Boswellia Serrata - Actemra (Tocilizumab) Interaction
Herbal: Boswellia Serrata
Also Known As: Boswellia serrata, Arbre à Oliban Indien, Boswella, Boswellin, Boswellin Serrata Resin, Encens Indien, Gajabhakshya, Indian Frankincense, Oliban Indien, Salai Guggal, Salai Guggul, Sallaki Guggul, Shallaki
Drug: Tocilizumab
Brand names:
Actemra

Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jun 15, 2025
Interaction Details
Tocilizumab 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
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
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.
Boswellia Serrata Overview

Tocilizumab Overview
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Tocilizumab injection is used alone or in combination with other medications to relieve the symptoms of certain types of arthritis and other conditions including:
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rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain, swelling, and loss of function) in adults who have not been helped by other disease-modifying antirheumatic drugs (DMARDs),
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giant cell arteritis (a condition that causes swelling of blood vessels, especially in the scalp and head) in adults,
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systemic sclerosis-associated interstitial lung disease (SSc-ILD; also known as scleroderma-associated ILD: a lung disease that involves scarring of the lungs) in adults,
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polyarticular juvenile idiopathic arthritis (PJIA; a type of childhood arthritis that affects five or more joints during the first six months of the condition, causing pain, swelling, and loss of function) in children 2 years of age or older.
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systemic juvenile idiopathic arthritis (SJIA; a condition in children that causes inflammation in different areas of the body, causing fever, joint pain and swelling, loss of function, and delays in growth and development) in children 2 years of age or older,
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cytokine release syndrome (a severe and possibly life-threatening reaction) in adults and children 2 years of age or older after receiving certain immunotherapy infusions.
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Tocilizumab injection is in a class of medications called interleukin-6 (IL-6) receptor inhibitors. It works by blocking the activity of interleukin-6, a substance in the body that causes inflammation.
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.
Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
Unknown | No interactions have been reported or no interaction data is currently available. |
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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.
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Drug descriptions are provided by MedlinePlus.