Boswellia Serrata + Benzhydrocodone, Acetaminophen
Benzhydrocodone, Acetaminophen brand name: Apadaz.
Benzhydrocodone, Acetaminophen 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 Benzhydrocodone, Acetaminophen
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. Benzhydrocodone, Acetaminophen 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 Benzhydrocodone, Acetaminophen
Benzhydrocodone, Acetaminophen 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 a wrinkle worth knowing about Apadaz. Benzhydrocodone is a prodrug, meaning your body has to convert it into hydrocodone (the part that actually relieves pain) using an enzyme called CYP2D6. Lab studies hint that boswellic acids in Boswellia may slow that enzyme down. If that happens, your body might make a little less active hydrocodone, so you could feel less pain relief than expected.
I want to be honest about how soft this evidence is. It comes only from test-tube research, not from real people, so it may not matter much in practice. Still, if you take Apadaz for pain and want to add Boswellia, run it by your pharmacist or doctor first so they can keep an eye on how well your pain is controlled.
- 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 3Benzhydrocodone, Acetaminophen 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.
Here's the gist for Apadaz (benzhydrocodone with acetaminophen). Lab studies hint that boswellia may slow down a liver enzyme called CYP1A2. In theory, blocking an enzyme that helps clear a drug could let that drug build up a bit. With this particular opioid combo, more drug hanging around could mean stronger effects like drowsiness, dizziness, constipation, or slowed breathing.
That said, I want to be honest: this is a theoretical concern based only on test-tube data, not real patient reports, and CYP1A2 isn't even the main pathway for these ingredients. So I wouldn't lose sleep over it. Still, since this opioid is potent, it's worth a quick word with your pharmacist or doctor before pairing the two.
- 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 3Benzhydrocodone, Acetaminophen 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 something worth knowing about Apadaz (benzhydrocodone with acetaminophen). The benzhydrocodone part is actually a prodrug, meaning your body has to convert it into active hydrocodone before it does much. That conversion isn't the main concern here, but the CYP3A4 enzyme does help break hydrocodone down afterward. Boswellia, in lab studies, appears to mildly block CYP3A4.
So in theory, if Boswellia slows that enzyme, you could end up with a bit more opioid hanging around. That might mean stronger drowsiness, constipation, or slowed breathing. I want to be honest though: this is only based on test-tube research, not real people, so the actual risk is uncertain. Still, since opioids carry real stakes, please mention the Boswellia to your pharmacist or doctor before combining them.
- 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 Benzhydrocodone, Acetaminophen 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 Benzhydrocodone, Acetaminophen
This page covers Boswellia Serrata only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Benzhydrocodone, Acetaminophen page lists 299 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 Gamma-hydroxybutyrate (ghb) (major).
By severity: 14 major · 239 moderate · 46 minor.
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 Benzhydrocodone, Acetaminophen 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 Benzhydrocodone, Acetaminophen 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.
#100 of 1,452 supplements looked up here in the last 7 days
#2,389 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.
About Benzhydrocodone and Acetaminophen
What Is Benzhydrocodone and Acetaminophen Used For?
Brand name: Apadaz
Apadaz is indicated for the short-term management of acute pain — up to 14 days — that is severe enough to require an opioid and for which non-opioid treatments have not worked or are not expected to work. It combines benzhydrocodone (a prodrug that converts to the opioid hydrocodone) with acetaminophen.
Because of serious risks including addiction, abuse, and misuse, Apadaz is reserved for patients who have not tolerated or have not gotten adequate relief from alternative pain treatments. It should not be used for an extended period of time unless the pain remains severe enough to require an opioid and alternatives remain inadequate.
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 ›
- Aspirin ›
- Rosuvastatin ›
- Escitalopram ›
- Docusate ›
- Tirzepatide ›
- Hydroxyurea ›
- Valacyclovir ›
- Semaglutide ›
- Sumatriptan ›
- Metformin ›
- Amoxicillin ›
- Lisinopril ›
- Methotrexate ›
- Bupropion ›
- Isotretinoin ›
- Doxycycline ›
- Acyclovir ›
- Azithromycin ›
- Pregabalin ›
- Lamotrigine ›
- Gabapentin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Candesartan Cilexetil ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Amoxicillin, Clavulanate Potassium ›
- Cyclopentolate ›
- Cephalexin ›
- Mannitol ›
- Roxithromycin ›
- Levetiracetam ›
- Ezetimibe ›
- Phentermine, Topiramate ›
- Acetylsalicylic Acid ›
- Dexmethylphenidate ›
- Levothyroxine Sodium ›
- Carbidopa, Levodopa ›
- Thyroid Hormone ›
- Spironolactone ›
- Daptomycin ›
- Pizotifen ›
- Pegunigalsidase Alfa-iwxj ›
- Mitomycin ›
- Hexobarbitone ›
- Levodopa ›
- Cefaclor ›
- Bentoquatam ›
- Factor 7a ›
- Flutemetamol F-18 ›
- Hethylphenidate Hcl ›
- Magnesium Hydroxide (otc Drug) ›
- Alglucosidase Alpha ›
- Insulin Degludec, Liraglutide ›
- Azelaic Acid ›
- Minoxidil ›
- Canagliflozin, Metformin ›
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
Benzhydrocodone, Acetaminophen Is Linked to Lower Levels of One Nutrient
Natural Medicines records Benzhydrocodone, Acetaminophen 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 Benzhydrocodone, Acetaminophen 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 Benzhydrocodone, Acetaminophen Together: Common Questions
Can you take Boswellia Serrata with Benzhydrocodone, Acetaminophen?
Why are there 3 interactions listed for Boswellia Serrata and Benzhydrocodone, Acetaminophen?
How serious is the Boswellia Serrata and Benzhydrocodone, Acetaminophen interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Benzhydrocodone, Acetaminophen and Boswellia Serrata?
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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.