Boswellia

Boswellia/Drug Interactions:

  • AnalgesicsAnalgesics: In animal research, the nonphenolic ration of Boswellia serrata gum resin (20-300mg/kg) exhibited an analgesic effect similar to morphine (4.5mg/kg) (32).
  • AntiarthriticsAntiarthritics: In human research, Boswellia had antiarthritic properties (23; 22; 80; 86; 24; 87; 30; 73; 75; 74; 65). In animal research, it was indicated that the purported mechanism of Boswellia's activity is reduction of glycosaminoglycan (GAG) degradation (88).
  • AntiasthmaticsAntiasthmatics: In human research, Boswellia had anti-asthma effects (26; 89; 28). In human research, blood eosinophilic counts decreased in the mild, moderate, and severe asthma groups; however, significant changes in leukotriene levels were lacking (89). In animal research, Boswellia inhibited the release of leukotriene B4 (LTB4), a potent inducer of bronchoconstriction and asthma (3; 4; 5; 6; 7; 8; 9; 10).
  • AntibioticsAntibiotics: In laboratory research, Boswellia exhibited antibacterial activity (35). According to results of a randomized controlled trial, Proxelan? improved symptom scores in patients with chronic prostatitis; however, microbiological effects were lacking (90).
  • AntidiabeticsAntidiabetics: In a clinical trial, hypoglycemia leading to withdrawal occurred in a patient treated with Boswellia serrata extract (66).
  • Anti-edema agentsAnti-edema agents: Pedal edema was reported in a clinical trial (30).
  • AntifungalsAntifungals: The essential oil from Boswellia serrata has been reported to possess antifungal activity, with weak activity against human fungal pathogens in vitro (but greater effect against plant fungal pathogens) (37).
  • Anti-inflammatoriesAnti-inflammatories: In animal and in vitro research, Boswellia exhibited anti-inflammatory activity (3; 91; 92; 93; 94; 95; 82; 10; 39; 96; 38; 31). In animal research, it was indicated that the purported anti-arthritis mechanism of Boswellia's activity is reduction of glycosaminoglycan (GAG) degradation (88). Earlier studies showed that boswellic acids reduce enzymes that are elevated in inflammatory conditions like arthritis, such as glutamic pyruvic transaminase, glycohydrolase, and beta-glucuronidase (97; 98; 88). In a review of unpublished studies, the authors concluded that across investigations, the standardized Boswellia extract H15? was not efficacious for the relief of acute pain but may improve chronic symptoms, such as joint swelling and stiffness, and may reduce NSAID intake (70).
  • AntilipemicsAntilipemics: In animal research, the gum of Boswellia lowered cholesterol and triglyceride levels (48).
  • AntineoplasticsAntineoplastics: Anti-cancer effects of Boswellia have been shown in human research (29). Numerous in vitro preclinical studies have shown that boswellic acids exhibit potent cytotoxic and antiproliferative activity against numerous cancer cell lines (45; 99; 11; 13; 21; 100; 18; 43; 101; 20; 46; 17; 102).
  • CNS depressantsCNS depressants: In animal research, the nonphenolic ration of Boswellia serrata gum resin (20-300mg/kg) exhibited a sedative effect (55-300mg/kg) comparable to chlorpromazine (7.5mg/kg) (32).
  • Cytochrome P450-modifying agents Cytochrome P450-modifying agents : In laboratory research, Boswellia carterii, Boswellia frereana, Boswellia sacra, and Boswellia serrata are moderate-to-potent nonselective inhibitors of CYP enzymes 1A2, 2C8, 2C9, 2C19, 2D6, and 3A4 (61).
  • Dermatologic agentsDermatologic agents: Itching and dermatitis have been reported in case reports and clinical trials of agents containing Boswellia serrata (64; 30; 23; 24). In human research, use of a cream containing boswellic acids improved fine surface lines and tactile roughness; other changes included a reduction in sebum and skin distensibility, and increases in skin thickness and the number of pixels, without improvements in transepidermal water loss (59; 60).
  • Gastrointestinal agentsGastrointestinal agents: In clinical trials and case reports, gastrointestinal adverse effects have been reported (22; 23; 24; 65; 25; 26; 28; 29; 30; 66). There is mixed evidence of the benefit of Boswellia for gastrointestinal disorders, such as colitis and Crohn's in human research (78; 79; 66; 87; 58; 71).
  • HepatotoxinsHepatotoxins: In animal research, hepatotoxicity with pronounced hepatomegaly and steatosis has been observed with Boswellia (31).
  • ImmunosuppressantsImmunosuppressants: In vitro, boswellic acids exhibited immunostimulant activity, modifying lymphocyte response and release of inflammatory mediators (50; 49), and boswellic acids reportedly have immunostimulant effects as shown in laboratory research (50; 49; 31; 61; 25; 26; 48; 32; 62; 63; 22; 23; 24; 27).
  • Leukotriene receptor antagonistsLeukotriene receptor antagonists: In animal and in vitro research, Boswellia inhibited 5-lipoxygenase, thereby reducing the production of leukotrienes (6; 4; 7; 8). In animal research, Boswellia inhibited the release of LTB4, a potent inducer of bronchoconstriction and asthma (3; 4; 5; 6; h 7; 8; 9; 10). According to secondary sources, Boswellia may potentiate the actions of pharmaceutical leukotriene receptor antagonists such as zafirlukast (Accolate?) and montelukast (Singulair?), which are used in the treatment of asthma.
  • Neurologic agentsNeurologic agents: In a clinical trial, dizziness and headache were reported as adverse effects to Boswellia (66; 30). Lampl et al. determined that oral Boswellia serrata reduced the intensity and frequency of headaches in four patients with chronic cluster headaches (103). According to a review, incensole acetate (a major component of Boswellia resin) has neuroprotective effects in animal research (55). It has also been suggested to have behavioral, anti-depressive, and anxiolytic effects in animal research.
  • Respiratory agentsRespiratory agents: One study showed that exposure to inhaled Arabian incense (the oleoresin of Boswellia) in rats induced potentially harmful changes in pulmonary tissue (62; 63). Additional studies have found that Boswellia inhibits human leukocyte elastase (HLE), which is involved in the pathogenesis of emphysema, cystic fibrosis, chronic bronchitis, and acute respiratory distress syndrome (6; 4).
  • SedativesSedatives: In animal research, the nonphenolic ration of Boswellia serrata gum resin (20-300mg/kg) exhibited a sedative effect (55-300mg/kg) comparable to chlorpromazine (7.5mg/kg) (32).
  • Tumor necrosis factor inhibitorsTumor necrosis factor inhibitors: In human, animal, and in vitro research, Boswellia extract inhibited TNF-alpha-induced inflammatory response (38; 40).

    • Boswellia/Herb/Supplement Interactions:

  • AnalgesicsAnalgesics: In animal research, the nonphenolic ration of Boswellia serrata gum resin (20-300mg/kg) exhibited an analgesic effect similar to morphine (4.5mg/kg) (32).
  • AntiarthriticsAntiarthritics: In human research, Boswellia had antiarthritic properties (23; 22; 80; 86; 24; 87; 30; 73; 75; 74; 65). In animal research, it was indicated that the purported mechanism of Boswellia's activity is reduction of glycosaminoglycan (GAG) degradation (88).
  • AntiasthmaticsAntiasthmatics: In human research, Boswellia had anti-asthma effects (26; 89; 28). In human research, blood eosinophilic counts decreased in the mild, moderate, and severe asthma groups; however, significant changes in leukotriene levels were lacking (89). In animal research, Boswellia inhibited the release of leukotriene B4 (LTB4), a potent inducer of bronchoconstriction and asthma (3; 4; 5; 6; 7; 8; 9; 10).
  • AntibacterialsAntibacterials: In laboratory research, Boswellia exhibited antibacterial activity (35). According to results of a randomized controlled trial, Proxelan? improved symptom scores in patients with chronic prostatitis; however, microbiological effects were lacking (90).
  • Anti-edema agentsAnti-edema agents: Pedal edema was reported in a clinical trial (30).
  • AntifungalsAntifungals: The essential oil from Boswellia serrata has been reported to possess antifungal activity, with weak activity against human fungal pathogens in vitro (but greater effect against plant fungal pathogens) (37).
  • Anti-inflammatoriesAnti-inflammatories: In animal and in vitro research, Boswellia exhibited anti-inflammatory activity (3; 91; 92; 93; 94; 95; 82; 10; 39; 96; 38; 31). In animal research, it was indicated that the purported anti-arthritis mechanism of Boswellia's activity is reduction of glycosaminoglycan (GAG) degradation (88). Earlier studies showed that boswellic acids reduce enzymes that are elevated in inflammatory conditions like arthritis, such as glutamic pyruvic transaminase, glycohydrolase, and beta-glucuronidase (97; 98; 88). In a review of unpublished studies, the authors concluded that across investigations, the standardized Boswellia extract H15? was not efficacious for the relief of acute pain but may improve chronic symptoms, such as joint swelling and stiffness, and may reduce NSAID intake (70).
  • AntilipemicsAntilipemics: In animal research, the gum of Boswellia lowered cholesterol and triglyceride levels (48).
  • AntineoplasticsAntineoplastics: Anti-cancer effects of Boswellia have been shown in human research (29). Numerous in vitro preclinical studies have shown that boswellic acids exhibit potent cytotoxic and antiproliferative activity against numerous cancer cell lines (45; 99; 11; 13; 21; 100; 18; 43; 101; 20; 46; 17; 102).
  • Chondroitin sulfateChondroitin sulfate: In animal research, Boswellia has been reported to reduce the degradation of GAGs (88).
  • Cytochrome P450-modifying agents Cytochrome P450-modifying agents : In laboratory research, Boswellia carterii, Boswellia frereana, Boswellia sacra, and Boswellia serrata are moderate-to-potent nonselective inhibitors of CYP enzymes 1A2, 2C8, 2C9, 2C19, 2D6, and 3A4 (61).
  • Dermatologic agentsDermatologic agents: Itching and dermatitis have been reported in case reports and clinical trials of agents containing Boswellia serrata (64; 30; 23; 24). In human research, use of a cream containing boswellic acids improved fine surface lines and tactile roughness; other changes included a reduction in sebum and skin distensibility, and increases in skin thickness and the number of pixels, without improvements in transepidermal water loss (59; 60).
  • Gastrointestinal agentsGastrointestinal agents: In clinical trials and case reports, gastrointestinal adverse effects have been reported (22; 23; 24; 65; 25; 26; 28; 29; 30; 66). There is mixed evidence of benefit of Boswellia for gastrointestinal disorders, such as colitis and Crohn's disease in human research (78; 79; 66; 87; 58; 71).
  • GlucosamineGlucosamine: In animal research, Boswellia has been reported to reduce the degradation of glycosaminoglycans GAGs (88).
  • HepatotoxinsHepatotoxins: In animal research, hepatotoxicity with pronounced hepatomegaly and steatosis has been observed with Boswellia (31).
  • HypoglycemicsHypoglycemics: In a clinical trial, hypoglycemia leading to withdrawal occurred in a patient treated with Boswellia serrata extract (66).
  • ImmunomodulatorsImmunomodulators: In vitro, boswellic acids exhibited immunostimulant activity, modifying lymphocyte response and release of inflammatory mediators (50; 49), and boswellic acids reportedly have immunostimulant effects as shown in laboratory research (50; 49; 31; 61; 25; 26; 48; 32; 62; 63; 22; 23; 24; 27).
  • Neurologic agentsNeurologic agents: In a clinical trial, dizziness and headache were reported as adverse effects of Boswellia (66; 30). Lampl et al. determined that oral Boswellia serrata reduced the intensity and frequency of headaches in four patients with chronic cluster headaches (103). According to a review, incensole acetate (a major component of Boswellia resin) has neuroprotective effects in animal research (55). It has also been suggested to have behavioral, anti-depressive, and anxiolytic effects in animal research.
  • Respiratory agentsRespiratory agents: One study showed that exposure to inhaled Arabian incense (the oleoresin of Boswellia) in rats induced potentially harmful changes in pulmonary tissue (62; 63). Additional studies have found that Boswellia inhibits human leukocyte elastase (HLE), which is involved in the pathogenesis of emphysema, cystic fibrosis, chronic bronchitis, and acute respiratory distress syndrome (6; 4).
  • SedativesSedatives: In animal research, the nonphenolic ration of Boswellia serrata gum resin (20-300mg/kg) exhibited a sedative effect (55-300mg/kg) comparable to chlorpromazine (7.5mg/kg) (32).

    • Boswellia/Food Interactions:

  • General:General: Skarke et al. discussed the increased bioavailability of 11-keto-beta-boswellic acid in human research, following a single oral dose of frankincense extract after a standardized meal (104). Further details are lacking.
  • High-fat foodsHigh-fat foods: In clinical research, a profound effect of food intake on the pharmacokinetic parameters of boswellic acids has been demonstrated (105). Meals that are high in fat increased the concentration of Boswellia constituents in the plasma.

    • Boswellia/Lab Interactions:

  • Blood sugarBlood sugar: In a clinical trial, hypoglycemia leading to withdrawal occurred in a patient treated with Boswellia serrata extract (66).
  • Cell countsCell counts: In human research, blood eosinophilic counts decreased in the mild, moderate, and severe asthma groups (89).
  • LeukotrienesLeukotrienes: In animal and in vitro research, Boswellia inhibited 5-lipoxygenase, thereby reducing the production of leukotrienes (6; 4; 7; 8). In animal research, Boswellia inhibited the release of LTB4, a potent inducer of bronchoconstriction and asthma (3; 4; 5; 6; 7; 8; 9; 10).
  • Lipid profileLipid profile: In animal research, the gum of Boswellia lowered cholesterol and triglyceride levels (48).
  • Liver function testsLiver function tests: In animal research, hepatotoxicity with pronounced hepatomegaly and steatosis has been observed with Boswellia (31). Toxin-induced transaminitis in mice was reduced by the administration of Boswellia, although the effects on normal livers or on humans are not clear (7).