Boswellia Serrata + Amitriptyline, Perphenazine
Amitriptyline, Perphenazine brand names: Triavil, Etrafon, Etrafon-A, Etrafon-Forte.
Amitriptyline, Perphenazine falls into 5 drug categories that Boswellia Serrata can interact with; the most serious is rated moderate. Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.
Read the full interaction reportBoswellia Serrata and Amitriptyline, Perphenazine
These two interact in 5 distinct ways. Each one is explained separately below.
Why Are There 5 Interactions?
Boswellia Serrata interacts with whole categories of medication. Amitriptyline, Perphenazine falls into 5 of those categories, so it can interact with Boswellia Serrata in 5 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
1 of 5Why this applies to Amitriptyline, Perphenazine
Amitriptyline, Perphenazine falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Boswellia Serrata interacts with.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2D6 enzymes.
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.
This combination pill pairs amitriptyline (an older antidepressant) with perphenazine (an antipsychotic). Both rely partly on a liver enzyme called CYP2D6 to be broken down and cleared from your body. In test-tube studies, boswellia appears to slow that enzyme down a bit. If that happened in real life, these medicines could build up a little higher than usual, which might mean more of their typical side effects.
For amitriptyline that can look like extra drowsiness, dry mouth, constipation, blurry vision, or feeling lightheaded when you stand. With perphenazine, you might notice more sedation or muscle stiffness. Keep in mind this is only a theoretical concern from lab work, not proven in people, so it is likely mild. Still, mention the boswellia to your pharmacist or doctor so they can keep an eye on how you feel.
- 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 PubMed
CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES
2 of 5Amitriptyline, Perphenazine also falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C19 enzymes.
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.
This combo pill pairs amitriptyline (a tricyclic antidepressant) with perphenazine (an antipsychotic). Your body partly relies on a liver enzyme called CYP2C19 to clear amitriptyline. In a test-tube study, boswellia appeared to slow that enzyme down. If that holds true in people, amitriptyline could clear a bit more slowly and build up, which might mean more of its usual effects like drowsiness, dry mouth, constipation, blurred vision, dizziness on standing, or a faster heartbeat.
Here's the reassuring part: this is only a theoretical concern based on lab data, not real patient reports, so the risk is likely small. Still, since this medication has a fairly narrow safe range, I'd mention the boswellia to your pharmacist or doctor before starting it.
- 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 PubMed
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
3 of 5Amitriptyline, Perphenazine also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.
In vitro research shows that Boswellia serrata gum resin inhibits CYP1A2 enzymes.
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.
This combination pill pairs amitriptyline (an antidepressant) with perphenazine (an antipsychotic). Amitriptyline is partly cleared by a liver enzyme called CYP1A2. In lab dishes, boswellia appears to slow that same enzyme down. If that effect carried over in real life, your body might break amitriptyline down a little slower, letting its levels creep up.
What that could feel like is more of amitriptyline's usual side effects: drowsiness, dry mouth, constipation, blurred vision, dizziness on standing, or a faster heartbeat. Here's the honest part, though. This warning is only theoretical, based on test-tube data, not on people. It may not amount to much. Still, since this is a sedating medicine, it's worth a quick chat with your pharmacist or doctor before adding boswellia.
- 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 PubMed
CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES
4 of 5Amitriptyline, Perphenazine also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C9 enzymes.
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.
Here's the gist with this combo pill (which pairs amitriptyline, an antidepressant, with perphenazine, an antipsychotic). Lab studies hint that boswellia can slow down a liver enzyme called CYP2C9, which is one of the pathways your body uses to clear these medicines. If that pathway slows, a bit more of the drug could linger in your system, which might nudge up the usual side effects.
For this medication, that could mean more drowsiness, dry mouth, constipation, dizziness on standing, or blurred vision. I want to be honest though: this is theoretical, based only on test-tube research, not real patients. So it's a maybe, not a sure thing. Still, since both ingredients can already make you sleepy, it's worth a quick chat with your pharmacist or doctor before adding boswellia.
- 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 PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
5 of 5Amitriptyline, Perphenazine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research shows that Boswellia serrata gum resin inhibits CYP3A4 enzymes. Other in vitro research shows that Boswellia serrata extract inhibits CYP3A4 enzymes at most concentrations, although it may modestly induce enzyme activity at low concentrations.
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.
This combination pill pairs amitriptyline (an older antidepressant) with perphenazine (an antipsychotic). Both are partly cleared by a liver enzyme called CYP3A4. Boswellia, in test-tube studies, mostly seems to slow that enzyme down, which could in theory let these medicines build up a bit more than usual. If that happened, you might notice stronger versions of their typical side effects, like drowsiness, dry mouth, constipation, blurry vision, dizziness on standing, or feeling unusually groggy.
I want to keep this in perspective, though. The concern here is theoretical, based only on lab data, not real patient reports, and the effect could even go the other way at low levels. So I'd flag it, not panic over it. Just give your pharmacist or doctor a heads-up before adding Boswellia so they can keep an eye on how you feel.
- 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 PubMed
- Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
- ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
- 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.
- UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
- AHigh-quality meta-analysis (quantitative systematic review).
- BCase-control study.
- CConsensus.
- DAnecdotal evidence.
These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.
Boswellia Serrata Also Interacts With Other Medications
Boswellia Serrata has 951 moderate known drug interactions in our database — the Amitriptyline, Perphenazine one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Boswellia Serrata
We haven’t checked that one against Boswellia Serrata yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Boswellia Serrata. Pick one to open its full report.
See Every Supplement That Interacts With Amitriptyline, Perphenazine
This page covers Boswellia Serrata only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amitriptyline, Perphenazine page lists 311 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), American Hellebore (major), Arsenic (major) and Beer (major).
By severity: 19 major · 235 moderate · 57 minor.
From our pharmacist’s overview on the Amitriptyline, Perphenazine page
“Alcohol is the risk I'd flag first for anyone taking amitriptyline with perphenazine (Triavil, Etrafon). Beer and wine both carry major ratings here, and 78 of the 311 ingredients on file deepen the drowsiness this antidepressant and antipsychotic combination already causes, sometimes to the point of slowed breathing.”
Reviewed by 2 · Jul 18, 2026
Taking Boswellia Serrata as Part of a Dietary Supplement Product? Check It for Interactions
We hold 1,914 real supplement products containing Boswellia Serrata, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Boswellia Serrata. Your product may carry other ingredients that interact with Amitriptyline, Perphenazine too, on top of Boswellia Serrata — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Boswellia Serrata and Amitriptyline, Perphenazine 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.
#93 of 1,452 supplements looked up here in the last 7 days
#1,070 of 2,830 medications looked up here in the last 7 days
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.
About Boswellia Serrata
What is Boswellia Serrata?
- Osteoarthritis joint pain
- Rheumatoid arthritis
- Inflammation
- Asthma
- Inflammatory bowel conditions
Boswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoarthritis symptoms, but the overall evidence is limited and more research is needed. It is generally well tolerated, but you should check with your pharmacist or doctor before using it, especially during pregnancy or breastfeeding.
Other Drugs & Boswellia Serrata
Browse every other medication we’ve checked against Boswellia Serrata — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
951 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Hydrocortisone ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Miconazole ›
- Morphine Sulfate ›
- Trimipramine ›
- Acetaminophen ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Lofepramine ›
- Medroxyprogesterone ›
- Medroxyprogesterone Acetate ›
- Meloxicam ›
- Nortriptyline ›
- Propoxyphene ›
- Rifampin ›
- Testosterone Undecanoate ›
- Aripiprazole ›
Showing 60 of 951 moderate interactions — see all 951 on the Boswellia Serrata page.
No interaction 1,878 drugs checked — show the list
We also checked Boswellia Serrata against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Aspirin ›
- Ivermectin ›
- Rosuvastatin ›
- Escitalopram ›
- Docusate ›
- Valacyclovir ›
- Hydroxyurea ›
- Sumatriptan ›
- Semaglutide ›
- Tirzepatide ›
- Bupropion ›
- Metformin ›
- Amoxicillin ›
- Lisinopril ›
- Acyclovir ›
- Doxycycline ›
- Methotrexate ›
- Lamotrigine ›
- Gabapentin ›
- Pregabalin ›
- Azithromycin ›
- Isotretinoin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Mannitol ›
- Cephalexin ›
- Roxithromycin ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Pegunigalsidase Alfa-iwxj ›
- Daptomycin ›
- Hexobarbitone ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Levetiracetam ›
- Spironolactone ›
- Factor 7a ›
- Phentermine, Topiramate ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Minoxidil ›
- Mitomycin ›
- Levodopa ›
- Ezetimibe ›
- Cefaclor ›
- Phenylephrine ›
- Vancomycin ›
- Lenvatinib ›
- Hethylphenidate Hcl ›
- Dirithromycin ›
- Pentobarbitone ›
- Bentoquatam ›
- Procainamide ›
- Hydroxychloroquine ›
- Amoxicillin, Clavulanate Potassium ›
- Tenecteplase ›
Showing the 60 most looked-up of 1,878 medications checked with no known interaction — see the full Boswellia Serrata list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
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
Amitriptyline, Perphenazine Is Linked to Lower Levels of 3 Nutrients
Natural Medicines records Amitriptyline, Perphenazine as a medicine that can lower these. This is not an interaction with Boswellia Serrata — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Amitriptyline, Perphenazine nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Boswellia Serrata and Amitriptyline, Perphenazine Together: Common Questions
Can you take Boswellia Serrata with Amitriptyline, Perphenazine?
Why are there 5 interactions listed for Boswellia Serrata and Amitriptyline, Perphenazine?
How serious is the Boswellia Serrata and Amitriptyline, Perphenazine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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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.