What is it?
Bromelain is an enzyme found in pineapple juice and in the pineapple stem. People use it for medicine.
Bromelain is used for reducing swelling (inflammation), especially of the nose and sinuses, after surgery or injury. It is also used for hay fever, treating a bowel condition that includes swelling and ulcers (ulcerative colitis), removing dead and damaged tissue after a burn (debridement), preventing the collection of water in the lung (pulmonary edema), relaxing muscles, stimulating muscle contractions, slowing clotting, improving the absorption of antibiotics, preventing cancer, shortening labor, and helping the body get rid of fat.
It is also used for preventing muscle soreness after intense exercise. This use has been studied, and the evidence suggests bromelain doesn’t work for this.
Some people use a product (Phlogenzym) for arthritis (osteoarthritis) that combines bromelain with trypsin (a protein) and rutin (a substance found in buckwheat). Bromelain used in this way seems to reduce pain and improve knee function in people with arthritis.
There isn’t enough scientific evidence to determine whether or not bromelain is effective for any of its other uses.
How effective is it?
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
The effectiveness ratings for BROMELAIN are as follows:
Possibly ineffective for...
- Preventing muscle soreness (myalgia) after exercise. Taking bromelain orally, immediately following intense exercise, does not seem to delay onset of muscle soreness and has no effect on pain, flexibility, or skeletal weakness.
Insufficient evidence to rate effectiveness for...
- Arthritis (osteoarthritis). Taking bromelain alone doesn’t seem to help arthritis pain. However, a specific combination of bromelain, trypsin and rutin (Phlogenzym) might help about as well as the prescription anti-inflammatory drug, diclofenac.
- Arthritis (rheumatoid arthritis). Some research suggests that bromelain might help reduce joint swelling in rheumatoid arthritis; however this research is not very reliable.
- Knee pain. There's some evidence that taking bromelain by mouth might reduce mild acute knee pain that’s lasted for less than three months in otherwise healthy people.
- Severe burns. There’s some evidence that using a bromelain-derived product called Debridase under a dressing helps to remove the dead tissue from burns.
- Improving antibiotic absorption.
- Hay fever.
- Preventing cancer.
- Shortening of labor.
- Ulcerative colitis.
- Other conditions.
More evidence is needed to rate the effectiveness of bromelain for these uses.
Bromelain seems to cause the body to produce substances that fight pain and swelling (inflammation).
Bromelain also contains chemicals that interfere with the growth of tumor cells and slow blood clotting.
Bromelain is POSSIBLY SAFE for most people when taken in appropriate amounts. Bromelain may cause some side effects, such as diarrhea and stomach and intestinal discomfort. Bromelain may also cause allergic reactions, especially in people who have other allergies. If you have allergies, be sure to check with your healthcare provider before taking bromelain.
Special precautions & warnings:
Pregnancy and breast-feeding: Not enough is known about the use of bromelain during pregnancy and breast-feeding. Stay on the safe side and avoid use.
Allergies: If you are allergic to pineapple, latex, wheat, celery, papain, carrot, fennel, cypress pollen, or grass pollen, you might have an allergic reaction to bromelain.
Surgery: Bromelain might increase the risk of bleeding during and after surgery. Stop using bromelain at least 2 weeks before a scheduled surgery.
Be cautious with this combination.
Amoxicillin (Amoxil, Trimox)
Taking bromelain might increase how much amoxicillin is in the body. Taking bromelain along with amoxicillin might increase the effects and side effects of amoxicillin.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Bromelain might slow blood clotting. Taking bromelain along with medications that also slow clotting might increase the chances of bruising and bleeding.
Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, indomethacin (Indocin), ticlopidine (Ticlid), warfarin (Coumadin), and others.
Be watchful with this combination.
Antibiotics (Tetracycline antibiotics)
Taking bromelain might increase how much antibiotic the body absorbs. Taking bromelain along with some antibiotics called tetracyclines might increase effects and side effects of these antibiotics.
Some tetracyclines include demeclocycline (Declomycin), minocycline (Minocin), and tetracycline (Achromycin).
Herbs and supplements that might slow blood clotting
Bromelain might slow blood clotting. Taking bromelain along with other herbs and supplements that also slow clotting might increase the chances of bruising and bleeding. Some of these products include alfalfa, angelica, aniseed, arnica, asafoetida, bladderwrack, celery, chamomile, clove, fenugreek, feverfew, garlic, ginger, horse chestnut, licorice, meadowsweet, poplar, northern and southern prickly ash, quassia, red clover, and willow.
Metals such as zinc might slow down the activity of bromelain in the body, but there are no medical reports of this happening in people.
Potato contains a substance that might slow down bromelain's activity in the body.
Soybean contains a substance that might slow down bromelain's activity in the body.
The following doses have been studied in scientific research:
- For osteoarthritis: a combination product (Phlogenzym), which contains rutin 100 mg, trypsin 48 mg, and bromelain 90 mg, given as 2 tablets 3 times daily has been used.
Ananas, Ananus ananus, Ananas comosus, Ananus duckei, Ananas sativus, Bromelaine, Bromélaïne, Bromelains, Bromelainum, Bromelia ananus, Bromelia comosa, Bromelin, Bromelina, Broméline, Concentré de Protéase Végétale, Enzyme d’Ananas, Extrait d’Ananas, pHysioprotease, Pineapple, Pineapple Enzyme, Pineapple Extract, Plant Protease Concentrate.
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (//www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).
To see all references for the Bromelain page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/895.html.
- Miller JM, Ginsberg M, McElfatrick GC, and et al. The administration of bromelain orally in the treatment of inflammation and edema. Exper Med & Surg 1964;22:293-299.
- Cirelli MG. Five years of clinical experience with bromelains in therapy of edema and inflammation in postoperative tissue reaction, skin infections and trauma. Clinical Medicine 1967;74:55-59.
- Tassman GC, Zafran JN, and Zayon GM. A double-blind crossover study of a plant proteolytic enzyme in oral surgery. J Dent Med 1965;20:51-54.
- Ferrari A, Pifarotti G, Dindelli M, and et al. Clinical trial of the efficacy and safety of seaprose S in patients with benign breast disease. Controlled trial vs bromeline. Gironale Italiano Di Ricerche Cliniche e Terapeutiche 1995;16:1-6.
- Kugener H, Bergmann D, and Beck K. [Efficacy of bromelain in pancreatogenic digestive insufficiency]. Zeitschrift fur Gastroenterologie 1968;6:430-433.
- Klaue P, Dilbert G, Hinke G, and et al. [Experiments on the local treatment of subdermal burns with bromelain]. Therapiewoche 1979;29:796-797.
- Klein GK. Enzymatic debridement of third degree burns in animals with bromelains - a preliminary report. J Maine Med Assoc 1964;55:169-171.
- Kolac C, Streichhan P, and Lehr CM. Oral bioavailability of proteolytic enzymes. Eur J Pharm Biopharm 1996;42:232.
- Kleine MW. Introduction to oral enzyme therapy. Int J Immunotherapy 1997;13(3-4):59-65.
- Donath F, Mai I, Maurer A, and et al. Dose-related bioavailabilty of bromelain and trypsin after repeated oral administration: PI-79 [abstract]. Clinical Pharmacology and Therapeutics 1997;61:157.
Stange R, Schneider R, Maurer R, and et al. Proteolytic enzyme bromelaine enhances zytotoxicity in patients with breast cancer [abstract]. National Scientific Conference on Complementary, Alternative & Integrative Medicine Research, April 12 - 14 2002;
- Anonymous. Bromelain. Alternative Medicine Review 1998;3:302-305.
- Tassman GC, Zafran JN, and Zayon GM. Evaluation of a plant proteolytic enzyme for the control of inflammation and pain. Journal of Dental Medicine 1964;19:73-77.
- Martin GJ, Ehrenreich J, and Asbell N. Bromelain: pineapple proteases with anti-edema activity. Exp Med Surg 1962;20:227-247.
- Perez-Camo I, Quirce S, Duran MA, and et al. Latex allergy: evidence of cross-reactivity with papain and bromelain [abstract]. Allergy 1996;51(suppl 31):48.
- Kelly GS. Bromelain: a literature review and discussion of its therapeutic applications. Alternative Medicine Review 1996;1:243-257.
- Nasciuti M and Benini P. Sperimentazione clinica in doppio cieco della bromelina in pazienti con fratture recenti degli arti inferiori. Gaz Med It 1977;136:535-546.
- Cohen A and Goldman J. Bromelains therapy in rheumatoid arthritis. Pennsylvania Med J 1964;67:27-30.
- Morrison AW and Morrison MC. Bromelain - a clinical assessment in the post-operative treatment of arthrotomies of the knee and facial injuries. Brit J Clin Pract 1965;19:207-210.
- Morton, J. F. Major Medicinal Plants. 1977;
- Seligman B. Bromelain: an anti-inflammatory agent. Angiology 1962;13:508-510.
- Hunter RG, Henry GW, and Heinicke RM. The action of papain and bromelain on the uterus. Part I. Mucolytic properties of papain and bromelain, effect on cervical mucus. Am J Obst & Gynec 1957;73:867-874.
- Castell, J. V., Friedrich, G., Kuhn, C. S., and Poppe, G. E. Intestinal absorption of undegraded proteins in men: presence of bromelain in plasma after oral intake. Am.J Physiol 1997;273(1 Pt 1):G139-G146. View abstract.
- Mynott, T. L., Guandalini, S., Raimondi, F., and Fasano, A. Bromelain prevents secretion caused by Vibrio cholerae and Escherichia coli enterotoxins in rabbit ileum in vitro. Gastroenterology 1997;113:175-184. View abstract.
- Mudrak, J., Bobak, L., and Sebova, I. Adjuvant therapy with hydrolytic enzymes in recurrent laryngeal papillomatosis. Acta Otolaryngol.Suppl 1997;527:128-130. View abstract.
- Kleef, R., Delohery, T. M., and Bovbjerg, D. H. Selective modulation of cell adhesion molecules on lymphocytes by bromelain protease 5. Pathobiology 1996;64:339-346. View abstract.
- Mynott, T. L., Luke, R. K., and Chandler, D. S. Oral administration of protease inhibits enterotoxigenic Escherichia coli receptor activity in piglet small intestine. Gut 1996;38:28-32. View abstract.
- Taussig, S. J., Yokoyama, M. M., Chinen, A., Onari, K., and Yamakido, M. Bromelain: a proteolytic enzyme and its clinical application. A review. Hiroshima J.Med.Sci. 1975;24(2-3):185-193. View abstract.
- Desser, L., Rehberger, A., Kokron, E., and Paukovits, W. Cytokine synthesis in human peripheral blood mononuclear cells after oral administration of polyenzyme preparations. Oncology 1993;50:403-407. View abstract.
- Ako, H., Cheung, A. H., and Matsuura, P. K. Isolation of a fibrinolysis enzyme activator from commercial bromelain. Arch Int Pharmacodyn.Ther 1981;254:157-167. View abstract.
- Balakrishnan, V., Hareendran, A., and Nair, C. S. Double-blind cross-over trial of an enzyme preparation in pancreatic steatorrhoea. J Assoc Physicians India 1981;29:207-209. View abstract.
- Gutfreund, A. E., Taussig, S. J., and Morris, A. K. Effect of oral bromelain on blood pressure and heart rate of hypertensive patients. Hawaii Med J 1978;37:143-146. View abstract.
- Galleguillos, F. and Rodriguez, J. C. Asthma caused by bromelin inhalation. Clin Allergy 1978;8:21-24. View abstract.
- Mattei, O., Fabri, G., and Farina, G. [Occupational health experience regarding four cases of asthma due to bromelain (author's transl)]. Medicina del Lavoro 1979;70:404-409. View abstract.
- Hine, S. and Tamura, N. [Clinical use of bromelain (Ananase) in chronic rhino-sinusitis]. Jibiinkoka 1966;38:439-442. View abstract.
- Kagitomi, T. and Shozuka, K. [Effect of bromelain in chronic sinusitis]. Jibiinkoka 1966;38:433-437. View abstract.
- Zatuchni, G. I. and Colombi, D. J. Bromelains therapy for the prevention of episiotomy pain. Obstet Gynecol. 1967;29:275-278. View abstract.
- Koshiishi, T., Furusawa, Y., Iseki, H., and Iwasaki, Y. A double blind study of the effects of Kimotab on engorgement of the breast. Acta Obstet.Gynaecol.Jpn. 1971;18:222-228. View abstract.
- Cowie, D. H., Fairweather, D. V., and Newell, D. J. A double-blind trial of bromelains as an adjunct to vaginal plastic repair operations. J Obstet Gynaecol Br Commonw. 1970;77:365-368. View abstract.
- Korlof, B., Ponten, B., and Ugland, O. Bromelain--a proteolytic enzyme. Scand.J.Plast.Reconstr.Surg. 1969;3:27-29. View abstract.
- Seligman, B. Oral bromelains as adjuncts in the treatment of acute thrombophlebitis. Angiology 1969;20:22-26. View abstract.
- Spaeth, G. L. The effect of bromelains on the inflammatory response caused by cataract extraction: a double-blind study. Eye Ear Nose Throat Mon. 1968;47:634-639. View abstract.
- Mader, H. [Comparative studies on the effect of bromelin and oxyphenbutazone in episiotomy pains]. Schweiz Rundsch.Med Prax. 8-28-1973;62:1064-1068. View abstract.
- Howat, R. C. and Lewis, G. D. The effect of bromelain therapy on episiotomy wounds--a double blind controlled clinical trial. J Obstet.Gynaecol.Br.Commonw. 1972;79:951-953. View abstract.
- Weiss, S. and Scherrer, M. [Crossed double-blind trial of potassium iodide and bromelain (Traumanase) in chronic bronchitis]. Schweiz.Rundsch.Med Prax. 10-24-1972;61:1331-1333. View abstract.
- Izaka, K. I., Yamada, M., Kawano, T., and Suyama, T. Gastrointestinal absorption and antiinflammatory effect of bromelain. Jpn J Pharmacol 1972;22:519-534. View abstract.
- Levine, N., Seifter, E., Connerton, C., and Levenson, S. M. Debridement of experimental skin burns of pigs with bromelain, a pineapple-stem enzyme. Plast.Reconstr.Surg. 1973;52:413-424. View abstract.
- Ito, C., Yamaguchi, K., Shibutani, Y., Suzuki, K., Yamazaki, Y., Komachi, H., Ohnishi, H., and Fujimura, H. [Anti-inflammatory actions of proteases, bromelain, trypsin and their mixed preparation (author's transl)]. Nippon Yakurigaku Zasshi 4-20-1979;75:227-237. View abstract.
- Gailhofer, G., Wilders-Truschnig, M., Smolle, J., and Ludvan, M. Asthma caused by bromelain: an occupational allergy. Clin Allergy 1988;18:445-450. View abstract.
- Felton, G. E. Does kinin released by pineapple stem bromelain stimulate production of prostaglandin E1-like compounds? Hawaii Med J 1977;36:39-47. View abstract.
- Maurer, H. R., Hozumi, M., Honma, Y., and Okabe-Kado, J. Bromelain induces the differentiation of leukemic cells in vitro: an explanation for its cytostatic effects? Planta Med 1988;54:377-381. View abstract.
- Kumakura, S., Yamashita, M., and Tsurufuji, S. Effect of bromelain on kaolin-induced inflammation in rats. Eur.J Pharmacol 6-10-1988;150:295-301. View abstract.
- Lotz-Winter, H. On the pharmacology of bromelain: an update with special regard to animal studies on dose-dependent effects. Planta Med 1990;56:249-253. View abstract.
- Sideris, C. P. and Young, H. Y. GROWTH OF ANANAS COMOSUS (L.) MERR. AT DIFFERENT LEVELS OF MINERAL NUTRITION UNDER GREENHOUSE AND FIELD CONDITIONS. I. PLANT AND FRUIT WEIGHTS AND ABSORPTION OF NITRATE AND POTASSIUM AT DIFFERENT GROWTH INTERVALS. Plant Physiol 1950;25:594-616. View abstract.
- Klein, G., Kullich, W., Schnitker, J., and Schwann, H. Efficacy and tolerance of an oral enzyme combination in painful osteoarthritis of the hip. A double-blind, randomised study comparing oral enzymes with non-steroidal anti-inflammatory drugs. Clin Exp Rheumatol. 2006;24:25-30. View abstract.
- Hou, R. C., Chen, Y. S., Huang, J. R., and Jeng, K. C. Cross-linked bromelain inhibits lipopolysaccharide-induced cytokine production involving cellular signaling suppression in rats. J Agric.Food Chem 3-22-2006;54:2193-2198. View abstract.
- Secor, E. R., Jr., Carson, W. F., Cloutier, M. M., Guernsey, L. A., Schramm, C. M., Wu, C. A., and Thrall, R. S. Bromelain exerts anti-inflammatory effects in an ovalbumin-induced murine model of allergic airway disease. Cell Immunol. 2005;237:68-75. View abstract.
- Seltzer, A. P. Minimizing post-operative edema and ecchymoses by the use of an oral enzyme preparation (bromelain). A controlled study of 53 rhinoplasty cases. Eye Ear Nose Throat Mon. 1962;41:813-817. View abstract.
- Eckert, K., Grabowska, E., Stange, R., Schneider, U., Eschmann, K., and Maurer, H. R. Effects of oral bromelain administration on the impaired immunocytotoxicity of mononuclear cells from mammary tumor patients. Oncol.Rep. 1999;6:1191-1199. View abstract.
- Mynott, T. L., Ladhams, A., Scarmato, P., and Engwerda, C. R. Bromelain, from pineapple stems, proteolytically blocks activation of extracellular regulated kinase-2 in T cells. J Immunol 9-1-1999;163:2568-2575. View abstract.
- Perez-Camo I, Quirce S, Duran MA, et al. Latex allergy: evidence of cross-reactivity with papain and bromelain [abstract]. Allergy 1996;51:48.
- Renzini G. Varengo M. [Absorption of tetracycline in presence of bromelain after oral administration]. Arzneimittelforschung 1972;22:410-2. View abstract.
- Heinicke R M, van der Wal L, Yokoyama M. Effect of bromelain (Ananase) on human platelet aggregation. Experientia 1972;28:844-5. View abstract.
- Glaser D, Hilberg T. The influence of bromelain on platelet count and platelet activity in vitro. Platelets 2006;17:37-41. View abstract.
- Gerard G. [Anticancer treatment and bromelains]. Agressologie 1972;13:261-74. View abstract.
- Gylling U, Rintala A, Taipale S, Tammisto T. The effect of a proteolytic enzyme combinate (bromelain) on the postoperative oedema by oral application. A clinical and experimental study. Acta Chir Scand 1966;131:193-6. View abstract.
- Mori S, Ojima Y, Hirose T, et al. The clinical effect of proteolytic enzyme containing bromelain and trypsin on urinary tract infection evaluated by double blind method. Acta Obstet Gynaecol Jpn 1972;19:147-53. View abstract.
- Cohen A, Goldman J. Bromelains therapy in rheumatoid arthritis. Pa Med J. 1964;67:27-30. View abstract.
- Massimiliano R, Pietro R, Paolo S, et al. Role of bromelain in the treatment of patients with pityriasis lichenoides chronica. J DermatologTreat 2007;18:219-22. View abstract.
- Taub SJ. The use of Ananase in sinusitis. A study of 60 patients. Eye Ear Nose Throat Mon 1966;45:96, 98. View abstract.
- Seltzer AP. Adjunctive use of bromelains in sinusitis: a controlled study. Eye Ear Nose Throat Mon 1967;46:1281, 1284, 1286-8. View abstract.
- Taub SJ. The use of bromelains in sinusitis: a double-blind clinical evaluation. Eye Ear Nose Throat Mon 1967;46:361-2. View abstract.
- Ryan RE. A double-blind clinical evaluation of bromelains in the treatment of acute sinusitis. Headache 1967;7:13-17. View abstract.
- Rosenberg L, Lapid O, Bogdanov-Berezovsky A, et al. Safety and efficacy of a proteolytic enzyme for enzymatic burn debridement: a preliminary report. Burns 2004;30:843-50. View abstract.
- Brien S, Lewith G, Walker AF, et al. Bromelain as an adjunctive treatment for moderate-to-severe osteoarthritis of the knee: a randomized placebo-controlled pilot study. QJM 2006;99:841-50. View abstract.
- Bush TM, Rayburn KS, Holloway SW, et al. Adverse interactions between herbal and dietary substances and prescription medications: a clinical survey. Altern Ther Health Med 2007;13:30-5. View abstract.
- Bradbrook ID, Morrison PJ, Rogers HJ. The effect of bromelain on the absorption of orally administered tetracycline. Br J Clin Pharmacol 1978;6:552-4. View abstract.
- Tinozzi S, Venegoni A. Effect of bromelain on serum and tissue levels of amoxicillin. Drugs Exptl Clin Res 1978;4:39-44.
- Walker AF, Bundy R, Hicks SM, Middleton RW. Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adults. Phytomedicine 2002;9:681-6. View abstract.
- Taussig SJ, Batkin S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J Ethnopharmacol 1988;22:191-203.. View abstract.
- Stone MB, Merrick MA, Ingersoll CD, et al. Preliminary comparison of bromelain and Ibuprofen for delayed onset muscle soreness management. Clin J Sport Med 2002;12:373-8.. View abstract.
- Nettis E, Napoli G, Ferrannini A, Tursi A. IgE-mediated allergy to bromelain. Allergy 2001;56:257-8. View abstract.
- Hale LP, Greer PK, Sempowski GD. Bromelain treatment alters leukocyte expression of cell surface molecules involved in cellular adhesion and activation. Clin Immunol 2002;104:183-90. View abstract.
- Kane S, Goldberg MJ. Use of bromelain for mild ulcerative colitis. Ann Intern Med 2000;132:680. View abstract.
- Klein G, Kullich W. Short-term treatment of painful osteoarthritis of the knee with oral enzymes. Clin Drug Invest 2000;19:15-23.
- Zavadova E, Desser L, Mohr T. Stimulation of reactive oxygen species production and cytotoxicity in human neutrophils in vitro and after oral administration of a polyenzyme preparation. Cancer Biother 1995;10:147-52. View abstract.
- Zimacheva AV, Mosolov VV. [Cysteine proteinase inhibitors from soy seeds]. Biokhimiia 1995;60:118-23. View abstract.
- Masson M. [Bromelain in blunt injuries of the locomotor system. A study of observed applications in general practice]. Fortschr Med 1995;113:303-6. View abstract.
- Tanabe S, Tesaki S, Watanabe M, Yanagihara Y. [Cross-reactivity between bromelain and soluble fraction from wheat flour]. Arerugi 1997;46:1170-3. View abstract.
- Valueva TA, Revina TA, Mosolov VV. Potato tuber protein proteinase inhibitors belonging to the Kunitz soybean inhibitor family. Biochemistry (Mosc) 1997;62:1367-74. View abstract.
- Hotz G, Frank T, Zoller J, Wiebelt H. [Antiphlogistic effect of bromelaine following third molar removal]. Dtsch Zahnarztl Z 1989;44:830-2. View abstract.
- Shoskes DA, Zeitlin SI, Shahed A, Rajfer J. Quercetin in men with category III chronic prostatitis: A preliminary prospective, double-blind, placebo-controlled trial. Urol 1999;54:960-3. View abstract.
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- Show more references
- Show fewer references
Last reviewed - 02/14/2015
This copyrighted, evidence-based medicine resource is provided by Natural Medicines Comprehensive Database Consumer Version. Natural Medicines Comprehensive Database disclaims any responsibility related to consequences of using any product. This monograph should not replace advice from a healthcare professional and should not be used for the diagnosis or treatment of any medical condition.
Copyright © 1995 - 2015 Therapeutic Research Center, publishers of Natural Medicines, Prescriber's Letter, Pharmacist's Letter. All rights reserved. For scientific data on natural medicines, professionals may consult Natural Medicines