Interaction Details

Venetoclax 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

Moderate

Likelihood of Occurrence

Possible

Interaction 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.

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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

Boswellia Serrata Boswellia serrata is a tree that is native to regions of India, Nepal, and Pakistan. It is also known commonly as Indian frankincense or simply, boswellia. The tree is known for producing a resin, which is used in traditional medicine and in the production of incense and perfumes. The gum resin and the bark of Boswellia serrata are used in traditional medicine as a natural remedy for a variety of health conditions, including inflammation, joint pain, and asthma. It is believed to have anti-inflammatory properties and may be useful in reducing inflammation and swelling in the joints.
See More Information Regarding Boswellia Serrata

Venetoclax Overview

  • Venetoclax is used alone or in combination with obinutuzumab (Gazyva) or rituximab (Rituxan) to treat certain types of chronic lymphocytic leukemia (CLL; a type of cancer that begins in the white blood cells) or certain types of small lymphocytic lymphoma (SLL; a type of cancer that begins mostly in the lymph nodes). It is also used in combination with either azacitidine (Vidaza), decitabine (Dacogen), or cytarabine as a first treatment for acute myeloid leukemia (AML; a type of cancer that begins in the white blood cells) in people 75 years of age or older, or in adults who have medical conditions that prevents them from being treated with other chemotherapy medications. Venetoclax is in a class of medications called B-cell lymphoma-2 (BCL-2) inhibitors. It works by blocking the action of a certain protein in the body that helps cancer cells survive. This helps to kill cancer cells.

See More Information Regarding Venetoclax

Boswellia Serrata - More Interactions

Boswellia Serrata interacts with 902 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.

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In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!

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