Boswellia Serrata - Caplyta (Lumateperone) Interaction

Interaction Details

Lumateperone is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of 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 Rating

Likelihood of Occurrence

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.

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
• 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.

Interaction Details

Lumateperone is classified as belonging to the following category: Immunosuppressants

Theoretically, Boswellia serrata might alter the effects of immunosuppressive drugs.
Some in vitro research suggests that Boswellia serrata extracts might inhibit mediators of autoimmune disorders such as leukotrienes and reduce production of antibodies and cell-mediated immunity. However, other in vitro research suggests that, when coupled with calcium ions, boswellic acids containing the keto group have immunostimulant properties within specific cell signaling pathways.

Interaction Rating

Likelihood of Occurrence

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

References

• Kimmatkar N, Thawani V, Hingorani L, et al. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee--a randomized double blind placebo controlled trial. Phytomedicine 2003;10:3-7.
• Liu JJ, Nilsson A, Oredsson S, et al. Boswellic acids trigger apoptosis via a pathway dependent on caspase-8 activation but independent on Fas/Fas ligand interaction in colon cancer HT-29 cells. Carcinogenesis 2002;23:2087-93.
• Wildfeuer A, Neu IS, Safayhi H, et al. Effects of boswellic acids extracted from a herbal medicine on the biosynthesis of leukotrienes and the course of experimental autoimmune encephalomyelitis. Arzneimittelforschung 1998;48:668-74.
• Gupta I, Parihar A, Malhotra P, et al. Effects of gum resin of Boswellia serrata in patients with chronic colitis. Planta Med 2001;67:391-5.
• Altmann A, Poeckel D, Fischer L, et al. Coupling of boswellic acid-incuded Ca2+ mobilisation and MAPK activation to lipid metabolism and peroxide formation in human leucocytes. Br J Pharmacol 2004;141:223-32.

Lumateperone Overview

• Lumateperone is used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions). Lumateperone is in a class of medications called atypical antipsychotics. It works by changing the activity of certain natural substances in the brain.

Boswellia Serrata - More Interactions

Boswellia Serrata interacts with 922 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.