Andrographolide is the main active constituent of Andrographis paniculata, a plant traditionally used in Ayurvedic and Chinese medicine for treating infections and inflammation. Its use for supporting or treating colds, especially those accompanied by fever, has been investigated in several clinical studies and systematic reviews.

Randomized controlled trials (RCTs) and meta-analyses indicate that standardized Andrographis paniculata extracts (often containing a defined amount of andrographolide) can reduce the severity and duration of cold symptoms, including sore throat, cough, and fever, compared to placebo. A 2017 Cochrane review and other systematic reviews found moderate-quality evidence that Andrographis preparations are more effective than placebo and possibly as effective as standard therapies for symptomatic relief of uncomplicated upper respiratory tract infections (URTIs).

Proposed mechanisms for these effects include immunomodulatory actions, anti-inflammatory activity, and possible antiviral effects, though the exact mechanism in humans remains under investigation. The evidence is limited by heterogeneity in product composition, dosing, and study quality; most studies are short-term and focus on mild to moderate URTIs. Nevertheless, the consistency of results across trials supports its use, especially in settings where conventional therapies are not available or tolerated.

In summary, while further high-quality studies are needed, there is scientific support for the use of andrographolide-containing preparations in reducing symptoms of colds with fever, with an evidence strength of moderate quality.