Herb & supplement monograph

Boswellia Serrata Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS ·Updated July 2026

What is this page for?

First and foremost: how Boswellia Serrata interacts with medications. The heart of this page is the interaction list — every drug Boswellia Serrata is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Boswellia Serrata is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

Check Boswellia Serrata against your medication

Add one medication

✓ Supplement

Boswellia Serrata

1 Your medication

Start typing any prescription or over-the-counter drug name.

Reviewed by licensed pharmacists Sourced from Natural Medicines

On this page

Boswellia Serrata Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Boswellia Serrata drug interaction appears low for most people. None of the listed interactions are rated major, and every one is theoretical, based on lab research rather than documented effects in people.

Interactions deserving the most attention

The category that deserves the most thought is immunosuppressants, because lab findings suggest boswellia might alter immune activity, and even a small change could matter for someone protecting a transplant or controlling an autoimmune condition. Boswellia may also affect several liver enzymes the body uses to clear many medications, so anyone taking a narrow-margin medicine processed by these enzymes should be a bit more careful. Still, none of these effects has been confirmed in humans.

What the rest of the list means

The list looks long mainly because those enzyme pathways handle hundreds of everyday medications, so a single lab finding pulls many drugs onto it at once. That does not mean each combination is harmful; effects seen in a test tube often never appear at a meaningful level in people, and for one enzyme the research even conflicts on whether boswellia raises or lowers its activity.

Check your medications against Boswellia Serrata

Based on HelloPharmacist’s Boswellia Serrata interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Boswellia Serrata

952 medications have a known interaction with Boswellia Serrata, graded by severity. Select any drug for the full evidence-based detail.

Don’t want to scroll the list? Just ask.

Tell us the medications you take and we’ll check each one against Boswellia Serrata using our pharmacist-reviewed interaction data.

AI summaries are generated from our Boswellia Serrata interaction data for education only — always confirm with your pharmacist. How we use AI

2,830 drugs

Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
Probable. Interaction 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.
Possible. 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
Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
Each drug listed above links to the full report for that exact Boswellia Serrata combination — clinical detail, likelihood, evidence level, and citations.
Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

The big picture

The kinds of drugs Boswellia Serrata affects

Every type of medication (drug category) Boswellia Serrata is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 6 drug categories Boswellia Serrata interacts with

Cytochrome P450 1a2 (cyp1a2) SubstratesCytochrome P450 2c19 (cyp2c19) SubstratesCytochrome P450 2c9 (cyp2c9) SubstratesCytochrome P450 2d6 (cyp2d6) SubstratesCytochrome P450 3a4 (cyp3a4) SubstratesImmunosuppressants

Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP1A2 enzymes.

Likelihood Possible Evidence D

Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2C19 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C19 enzymes.

Likelihood Possible Evidence D

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.

Likelihood Possible Evidence D

Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2D6 enzymes.

Likelihood Possible Evidence D

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.

Likelihood Possible Evidence D

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.

Likelihood Possible Evidence D

Monograph

Boswellia Serrata: Uses, Safety & Side Effects

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Reviewed July 2026 ·

The bottom line

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.

Scientific name: Boswellia serrata
Family: Burseraceae
Part used: Gum resin (and bark)
Common forms: Capsules, tablets, extracts (often standardized to boswellic acids), topical creams, resin

People commonly use it for

Osteoarthritis joint pain
Rheumatoid arthritis
Inflammation
Asthma
Inflammatory bowel conditions

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance

OverallUse caution

Generally well tolerated short-term, but quality and dose vary widely between products.

PregnancyLikely Safe

When used orally in amounts commonly found in foods. There is insufficient reliable information available about the safety of using Boswellia serrata...

Read the full pregnancy detail

BreastfeedingLikely Safe

When used orally in amounts commonly found in foods. There is insufficient reliable information available about the safety of using Boswellia serrata...

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

Boswellia serrata is a tree native to dry, hilly areas of India, Nepal, and Pakistan. It is often called Indian frankincense. When the bark is cut, the tree produces a sticky gum resin that has been used for centuries in traditional Ayurvedic medicine and as incense.

Today, the resin is processed into capsules, tablets, and extracts, many of which are standardized to contain a certain amount of natural compounds called boswellic acids. People most often take boswellia for joint pain and inflammation, though it has been used traditionally for many other conditions.

How it works

The resin contains active compounds called boswellic acids. In laboratory and animal studies, these compounds appear to block certain enzymes and chemical messengers that the body uses to create inflammation. One enzyme that has been studied is called 5-lipoxygenase (5-LOX).

By reducing some of these inflammatory signals, boswellia is thought to help with swelling and pain. It is important to know that much of this is based on lab and animal research, and the way it works in the human body is not fully understood.

Effectiveness

Does Boswellia Serrata work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by Dr. Brian Staiger, PharmD.

Evidence overview · 26 uses evaluated

1 Possibly effective 25 Insufficient evidence

How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.

2Likely EffectiveGood evidence, though not yet conclusive.

3Possibly EffectiveSome evidence suggests a benefit.

4Possibly IneffectiveSome evidence it may not help.

5Likely IneffectiveFairly strong evidence it doesn’t help.

6IneffectiveStrong evidence it doesn’t work.

7Insufficient Reliable Evidence to RateToo little research to say either way.

Possibly Effective Osteoarthritis