Myrrh

Burseraceae

Commiphora myrrha

Also known as: Gum Myrrh, Myrrha, Heerabol

Pregnancy C
Lactation C

clinical_notes Clinical Summary

Myrrh (Commiphora myrrha) is a resinous gum exudate with a 5,000-year history of medicinal use spanning ancient Egypt, TCM, Ayurveda, and traditional Western herbalism.

The key bioactives are furanodienes (curzerene, furanoeudesma-1,3-diene) which provide analgesic and anti-inflammatory activity, plus the antimicrobial resin fraction.

Best clinical evidence supports topical and oral rinse applications for oral health (gingivitis, periodontitis, aphthous ulcers, post-extraction wound healing) and topical wound healing including episiotomy repair.

Systemic use for IBD (in combination) and antiparasitic indications has clinical trial support.

Avoid in pregnancy due to emmenagogue potential.

Pregnancy Safety

C

Avoid in medicinal doses during pregnancy due to traditional emmenagogue and uterotonic properties. Topical wound-healing applications (episiotomy) have been used in clinical trials with no adverse effects reported.

Lactation Safety

C

Insufficient safety data for systemic use. Topical applications are likely safe. Avoid internal medicinal doses during lactation.

warning Contraindications

  • Pregnancy (avoid)
    Clinically Proven
  • Anticoagulant therapy (warfarin) (caution)
    Theoretical
  • Allergy to Burseraceae family (frankincense, balsam) (caution)
    Clinically Proven

vital_signs Clinical Profile

Primary Indications

  • check_circle gingivitis
  • check_circle periodontitis
  • check_circle pharyngitis
  • check_circle mouth ulcers
  • check_circle wound healing
  • check_circle inflammatory bowel disease
  • check_circle respiratory catarrh
  • check_circle parasitic infections
  • check_circle back pain
  • check_circle episiotomy wound healing

Therapeutic Actions

antimicrobialastringentvulneraryanti-inflammatoryanalgesicantifungalexpectorantemmenagogueantiparasiticantioxidant

System Affinities

  • check_circle oral mucosa
  • check_circle immune
  • check_circle respiratory
  • check_circle integumentary
  • check_circle digestive

labs Active Constituents

furanoeudesma-1,3-diene

curzerene

lindestrene

2-methoxyfuranodiene

sesquiterpene lactones

resins

gums

volatile oil

terpenoids

steroids

lignans

history_edu Traditional Use

Traditional Chinese Medicine (TCM)

Chinese Name

没药 (Mo Yao)

Properties

Nature: neutral

bitterpungent
Meridians / Channels
HeartLiverSpleen
TCM Indications
  • Blood stasis causing pain
  • Traumatic injuries with swelling
  • Swellings and carbuncles
  • Menstrual irregularities from Blood stasis
  • Wound healing
Zang-Fu Organ Patterns
Blood StasisQi and Blood StagnationLiver Blood Stasis
Classical Formulas
Juan Bi TangHuo Luo Xiao Ling DanSan Qi Tablets
Notes

Mo Yao is almost always paired with Ru Xiang (frankincense/Boswellia) in TCM formulas. The pairing of Mo Yao and Ru Xiang is a classical TCM combination for Blood stasis pain and traumatic injury. Mo Yao more strongly invigorates Blood while Ru Xiang moves Qi and reduces swelling.

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Traditional Uses Across Healing Systems

While many herbs lack controlled clinical trials, centuries of traditional practice across cultures provide valuable insight into their therapeutic applications.

Western Herbal Mediterranean, Europe
Used since ancient Egypt (Ebers Papyrus ~1550 BCE); documented in Dioscorides and Greek medicine

Antimicrobial astringent for oral infections, gingivitis, pharyngitis; wound-healing vulnerary; expectorant for respiratory catarrh

One of the most ancient medicinal resins. Used in embalming by Egyptians, in religious ceremonies, and as a medicine for wound healing and infection. Mentioned in Bible and ancient Greek texts.

TCM China
First recorded in Tang Materia Medica (659 CE) as an imported medicine from Arabia

Mo Yao - invigorating Blood, dissolving Blood stasis, reducing swelling, generating flesh in wound healing; used for traumatic injury and menstrual pain

A key herb in TCM trauma and pain formulas. Almost always paired with Ru Xiang (frankincense).

Ayurveda India
Used in Ayurvedic medicine for centuries; included in classical texts

Bola - astringent and bitter herb used for wound healing, infections, and as an emmenagogue in women's health formulations

Used in Ayurvedic formulations for gingivitis, wounds, and gynecological conditions.

Unani Middle East, North Africa
Ancient use in Arabic medicine; described by Ibn Sina (Avicenna) in Canon of Medicine (~1025 CE)

Bol/Murr - antiseptic, astringent, anthelmintic, carminative, expectorant; used for oral hygiene, digestive disorders, and joint pain

Unani medicine classifies myrrh as hot and dry in second degree; used to dissolve phlegm, clean wounds, and for stomach complaints.

spa Parts Used

resin

Constituents
furanoeudesma-1,3-dienecurzerenelindestrenesesquiterpene lactonesmyrrhin resingumvolatile oil
Indications
  • oral infections
  • wound healing
  • anti-inflammatory
  • antiparasitic
  • analgesic
Preparation

Resin tears dissolved in alcohol (tincture 1:5, 90% ethanol) or water. Used as mouthwash diluted in water (10-15 drops tincture per glass), topical application for wounds, or taken internally as tincture. Water-insoluble resin best extracted in ethanol.

shield Safety

Contraindications — Evidence Basis

Pregnancy
avoid Clinically Proven

Myrrh has traditional emmenagogue and uterotonic properties. Avoid during pregnancy, especially in medicinal doses.

Anticoagulant therapy (warfarin)
caution Theoretical

Myrrh may have anticoagulant properties. Theoretical potentiation of warfarin; monitor INR.

Allergy to Burseraceae family (frankincense, balsam)
caution Clinically Proven

Cross-reactivity possible within Burseraceae. Patch testing recommended for topical use in sensitized individuals.

Toxicity

Toxic Dose

Excessive doses (above 2-4 g/day) may cause nausea, vomiting, and gastrointestinal irritation

Symptoms

GI irritation, nausea, vomiting; skin sensitization with topical use; rare contact dermatitis

Management

Discontinue use. Supportive care. For contact dermatitis: topical corticosteroids and antihistamines.

Adverse Effects

GI irritation at high dosescontact dermatitisskin sensitizationpossible allergic reactions

CYP Metabolism

Limited CYP data. The sesquiterpene components are metabolized via hepatic pathways. No well-documented CYP interactions in clinical practice.

swap_horiz Interactions

Warfarin / Vitamin K Antagonists

Decreased Effect moderate

Class: Anticoagulant

Mechanism

Aqueous extracts of Commiphora molmol (myrrh) can induce hepatic microsomal enzymes, accelerating warfarin metabolism and reducing its plasma concentration. A published case report documented antagonism of warfarin's anticoagulant effect (reduced INR) in a patient taking Commiphora molmol preparations concurrently.

Clinical Guidance

Monitor INR closely if a patient taking warfarin begins or discontinues myrrh supplementation. Adjust warfarin dose accordingly. Be particularly vigilant within 2 weeks of starting or stopping myrrh. Alert patients to report any signs of reduced anticoagulation (new clots, worsening DVT symptoms).

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Evidence Source Al Faraj S. Antagonism of the anticoagulant effect of warfarin caused by the use of Commiphora molmol as a herbal medication: a case report. Ann Trop Med Parasitol 2005;99(3):219-220. View source open_in_new

Antidiabetic Agents (Metformin, Insulin, Sulfonylureas)

Synergistic low

Class: Antidiabetics

Mechanism

Commiphora myrrha has been shown to stimulate insulin secretion from pancreatic islets in experimental studies. Myrrh may lower blood glucose through multiple mechanisms. Combined with antidiabetic medications, additive hypoglycemic effects are possible.

Clinical Guidance

Monitor blood glucose in diabetic patients using myrrh. Advise patients to watch for hypoglycemic symptoms (trembling, sweating, confusion). Dose adjustment of antidiabetics may be needed with regular therapeutic myrrh use.

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Evidence Source Al-Romaiyan A, Huang GC, Jones P, Persaud S. Commiphora myrrha stimulates insulin secretion from mouse and human islets of Langerhans. J Ethnopharmacol 2021;264:113075. View source open_in_new

Thyroid Medications (Levothyroxine, Liothyronine, Methimazole)

Caution low

Class: Thyroid Agents

Mechanism

Myrrh is used in traditional Chinese and Ayurvedic medicine as a thyroid-stimulating herb. Certain compounds in myrrh may have thyroid-stimulating effects through increased mucus production and prostaglandin induction. Combined with thyroid medications, unpredictable alterations in thyroid hormone levels may occur.

Clinical Guidance

Monitor thyroid function tests in patients on levothyroxine or methimazole who use myrrh products regularly. Alert patients on thyroid medications to report symptoms of hyper- or hypothyroidism. Adjust thyroid medication dose if thyroid parameters change.

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Evidence Source Al Faraj S. Antagonism of the anticoagulant effect of warfarin caused by the use of Commiphora molmol as a herbal medication: a case report. Ann Trop Med Parasitol 2005;99(3):219-220. View source open_in_new

Immunosuppressants (Cyclosporine, Tacrolimus, Azathioprine, Corticosteroids)

Antagonistic low

Class: Immunosuppressants

Mechanism

Myrrh has demonstrated immunostimulatory properties, including enhancement of white blood cell function and increased cytokine production. These immunostimulatory effects may partially counteract immunosuppressive drug regimens in transplant patients or those with autoimmune conditions.

Clinical Guidance

Advise transplant recipients and patients on immunosuppressive therapy to avoid medicinal myrrh products. Monitor for signs of graft rejection or autoimmune disease flare if myrrh is used concurrently with immunosuppressants.

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Evidence Source al-Harbi MM, Qureshi S, Raza M, et al. Anticarcinogenic effect of Commiphora molmol on solid tumors induced by Ehrlich carcinoma cells in mice. Chemotherapy 1994;40(5):337-347. View source open_in_new

Cardiovascular Drugs / Cardiac Glycosides (Digoxin, Antiarrhythmics)

Caution low

Class: Cardiovascular

Mechanism

Large amounts of myrrh may affect heart rate through its terpenoid constituents. Myrrh's effects on cardiac conduction and heart rate may add unpredictable pharmacodynamic effects when combined with cardiac glycosides or antiarrhythmic medications.

Clinical Guidance

Patients with cardiac conditions or those on digoxin or antiarrhythmics should consult their cardiologist before using myrrh preparations. Monitor for cardiac symptoms (palpitations, bradycardia) with high-dose myrrh use.

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Evidence Source DerMarderosian A, editor. The Review of Natural Products. St Louis: Facts and Comparisons; 1999. View source open_in_new

hub Combinations

info

Synergistic pairings can enhance therapeutic outcomes, while knowing suitable substitutes helps when specific herbs are unavailable or contraindicated.

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Classical Formulas

1
Chamomile
Moderate Evidence
Rationale

The MYRRHINIL-INTEST formula (myrrh + chamomile + coffee charcoal) showed equivalence to mesalamine for maintaining ulcerative colitis remission over 12 months in a clinical study.

Clinical Evidence

Clinical study: Myrrh 100mg + chamomile 70mg + coffee charcoal 50mg (MYRRHINIL-INTEST) equivalent to mesalamine for UC remission maintenance.

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Synergistic Combinations

1
Boswellia
Traditional Use
Rationale

Classical TCM pairing (Mo Yao + Ru Xiang): Myrrh invigorates Blood while Boswellia moves Qi. Combined anti-inflammatory effects via complementary pathways (COX inhibition from both; 5-LOX inhibition from Boswellia). Used for joint pain, trauma, and inflammation.

Clinical Evidence

Classical TCM combination with extensive traditional evidence; limited modern RCT data specifically for this combination.

science Studies

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Episiotomy wound healing by Commiphora myrrha (Nees) Engl. and Boswellia carteri Birdw. in primiparous women: A randomized controlled trial

RCT
2021 |Faraji A et al. J Ethnopharmacol. 2021 Jan 10;264:113396.

This three-arm RCT enrolled 90 primiparous women following normal vaginal delivery at Hafez Hospital (Shiraz, Iran), randomized to myrrh sitz-bath extract, frankincense sitz-bath extract, or betadine sitz-bath (control), administered twice daily for 1 week. Episiotomy wound healing was measured with the REEDA scale on day 2 and day 7 postpartum. Myrrh treatment showed significantly better healing outcomes than both frankincense (p=0.003 on day 2) and betadine (p<0.001 on day 2). The study concluded that myrrh sitz-bath is a safe and effective natural therapy for promoting episiotomy wound healing, outperforming the standard betadine control.

anti-inflammatoryantimicrobialwound-healingantioxidant
View source open_in_new

Efficacy of Commiphora myrrh mouthwash on early wound healing after tooth extraction: A randomized controlled trial

RCT
2021 |Al Eid RAA. Saudi Dent J. 2021 Jan;33(1):44-54.

This double-blind RCT enrolled 40 healthy adult patients undergoing routine tooth extractions, randomized to myrrh (Commiphora molmol) mouthwash (n=20) or normal saline mouthwash (n=20) used twice daily for 7 days post-extraction. The primary outcome was wound healing assessed via postoperative edema, tenderness, and socket size. Myrrh mouthwash produced statistically significant improvements in all measured healing parameters compared to saline controls. The study concluded that myrrh mouthwash enhances wound healing during the early post-extraction period and may be a useful adjunctive dental treatment.

anti-inflammatoryantimicrobialwound-healing
View source open_in_new

medication Dosing

tincture

Dose Range

1-2 mL (1:5, 90% ethanol)

Frequency

TID for internal use; topically 2-3x/day

Notes

For mouthwash: dilute 10-15 drops in glass of warm water; rinse 2-3 min. For wounds: apply diluted tincture directly. For internal use: 1-2 mL in warm water TID.

powder

Dose Range

300-500 mg

Frequency

TID

Notes

Myrrh resin powder taken in capsules or mixed with water. Traditional Ayurvedic dose 1-3 g/day.

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Disclaimer: This information is largely AI-generated and reviewed by human experts at Evara Health. It is intended for educational and clinical reference purposes only and should not replace professional medical advice.

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