Herb & supplement monograph

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

Medically reviewed by ·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

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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.

2,830 drugs
6-mercaptopurinePurinethol
Moderate Immunosuppressants

Theoretically, Boswellia serrata might alter the effects of immunosuppressive drugs.

Read the full Boswellia Serrata + 6-mercaptopurine interaction 6-mercaptopurine drug page: uses, dosage & side effects
Ado-trastuzumab EmtansineKadcyla
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.

Read the full Boswellia Serrata + Ado-trastuzumab Emtansine interaction Ado-trastuzumab Emtansine drug page: uses, dosage & side effects
AbemaciclibVerzenio
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.

Read the full Boswellia Serrata + Abemaciclib interaction Abemaciclib drug page: uses, dosage & side effects
Abiraterone
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.

Read the full Boswellia Serrata + Abiraterone interaction Abiraterone drug page: uses, dosage & side effects
Abiraterone AcetateYonsa, Zytiga
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.

Read the full Boswellia Serrata + Abiraterone Acetate interaction Abiraterone Acetate drug page: uses, dosage & side effects
AbrocitinibCibinqo
Moderate Immunosuppressants

Theoretically, Boswellia serrata might alter the effects of immunosuppressive drugs.

Read the full Boswellia Serrata + Abrocitinib interaction Abrocitinib drug page: uses, dosage & side effects
AcalabrutinibCalquence
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.

Read the full Boswellia Serrata + Acalabrutinib interaction Acalabrutinib drug page: uses, dosage & side effects
AcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.

Read the full Boswellia Serrata + Acetaminophen interaction Acetaminophen drug page: uses, dosage & side effects
Acetaminophen, AspirinGemnisyn
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.

Read the full Boswellia Serrata + Acetaminophen, Aspirin interaction
Acetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.

Read the full Boswellia Serrata + Acetaminophen, Aspirin, Caffeine interaction
Acetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.

Read the full Boswellia Serrata + Acetaminophen, Brompheniramine, Phenylpropanolamine interaction
Acetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.

Read the full Boswellia Serrata + Acetaminophen, Butalbital interaction
Acetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.

Read the full Boswellia Serrata + Acetaminophen, Butalbital, Caffeine interaction Acetaminophen, Butalbital, Caffeine drug page: uses, dosage & side effects
Acetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.

Read the full Boswellia Serrata + Acetaminophen, Butalbital, Caffeine, Codeine interaction
Acetaminophen, Butalbital, CodeineBancap w/ Codeine
Moderate Cytochrome P450 2d6 (cyp2d6) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.

Read the full Boswellia Serrata + Acetaminophen, Butalbital, Codeine interaction
Acetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.

Read the full Boswellia Serrata + Acetaminophen, Butalbital, Codeine Phosphate interaction
Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
Moderate Cytochrome P450 2d6 (cyp2d6) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.

Read the full Boswellia Serrata + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interaction
Acetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.

Read the full Boswellia Serrata + Acetaminophen, Caffeine, Codeine interaction
Acetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
Moderate Cytochrome P450 2d6 (cyp2d6) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.

Read the full Boswellia Serrata + Acetaminophen, Caffeine, Codeine, Salicylamide interaction
Acetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.

Read the full Boswellia Serrata + Acetaminophen, Caffeine, Dihydrocodeine interaction
Acetaminophen, Caffeine, IsomethepteneMigralam
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.

Read the full Boswellia Serrata + Acetaminophen, Caffeine, Isometheptene interaction
Acetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.

Read the full Boswellia Serrata + Acetaminophen, Caffeine, Pyrilamine interaction
Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
Moderate Cytochrome P450 2d6 (cyp2d6) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.

Read the full Boswellia Serrata + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interaction
Acetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.

Read the full Boswellia Serrata + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interaction
Acetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
Moderate Cytochrome P450 2d6 (cyp2d6) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.

Read the full Boswellia Serrata + Acetaminophen, Chlorpheniramine, Dextromethorphan interaction
Acetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.

Read the full Boswellia Serrata + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interaction
Acetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
Moderate Cytochrome P450 2d6 (cyp2d6) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.

Read the full Boswellia Serrata + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interaction
Acetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.

Read the full Boswellia Serrata + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interaction
Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
Moderate Cytochrome P450 3a4 (cyp3a4) Substrates

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.

Read the full Boswellia Serrata + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interaction
Acetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
Moderate Cytochrome P450 1a2 (cyp1a2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.

Read the full Boswellia Serrata + Acetaminophen, Chlorpheniramine, Phenylephrine interaction
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 · 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.

Boswellia Serrata
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 .

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
Rating & evidence shown verbatim from Natural Medicines

Oral Boswellia serrata extracts, taken alone or in combination with other ingredients, appear to reduce pain and stiffness and improve function in knee osteoarthritis. However, most clinical studies have been small and of relatively short duration.

Also studied for 25 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Allergic rhinitis (hay fever)
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using oral Boswellia serrata for hay fever, there is insufficient reliable information about the clinical effects of Boswellia serrata for this condition.

Insufficient Reliable Evidence To Rate Alzheimer disease
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral Boswellia serrata improves cognitive function in patients with Alzheimer disease.

Insufficient Reliable Evidence To Rate Asthma
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral Boswellia serrata can improve symptoms of asthma.

Insufficient Reliable Evidence To Rate Brain tumor
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral Boswellia serrata improves outcomes in patients with brain tumors.

Insufficient Reliable Evidence To Rate Chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS)
Rating & evidence shown verbatim from Natural Medicines

Rectal Boswellia serrata has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Cluster headache
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using oral Boswellia serrata for cluster headache, there is insufficient reliable information about the clinical effects of Boswellia serrata for this condition.

Insufficient Reliable Evidence To Rate Coronavirus disease 2019 (COVID-19)
Rating & evidence shown verbatim from Natural Medicines

Oral Boswellia serrata has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Crohn disease
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral Boswellia serrata reduces relapse rates in patients with Crohn disease.

Insufficient Reliable Evidence To Rate Diabetes
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral Boswellia serrata improves glycemic control in patients with diabetes.

Insufficient Reliable Evidence To Rate Diarrhea
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral Boswellia serrata is beneficial in patients with acute diarrhea.

Insufficient Reliable Evidence To Rate Dysmenorrhea
Rating & evidence shown verbatim from Natural Medicines

Oral Boswellia serrata has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Exercise-induced muscle soreness
Rating & evidence shown verbatim from Natural Medicines

Oral Boswellia serrata has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Irritable bowel syndrome (IBS)
Rating & evidence shown verbatim from Natural Medicines

Small clinical studies suggest that an oral Boswellia serrata extract may improve symptoms of IBS.

Insufficient Reliable Evidence To Rate Knee pain
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral Boswellia serrata is beneficial for knee pain.

Insufficient Reliable Evidence To Rate Menorrhagia
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral Boswellia serrata is beneficial for menorrhagia.

Insufficient Reliable Evidence To Rate Microscopic colitis
Rating & evidence shown verbatim from Natural Medicines

There is limited evidence on the oral use of Boswellia serrata in patients with collagenous colitis.

Insufficient Reliable Evidence To Rate Pharyngitis
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using oral Boswellia serrata for pharyngitis, there is insufficient reliable information about the clinical effects of Boswellia serrata for this condition.

Insufficient Reliable Evidence To Rate Postoperative pain
Rating & evidence shown verbatim from Natural Medicines

Oral Boswellia serrata has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Rheumatoid arthritis (RA)
Rating & evidence shown verbatim from Natural Medicines

Oral Boswellia serrata has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Rhinosinusitis
Rating & evidence shown verbatim from Natural Medicines

Oral Boswellia serrata has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Stroke
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral boswellic acids improve neurological function after stroke.

Insufficient Reliable Evidence To Rate Traumatic brain injury (TBI)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral Boswellia serrata is effective for reducing disability, or improving cognitive function or memory in adults recovering from TBIs.

Insufficient Reliable Evidence To Rate Ulcerative colitis
Rating & evidence shown verbatim from Natural Medicines

Small clinical studies suggest that oral Boswellia serrata extracts may improve symptoms of ulcerative colitis.

Insufficient Reliable Evidence To Rate Urinary incontinence
Rating & evidence shown verbatim from Natural Medicines

Oral Boswellia serrata has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Urinary tract infections (UTIs)
Rating & evidence shown verbatim from Natural Medicines

Oral Boswellia serrata has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

Boswellia is generally considered well tolerated when taken by mouth for short periods. However, supplement quality varies, and products may differ in how much boswellic acid they actually contain.

People with digestive problems, those who are scheduled for surgery, or those with chronic health conditions should talk to a pharmacist or doctor before starting boswellia. During pregnancy and breastfeeding, it is best to avoid boswellia because there is not enough information to know whether it is safe. Always tell your healthcare provider about any supplements you take.

Side effects

When side effects occur, they are usually mild and involve the digestive system. These may include nausea, stomach upset, acid reflux, or diarrhea.

Some people may develop a skin rash or allergic reaction, especially with topical products. Serious side effects are uncommon, but if you notice signs of an allergic reaction such as swelling, trouble breathing, or a widespread rash, stop using it and seek medical care.

Boswellia Serrata: Reported Adverse Effects

Documented safety reports on Boswellia Serrata from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Orally, Boswellia serrata extract is generally well-tolerated. For information on the safety of Boswellia serrata when applied topically or used as aromatherapy, see the Frankincense monograph.

Most Common Adverse Effects:

Orally: Abdominal pain, diarrhea, headache, heartburn, itching, nausea.

Serious Adverse Effects (Rare):

Orally: Large amounts of Boswellia serrata gum resin can cause bezoar formation.

Reports by condition
Cluster headache Neurologic/CNS

Orally, Boswellia serrata extract may cause dizziness, headache, and vertigo. In one clinical study, nearly 11% of patients taking a specific Boswellia serrata extract (K-Vie) reported headache. Dizziness and vertigo were also reported, but at lower rates. In another study, headache was reported in one patient taking a specific Boswellia serrata extract (5-Loxin).

  1. Meshkat S, Mahmoodi Baram S, Rajaei S, et al. Boswellia serrata extract shows cognitive benefits in a double-blind, randomized, placebo-controlled pilot clinical trial in individuals who suffered traumatic brain injury. Brain Inj 2022;36(4):553-559.
  2. Sengupta K, Alluri KV, Satish AR, et al. A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin. Arthritis Res Ther 2008;10:R85.
Diarrhea Gastrointestinal

Orally, Boswellia serrata extract may cause diarrhea, nausea, abdominal pain, and heartburn. A case of a large gastrointestinal bezoar has been reported in a 17-year-old female who chewed and swallowed large quantities of boswellia gum resin (Boswellia species not specified) for celiac disease.

  1. Gupta I, Gupta V, Parihar A, et al. Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study. Eur J Med Res 1998;3:511-4.
  2. 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.
  3. 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.
  4. Sengupta K, Alluri KV, Satish AR, et al. A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin. Arthritis Res Ther 2008;10:R85.
  5. Sengupta K, Krishnaraju AV, Vishal AA, et al. Comparative efficacy and tolerability of 5-Loxin and Aflapin against osteoarthritis of the knee: a double blind, randomized, placebo controlled clinical study. Int J Med Sci 2010;7:366-77.
  6. Ernst E. Frankincense: systematic review. BMJ 2008;337:a2813.
  7. Kirste S, Treier M, Wehrle SJ, et al. Boswellia serratea extract acts on cerebral edema in patients irradiated for brain tumors: a prospective, randomized, placebo-controlled, double-blind pilot trial. Cancer 2011;117:3788-95.
  8. Meshkat S, Mahmoodi Baram S, Rajaei S, et al. Boswellia serrata extract shows cognitive benefits in a double-blind, randomized, placebo-controlled pilot clinical trial in individuals who suffered traumatic brain injury. Brain Inj 2022;36(4):553-559.
  9. Valente IVB, Garcia D, Abbott A, et al. The anti-proliferative effects of a frankincense extract in a window of opportunity phase ia clinical trial for patients with breast cancer. Breast Cancer Res Treat 2024;204(3):521-530.
  10. El Fortia, M., Badi, H., Elalem, Kh, Kadiki, O., and Topov, Y. Olibanum bezoar: complication of a traditional popular medicine. East Mediterr.Health J 2006;12(6):927-929.
Myasthenia gravis Dermatologic

Orally, Boswellia serrata extract (5-Loxin) has been associated with itching at doses of 100-250 mg daily.

  1. Sengupta K, Alluri KV, Satish AR, et al. A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin. Arthritis Res Ther 2008;10:R85.
Pregnancy-related edema Musculoskeletal

Orally, Boswellia serrata extract (5-Loxin) has been associated with one case of foot edema and four cases of generalized weakness in one clinical study.

  1. Sengupta K, Alluri KV, Satish AR, et al. A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin. Arthritis Res Ther 2008;10:R85.
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no single official or proven dose for boswellia. Products vary in strength and in how much boswellic acid they contain, which makes a standard dose hard to recommend.

The best approach is to follow the directions on the product label and to choose a product from a reputable brand. Because the right amount can depend on your health and other medicines, check with your pharmacist or doctor before starting, and do not take more than the label suggests.

Pregnancy & Breastfeeding

Boswellia Serrata & Pregnancy

Likely Safe

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

  1. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182

Boswellia Serrata & Breastfeeding

Likely Safe

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

  1. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

© 2026 Therapeutic Research Center

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 16 references that drive our Boswellia Serrata monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Gupta I, Gupta V, Parihar A, et al. Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study. Eur J Med Res 1998;3:511-4.
  2. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
  3. 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. PubMed
  4. 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. PubMed
  5. 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.
  6. 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. PubMed
  7. Sengupta K, Alluri KV, Satish AR, et al. A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin. Arthritis Res Ther 2008;10:R85.
  8. Sengupta K, Krishnaraju AV, Vishal AA, et al. Comparative efficacy and tolerability of 5-Loxin and Aflapin against osteoarthritis of the knee: a double blind, randomized, placebo controlled clinical study. Int J Med Sci 2010;7:366-77.
  9. Ernst E. Frankincense: systematic review. BMJ 2008;337:a2813. PubMed
  10. Kirste S, Treier M, Wehrle SJ, et al. Boswellia serratea extract acts on cerebral edema in patients irradiated for brain tumors: a prospective, randomized, placebo-controlled, double-blind pilot trial. Cancer 2011;117:3788-95.
  11. 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
  12. 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.
  13. El Fortia, M., Badi, H., Elalem, Kh, Kadiki, O., and Topov, Y. Olibanum bezoar: complication of a traditional popular medicine. East Mediterr.Health J 2006;12(6):927-929.
  14. Meshkat S, Mahmoodi Baram S, Rajaei S, et al. Boswellia serrata extract shows cognitive benefits in a double-blind, randomized, placebo-controlled pilot clinical trial in individuals who suffered traumatic brain injury. Brain Inj 2022;36(4):553-559. PubMed
  15. 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
Keep reading

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.

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

Brand directory

Brands that make products with Boswellia Serrata

538 brands in our database make a supplement containing Boswellia Serrata.

Product directory

Supplement products with Boswellia Serrata

2,029 products in our database contain Boswellia Serrata. Open any to see its full ingredient list and every drug interaction we check.

Pharmacist Counseling Corner

Boswellia Serrata: Common Questions

What is Boswellia Serrata used for, and does it work?
People use Boswellia Serrata for many reasons, but the evidence varies by use. According to the Natural Medicines database, there is at least some clinical evidence supporting Boswellia Serrata for Osteoarthritis. For most other uses it has been studied for, the evidence is currently insufficient to rate. See the graded list on this page, and always confirm with your pharmacist or doctor.
Does Boswellia Serrata interact with prescription medications?
Yes. We list 952 medications with a known interaction with Boswellia Serrata. Use the checker above to see how Boswellia Serrata interacts with a specific drug.
How are Boswellia Serrata interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Boswellia Serrata with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Boswellia Serrata interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
What is boswellia used for?
It is most commonly used for joint pain and inflammation, especially osteoarthritis. People also use it for arthritis, asthma, and some inflammatory bowel conditions, though the evidence for these is limited.
Is boswellia safe to take?
For most healthy adults, short-term use is generally well tolerated, with mild stomach upset being the most common complaint. Still, it is best to talk to your pharmacist or doctor first, especially if you have a health condition.
Can I take boswellia during pregnancy or breastfeeding?
No, it is best avoided. There is not enough reliable safety information for use during pregnancy or breastfeeding.
Is boswellia the same as frankincense?
Boswellia Serrata is sometimes called Indian frankincense, and it comes from a tree closely related to those that produce frankincense resin used in incense and perfumes.

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

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Products that contain Boswellia Serrata

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