Different products target different parts of the lower digestive tract. Oral forms (tablets and capsules) treat the colon more broadly.

Read the rest of what Mesalamine is prescribed for

Rectal forms — including enemas (ROWASA, sfROWASA, mesalamine rectal suspension) — are used for distal ulcerative colitis, proctosigmoiditis, or proctitis (inflammation limited to the lower end of the colon or rectum). Rectal suppositories (CANASA, mesalamine rectal suppositories) are specifically for ulcerative proctitis (inflammation of the rectum only).

Andrographis has been studied for:

  • Ulcerative colitis Natural Medicines rates the evidence for Andrographis: Possibly Effective Read what the research shows

    Andrographis for ulcerative colitis

    Oral andrographis extract has been evaluated for the management of ulcerative colitis symptoms, with promising results.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Mesalamine on your own; if you are taking Andrographis for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Andrographis or Mesalamine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Andrographis or Mesalamine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Mesalamine

This page covers Andrographis only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Mesalamine page lists 17 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 7 moderate · 9 minor.

From our pharmacist’s overview on the Mesalamine page

“Activated charcoal is the one entry here I would treat as a genuine problem for anyone taking mesalamine (Asacol, Lialda, Pentasa, and others). It is the lone major-rated interaction among the 17 on file, because charcoal soaks up drugs in the gut and can pull mesalamine out of the picture before it does its job.”

Reviewed by 2 · Jul 18, 2026

Open the Mesalamine interaction page

One more smart check

Taking Andrographis as Part of a Dietary Supplement Product? Check It for Interactions

We hold 656 real supplement products containing Andrographis, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Andrographis. Even though Andrographis itself has no known interaction with Mesalamine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Andrographis and Mesalamine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Andrographis
Top 25%

#160 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Mesalamine
Steady interest

#1,494 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Andrographis reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Andrographis and Mesalamine records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Andrographis

What is Andrographis?

Andrographis
  • Common cold and flu symptoms
  • Upper respiratory infections
  • Sore throat
  • Fever
  • Immune support
  • Digestive complaints

Andrographis is a bitter Asian herb traditionally used for colds, flu, and infections, and some studies suggest it may ease cold symptoms and shorten how long they last. The evidence is limited and the quality of studies varies, so it should not replace standard care. Talk to your pharmacist or doctor before using it, and avoid it during pregnancy.

Andrographis paniculata · Acanthaceae · Leaves and above-ground (aerial) parts · Capsules, tablets, tinctures, teas, and standardized extracts

An interaction check asks whether these two react with each other — it does not ask whether Andrographis is a good idea for someone in your situation. Here is what our Andrographis record says about it on its own.

Andrographis: dosing

There is no single official or standardized dose of Andrographis. Products differ in how they are made and in how much andrographolide they contain, which makes general dosing recommendations difficult.Many cold-related products are standardized to a specific amount of andrographolide and are usually taken for a short period at the start of symptoms.

From our Andrographis monograph — the full record covers uses, side effects and every documented interaction.

Read the full Andrographis monograph & all interactions
Medication

About Mesalamine

What Is Mesalamine Used For?

Brand names: Pentasa, Asacol, Canasa, Rowasa, Lialda, Delzicol

Mesalamine is used to treat mildly to moderately active ulcerative colitis — a condition where the lining of the large intestine becomes inflamed and ulcerated. Depending on the product and formulation, it can be used to bring the disease under control (induction of remission) and/or to keep it from coming back (maintenance of remission).

Different products target different parts of the lower digestive tract. Oral forms (tablets and capsules) treat the colon more broadly. Rectal forms — including enemas (ROWASA, sfROWASA, mesalamine rectal suspension) — are used for distal ulcerative colitis, proctosigmoiditis, or proctitis (inflammation limited to the lower end of the colon or rectum). Rectal suppositories (CANASA, mesalamine rectal suppositories) are specifically for ulcerative proctitis (inflammation of the rectum only).

See full Mesalamine drug information
Keep checking

Other Drugs & Andrographis

Browse every other medication we’ve checked against Andrographis — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
408Moderate
5Minor
2,416No known interaction
408 Moderate 5 Minor 2,416 No interaction
Moderate

408 interactions

Showing 60 of 408 moderate interactions — see all 408 on the Andrographis page.

Minor

5 interactions

No interaction 2,416 drugs checked — show the list

We also checked Andrographis against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,416 medications checked with no known interaction — see the full Andrographis list.

See the full Andrographis interactions page
See every supplement checked against Mesalamine, ranked by severity
Evidence & sources

Andrographis References

The 26 references that drive our Andrographis monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Thamlikitkul V, Dechatiwongse T, Theerapong S, et al. Efficacy of Andrographis paniculata, Nees for pharyngotonsillitis in adults. J Med Assoc Thai 1991;74:437-42.
  3. Zhang CY, Tan BK. Mechanisms of cardiovascular activity of Andrographis paniculata in the anaesthetized rat. J Ethnopharmacol 1997;56:97-101. PubMed
  4. Zhao HY, Fang WY. Antithrombotic effects of Andrographis paniculata nees in preventing myocardial infarction. Chin Med J (Engl) 1991;104:770-5.
  5. Amroyan E, Gabrielian E, Panossian A, et al. Inhibitory effect of andrographolide from Andrographis paniculata on PAF-induced platelet aggregation. Phytomedicine 1999;6:27-31. PubMed
  6. Zhang C, Kuroyangi M, Tan BK. Cardiovascular activity of 14-deoxy-11,12-didehydroandrographolide in the anaesthetised rat and isolated right atria. Pharmacol Res 1998;38:413-7. PubMed
  7. Puri A, Saxena R, Saxena RP, et al. Immunostimulant agents from Andrographis paniculata. J Nat Prod 1993;56:995-9. PubMed
  8. Melchoir J, Spasov AA, Ostrovskij OV, et al. Double-blind, placebo-controlled pilot and phase III study of activity of standardized Andrographis paniculata Herba Nees extract fixed combination (Kan Jang) in the treatment of uncomplicated upper-respirator
  9. Calabrese C, Berman SH, Babish JG, et al. A phase I trial of andrographolide in HIV positive patients and normal volunteers. Phytother Res 2000;14:333-8. PubMed
  10. Gabrielian ES, Shukarian AK, Goukasova GI, et al. A double blind, placebo-controlled study of Andrographis paniculata fixed combination Kan Jang in the treatment of acute upper respiratory tract infections including sinusitis. Phytomedicine 2002;9:589-97 PubMed
  11. Poolsup N, Suthisisang C, Prathanturarug S, et al. Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract infection: systematic review of randomized controlled trials. J Clin Pharm Ther 2004;29:37-45. PubMed
  12. Coon JT, Ernst E. Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy. Planta Med 2004;70:293-8.
  13. Kligler, B., Ulbricht, C., Basch, E., Kirkwood, C. D., Abrams, T. R., Miranda, M., Singh Khalsa, K. P., Giles, M., Boon, H., and Woods, J. Andrographis paniculata for the treatment of upper respiratory infection: a systematic review by the natural standa
  14. Burgos, R. A., Hancke, J. L., Bertoglio, J. C., Aguirre, V., Arriagada, S., Calvo, M., and Caceres, D. D. Efficacy of an Andrographis paniculata composition for the relief of rheumatoid arthritis symptoms: a prospective randomized placebo-controlled tria
  15. Saxena, R. C., Singh, R., Kumar, P., Yadav, S. C., Negi, M. P., Saxena, V. S., Joshua, A. J., Vijayabalaji, V., Goudar, K. S., Venkateshwarlu, K., and Amit, A. A randomized double blind placebo controlled clinical evaluation of extract of Andrographis pa

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Andrographis and Mesalamine Together: Common Questions

Is it safe to take Andrographis with Mesalamine?
We do not list a known interaction between Andrographis and Mesalamine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Andrographis and Mesalamine have any of the same side effects?
Yes — our sources link each of them separately to 6 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Andrographis and Mesalamine at the same time of day?
At least one FDA label for a product containing Mesalamine says to take it with food. If you take Andrographis on an empty stomach out of habit, keep them separate and take Mesalamine with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Mesalamine products can differ — so check the directions on your own box. This is about absorption, not an interaction.
Are Andrographis and Mesalamine used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Andrographis in each. That is a conversation for your prescriber, especially if Mesalamine is being adjusted to a target.
How was the Andrographis and Mesalamine combination checked?
Interactions in our licensed database are recorded against drug classes. Mesalamine is filed under 1 classification, and Andrographis has documented interactions with 6 drug classes — none of Mesalamine's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Andrographis interact with any other medications?
Yes. Andrographis has 413 documented drug interactions in our database — Mesalamine is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Mesalamine interact with any supplements?
Yes. Mesalamine has documented interactions with 17 supplements in our database — Andrographis is not one of them. The Mesalamine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Andrographis monograph Uses, safety profile, and every drug interaction in one place Mesalamine drug information The full plain-English guide to this medication Mesalamine supplement interactions Every supplement checked against Mesalamine, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 26 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Mesalamine and Andrographis?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.