Boswellia Serrata - Acetaminophen, Butalbital, Caffeine, Codeine Interaction
Herbal: Boswellia Serrata
Also Known As: Boswellia serrata, Arbre à Oliban Indien, Boswella, Boswellin, Boswellin Serrata Resin, Encens Indien, Gajabhakshya, Indian Frankincense, Oliban Indien, Salai Guggal, Salai Guggul, Sallaki Guggul, Shallaki
Drug: Acetaminophen, Butalbital, Caffeine, Codeine
Brand names:
Esgic with Codeine, Fioricet w/ Codeine
![](https://hellopharmacist.nyc3.digitaloceanspaces.com/images/OBrXo3ni0aNq6p1xr8LXWNogoaVtCExyhTj9MEzw.jpg)
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jun 02, 2024
Interaction Details
Acetaminophen, Butalbital, Caffeine, Codeine is classified as belonging to the following category: Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2D6 enzymes.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Frank A, Unger M. Analysis of frankincense from various Boswellia species with inhibitory activity on human drug metabolising cytochrome P450 enzymes using liquid chromatography mass spectrometry after automated on-line extraction. J Chromatogr A 2006;111
Interaction Details
Acetaminophen, Butalbital, Caffeine, Codeine is classified as belonging to the following category: Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP1A2 enzymes.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Frank A, Unger M. Analysis of frankincense from various Boswellia species with inhibitory activity on human drug metabolising cytochrome P450 enzymes using liquid chromatography mass spectrometry after automated on-line extraction. J Chromatogr A 2006;111
Interaction Details
Acetaminophen, Butalbital, Caffeine, Codeine is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, Boswellia serrata might increase the levels of CYP3A4 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP3A4 enzymes.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
Pharmacist Analysis
The evidence on whether boswellia supplements could cause drug interactions by inhibiting the metabolizing enzyme CYP3A4 is mixed.
Although lab studies have shown that the resin extracted from the boswellia tree, known as frankincense, can mildly inhibit the enzyme, this effect has not been observed in humans (only in a lab setting).
It is worth noting that boswellic acids are specific chemical compounds found in frankincense resin, while frankincense itself is the resin obtained from the Boswellia tree.
Boswellic acids are considered to be the primary anti-inflammatory compounds in boswellia supplements, which are usually standardized based on their boswellic acid content.
Recent research suggests that the inhibitory effect of frankincense on CYP enzymes is not due to boswellic acids, so supplements with high amounts of these acids would be expected to have a lower risk of causing drug interactions than frankincense extracts with lower boswellic acid content. In other words, it appears that other compounds in frankincense are thought to cause CYP3A4 inhibition, not boswellic acids.
Overall, it's important to know about the potential interaction between boswellia supplements (especially those that have a high boswellic acid content) and drugs metabolized by CYP3A4, even though it's generally not considered a serious risk.
References
- Frank A, Unger M. Analysis of frankincense from various Boswellia species with inhibitory activity on human drug metabolising cytochrome P450 enzymes using liquid chromatography mass spectrometry after automated on-line extraction. J Chromatogr A 2006;111
Boswellia Serrata Overview
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Boswellia Serrata - More Interactions
Boswellia Serrata interacts with 920 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.