Drug & supplement interaction

Boswellia Serrata + Ramelteon

Ramelteon brand name: Rozerem.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Ramelteon 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 CYP1A2 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Boswellia Serrata and Ramelteon

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. Ramelteon 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).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 3

Why this applies to Ramelteon

Ramelteon falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Boswellia Serrata interacts with.

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP1A2 enzymes.
Severity Moderate Likelihood Possible Evidence D

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for your sleep aid. Ramelteon (Rozerem) is cleared from your body mainly by a liver enzyme called CYP1A2. In lab studies (test tube only), boswellic acids from Boswellia appear to slow that same enzyme down. If that happened in real life, ramelteon could clear a bit more slowly and build up, which might make you feel more drowsy, groggy, or dizzy than usual, especially the next morning.

I want to be honest about the strength of this, though. This is theoretical, based only on early laboratory work, not on people taking both together. So I wouldn't lose sleep over it. Just give your pharmacist or doctor a heads-up before combining them so they can keep an eye on how rested you feel.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 3

Ramelteon also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, Boswellia serrata might increase the levels of CYP2C9 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C9 enzymes.
Severity Moderate Likelihood Possible Evidence D

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for Rozerem (ramelteon). Your liver uses certain enzymes to break this sleep aid down and clear it out. Lab studies hint that boswellic acids in Boswellia may slow one of those enzymes (CYP2C9). If that happened in the body, ramelteon could hang around a bit longer and feel stronger than usual.

In real life, that might mean more next-morning grogginess, drowsiness, or feeling foggy or dizzy. I want to be honest though: this is theoretical, based only on test-tube research, not on people taking the two together. So it's a possibility, not a proven problem. If you'd like to try Boswellia for joint pain while on ramelteon, just run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

Ramelteon also falls under 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.
Severity Moderate Likelihood Possible Evidence D

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the situation with Boswellia and Rozerem (ramelteon). Your body relies on an enzyme called CYP3A4 to break ramelteon down, and lab studies suggest boswellic acids can slow that enzyme. If clearance slows, more ramelteon could hang around, which might mean a bit more grogginess, dizziness, or feeling unusually drowsy or hungover the next morning.

That said, I want to keep this in perspective. This is a theoretical concern based only on test-tube research, not on real people. Some studies even hint Boswellia could nudge the enzyme the other way at low doses, so the direction isn't certain. I wouldn't lose sleep over it, but please run it by your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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
  2. 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.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • 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.
Evidence the quality of the studies behind the rating (graded A–D)
  • 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.

Keep it in perspective

Boswellia Serrata Also Interacts With Other Medications

Boswellia Serrata has 951 moderate known drug interactions in our database — the Ramelteon one above is among them. If you take anything else, check it against the full list below.

Moderate 951 No known interaction 1,879 (incl. Ramelteon)
Taking anything else?

Check Another of Your Medications Against Boswellia Serrata

Covers the 2,830 medications we’ve checked against Boswellia Serrata. Pick one to open its full report.

From our Q&A

Questions About Boswellia Serrata or Ramelteon

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Boswellia Serrata or Ramelteon, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Ramelteon

This page covers Boswellia Serrata only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ramelteon page lists 228 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), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 9 major · 173 moderate · 46 minor.

From our pharmacist’s overview on the Ramelteon page

“Ramelteon (Rozerem) is a prescription sleep aid, and its 228 interacting supplements call for real care, starting with the nine rated major. The frustrating part is that the things sleepless people typically reach for, kava, CBD, a glass of wine before bed, sit at the heart of the problem.”

Reviewed by 2 · Jul 18, 2026

Open the Ramelteon interaction page

One more smart check

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 Ramelteon 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:

How much people look this up

Where Boswellia Serrata and Ramelteon 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.

Supplement Boswellia Serrata
Top 10%

#93 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Ramelteon
Top half

#1,331 of 2,830 medications looked up here in the last 7 days

29 days ago today

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.

Supplement

About Boswellia Serrata

What is Boswellia Serrata?

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.

Read the full Boswellia Serrata monograph & all interactions
Medication

About Ramelteon

What Is Ramelteon Used For?

Brand name: Rozerem

Ramelteon tablets — sold as the brand Rozerem and as generic ramelteon — are used to treat insomnia when the main problem is trouble falling asleep at the start of the night. It is not indicated for difficulty staying asleep.

Clinical studies supporting its effectiveness ran up to six months in both adults and elderly patients.

See full Ramelteon drug information
Keep checking

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.

0Major
951Moderate
0Minor
1,878No known interaction
951 Moderate 1,878 No interaction
Moderate

951 interactions

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.

Showing the 60 most looked-up of 1,878 medications checked with no known interaction — see the full Boswellia Serrata list.

See the full Boswellia Serrata interactions page
See every supplement checked against Ramelteon, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

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

Keep exploring
Boswellia Serrata monograph › Uses, safety, and every drug interaction in one place Ramelteon supplement interactions › Every supplement checked against Ramelteon, ranked by severity Ramelteon drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Boswellia Serrata and Ramelteon Together: Common Questions

Can you take Boswellia Serrata with Ramelteon?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Boswellia Serrata and Ramelteon?
Ramelteon belongs to more than one drug category, and Boswellia Serrata interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Boswellia Serrata and Ramelteon interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Ramelteon 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.