Myrrh: Adverse Reactions. Significant Interactions. Pregnancy Use.

Toxicity

A dose of 10 mg/kg/day was given to subjects in one study with no serious adverse effects.

Adverse Reactions

Restlessness, mild abdominal discomfort and gastrointestinal symptoms, such as diarrhea and nausea, have been reported, mainly with orally administered extracts. Allergic dermatitis has also been reported for topical usage. The standardised guggulsterone (guggulipid) preparations tend to be far better tolerated.

Significant Interactions

Interactions are theoretical and based on in vitro and in vivo data; therefore, clinical significance is unclear and remains to be confirmed.

DIABETIC MEDICATION

In vivo studies suggest myrrh may have hypoglycaemic effects and therefore would have additive effects with diabetic medications. Monitor for changes in serum glucose in patients taking these medications.

LIPID-LOWERING MEDICATION

Guggul may have cholesterol-lowering activity and therefore have additive effects with other lipid-lowering medications — observe patients taking this combination and monitor drug requirements. Beneficial interaction possible.

ANTICOAGULANT AND ANTIPLATELET MEDICATION

Guggul inhibited platelet aggregation in vitro and in a clinical study, therefore concurrent use may theoretically increase the risk of bruising and bleeding. It is uncertain what implications this observation has for C. molmol use. Observe patients taking these combinations.

DILTIAZEM

Reduced efficacy possible. A clinical study confirmed guggulipid reduces bioavailability of this medicine. It is uncertain what implications this observation has for C. molmol use. Observe patients taking this combination.

PROPRANOLOL

Reduced efficacy possible. A clinical study confirmed guggulipid reduces bioavailability of this medicine. It is uncertain what implications this observation has for C. molmol use. Observe patients taking this combination.

Contraindications and Precautions

Do not use in cases of known allergy. Suspend use of guggul preparations 1 week before major surgery.

Pregnancy Use

Contraindicated in pregnancy.