Boswellia Serrata + Aspirin, Caffeine, Dihydrocodeine Bitartrate
Aspirin, Caffeine, Dihydrocodeine Bitartrate brand name: Synalgos DC.
Aspirin, Caffeine, Dihydrocodeine Bitartrate falls into 3 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 Aspirin, Caffeine, Dihydrocodeine Bitartrate
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Boswellia Serrata interacts with whole categories of medication. Aspirin, Caffeine, Dihydrocodeine Bitartrate falls into 3 of those categories, so it can interact with Boswellia Serrata in 3 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 3Why this applies to Aspirin, Caffeine, Dihydrocodeine Bitartrate
Aspirin, Caffeine, Dihydrocodeine Bitartrate 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.
Here's the wrinkle with Synalgos DC: the dihydrocodeine part is a prodrug. Your body uses an enzyme called CYP2D6 to turn it into the active painkiller. Lab studies hint that boswellia may slow that same enzyme down. If that happens, you could actually get less pain relief from this medicine, not more, because less of it gets converted to its active form.
I want to be honest about how thin this evidence is. It comes only from test-tube research, not from real people, so it may not amount to much in practice. The aspirin and caffeine pieces aren't really affected here. If you notice your pain isn't controlled as well, don't change anything on your own. Just give your pharmacist or doctor a quick call.
- 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
2 of 3Aspirin, Caffeine, Dihydrocodeine Bitartrate 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.
Of the three ingredients in Synalgos DC, the one that interacts here is the caffeine. Your body relies on a liver enzyme called CYP1A2 to clear caffeine out of your system. In lab dishes, Boswellia appears to slow that enzyme down, so in theory caffeine could hang around a bit longer and add up.
If that happens, you might feel more of caffeine's usual effects: jitteriness, a racing or pounding heart, trouble sleeping, or feeling wired. Keep in mind this is only a theoretical concern based on test-tube research, not real patient reports, so for most folks it is unlikely to be a big deal. The aspirin and dihydrocodeine parts are not affected by this particular pathway. If you take Boswellia regularly, just mention it to your pharmacist or doctor.
- 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
3 of 3Aspirin, Caffeine, Dihydrocodeine Bitartrate 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.
Here's the practical angle on combining Boswellia with Synalgos DC (aspirin, caffeine, and dihydrocodeine). This is a theoretical concern only, based on lab dish studies, not real patients. In those studies, boswellic acids mostly blocked the CYP3A4 enzyme, which helps process the dihydrocodeine portion of this combo. If that slowdown happened in your body, the opioid could linger a bit longer, possibly nudging up effects like drowsiness, constipation, nausea, or feeling lightheaded.
That said, the signal is mixed and weak, and ordinary supplement doses may not change much at all. I wouldn't lose sleep over it, but since this product contains an opioid and aspirin, it's worth a quick mention to your pharmacist or doctor before pairing them, especially if you notice extra grogginess.
- 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 Aspirin, Caffeine, Dihydrocodeine Bitartrate 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 Aspirin, Caffeine, Dihydrocodeine Bitartrate
This page covers Boswellia Serrata only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aspirin, Caffeine, Dihydrocodeine Bitartrate page lists 398 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), Asarabacca (major), Beer (major) and Danshen (major).
By severity: 17 major · 334 moderate · 47 minor.
Open the Aspirin, Caffeine, Dihydrocodeine Bitartrate interaction page
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 Aspirin, Caffeine, Dihydrocodeine Bitartrate 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 Aspirin, Caffeine, Dihydrocodeine Bitartrate 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.
#88 of 1,452 supplements looked up here in the last 7 days
#834 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 ›
- Ivermectin ›
- Rosuvastatin ›
- Aspirin ›
- Escitalopram ›
- Isotretinoin ›
- Tirzepatide ›
- Docusate ›
- Valacyclovir ›
- Metformin ›
- Hydroxyurea ›
- Sumatriptan ›
- Semaglutide ›
- Levothyroxine, Liothyronine ›
- Methotrexate ›
- Amoxicillin ›
- Lisinopril ›
- Bupropion ›
- Azithromycin ›
- Pregabalin ›
- Doxycycline ›
- Gabapentin ›
- Lamotrigine ›
- Acyclovir ›
- Methylene Blue ›
- Ciprofloxacin ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Acetylsalicylic Acid ›
- Aluminum Hydroxide, Aspirin, Magnesium Hydroxide ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Insulin Degludec, Liraglutide ›
- Ezetimibe ›
- Cephalexin ›
- Cyclopentolate ›
- Levetiracetam ›
- Atenolol, Chlorthalidone ›
- Avatrombopag Maleate ›
- Levodopa ›
- Thyroid Hormone ›
- Bendroflumethiazide, Rauwolfia Serpentina ›
- Mannitol ›
- Carbidopa, Levodopa ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Enalapril Maleate ›
- Canagliflozin, Metformin ›
- Aspirin, Butalbital ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Spironolactone ›
- Acarbose ›
- Ephedrine, Phenobarbital, Theophylline ›
- Alginic Acid, Aluminum Hydroxide ›
- Mitomycin ›
- Amobarbital, Ephedrine Sulfate ›
- Roxithromycin ›
- Atenolol ›
- Daunorubicin, Cytarabine ›
- Charcoal (otc Drug) ›
- Levothyroxine Sodium ›
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
Aspirin, Caffeine, Dihydrocodeine Bitartrate Is Linked to Lower Levels of 4 Nutrients
Natural Medicines records Aspirin, Caffeine, Dihydrocodeine Bitartrate 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 Aspirin, Caffeine, Dihydrocodeine Bitartrate 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 Aspirin, Caffeine, Dihydrocodeine Bitartrate Together: Common Questions
Can you take Boswellia Serrata with Aspirin, Caffeine, Dihydrocodeine Bitartrate?
Why are there 3 interactions listed for Boswellia Serrata and Aspirin, Caffeine, Dihydrocodeine Bitartrate?
How serious is the Boswellia Serrata and Aspirin, Caffeine, Dihydrocodeine Bitartrate 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.