The herb Australia pulled from its medicines is the one you know as kalmegh

There is a decent chance your household holds it in two places. An andrographis cold and flu tablet from the chemist, bought on a pharmacist’s suggestion or a friend’s. And a bitter dark green powder, or a bottle of tablets carried back from India, labelled kalmegh or kalamegha and kept for fevers and for the liver.

They are the same plant. On 17 September 2026 the Therapeutic Goods Administration removed Andrographis paniculata from the list of ingredients permitted in listed medicines in Australia, after years of reports of severe allergic reactions. This is not a proposal or a consultation. It has taken effect, and the ingredient can no longer go into new listed medicines. Products already on the register are a separate question, and NutraIngredients reports that current ARTG-listed medicines containing andrographis can continue to be supplied.

Why the regulator moved

The TGA’s reasoning, as reported by the ABC, was that waiting carried the greater risk. “The TGA considers that delaying implementation of this change would likely pose an imminent or serious risk of injury to consumers,” the regulator said.

The reports behind that judgement go back two decades. NutraIngredients reported that the TGA had received 287 reports of anaphylaxis linked to medicines containing andrographis as at 31 December 2025, and Australian Pharmacist reported that those reports date from 2005. Reporting in September, the ABC put the total at 1,468 adverse reaction reports across 90 medicines containing the herb.

The TGA, quoted by NutraIngredients, said adverse reactions to andrographis “are unpredictable and can happen the first time someone takes it”.

The regulator had already tried the smaller intervention. Australian Pharmacist reported that earlier measures, including mandatory warning labels introduced in 2019 and a safety alert in 2024, had not meaningfully reduced adverse events.

Professor Connie Katelaris, an immunology professor at Western Sydney University, told the ABC that “the risk far outweighs any benefit” of the herb in supplements.

What it means for what is already in the cupboard

Products bought before the change are still in Australian homes, and the TGA has asked sponsors to act rather than ordering products off shelves itself. Australian Pharmacist reported that the regulator strongly encouraged sponsors to voluntarily cancel their ARTG entry, work with manufacturers to cease manufacturing and release of stock, or undertake a consumer-level recall, and reported that from the middle of October 2026 the regulator would begin regulatory action, including compulsory recalls or cancellation of listings, where they did not. Whether a particular product has since been recalled is a matter for the TGA’s own recall listings, which are updated as decisions are made.

The published counts differ. NutraIngredients reported 75 andrographis-containing medicines on the Australian Register of Therapeutic Goods as at 21 September 2026; Australian Pharmacist put the number of affected listed medicines at about 70. Most are sold as cold, flu and immune support products, and the ABC named ArmaForce and BioCeuticals Clinical Immune Force among them.

The practical step is to read the ingredient panel for Andrographis paniculata rather than to reason from a brand name, and to take anything found there to a pharmacist or a GP.

The case against the andrographis decision

The decision has been criticised from two directions, one academic and one commercial.

Professor Jon Wardle, Professor of Public Health at Southern Cross University and Foundation Director of the National Centre for Naturopathic Medicine, told NutraIngredients the severity of the response surprised researchers. “I think a lot of us were surprised at the severity of the decision,” he said. His objection is methodological. “The decision seems to be based on signal tracing of adverse events alone, but that itself does not provide the story you need,” he said. “The TGA seems to have made a complete and rather drastic decision based on only half the story.” He also pointed out that andrographis use has increased significantly since COVID-19, which he said could have translated to a commensurate increase in adverse events.

John O’Doherty, chief executive of Complementary Medicines Australia, argues the regulator skipped a step. “The question is not whether additional regulatory action was warranted,” he said. “It is whether removal was proportionate before a mandatory, standardized and prominent front-of-pack warning had been implemented across the category, supported by targeted controls, consumer education and more effective monitoring of contributing factors.” Current warnings, he said, “are small, have never been required on the front of the pack, and have never described the symptoms expected or that it may occur unexpectedly.”

Where the two men converge is on what happens after the shelves clear. “Unfortunately, I think what the TGA has done is to inadvertently hand over safety and quality assessments for Andrographis to the online marketplace, which is not really going to protect anyone,” Wardle said. O’Doherty put it in plainer commercial terms, warning that overseas products “carry no Australian quality controls, no mandated warning label, have no Australian sponsor and no mandated obligation to report side effects”.

Wardle’s concern is the online marketplace; O’Doherty’s is overseas product specifically. Between them they describe a purchase moving off a regulated Australian shelf, and O’Doherty names what is missing at the other end.

The label test

A therapeutic good lawfully sold in Australia carries an AUST L number if it is listed, or an AUST R number if it is registered. Victoria’s Department of Health applies that test in its advisory on Ayurvedic medicines, which covers products imported from overseas or purchased in Victoria, telling anyone taking one without an AUST number to stop taking the product immediately. The department’s caution is that there is no guarantee that complementary medicines purchased online, overseas or available in grocery stores, where those products are not on the Australian Register of Therapeutic Goods, have been manufactured to Australian standards of safety and quality.

That test held before this decision and holds after it, whichever way any individual brand goes.

A narrower conclusion than it looks

This is not a verdict on Ayurveda. One regulator assessed one ingredient against one kind of harm, and the criticism includes a public health academic who thinks it was built on too little.

What it does expose is the position the diaspora occupies. A plant can carry centuries of use and a name a grandmother used, and still produce in a small number of people a reaction that nobody can predict in advance. Both of those are true, and a regulator is obliged to act on the second.

If there is andrographis or kalmegh in your house, the conversation to have is with a pharmacist or a GP.