URL of this page: https://www.nlm.nih.gov/medlineplus/druginfo/natural/895.html

Bromelain

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.
  • Inflammation.
  • Sinusitis.
  • 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.

How does it work?

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.

Are there safety concerns?

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.

Are there interactions with medications?

Moderate
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.
Minor
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).

Are there interactions with herbs and supplements?

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.
Zinc
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.

Are there interactions with foods?

Potato
Potato contains a substance that might slow down bromelain's activity in the body.
Soybean
Soybean contains a substance that might slow down bromelain's activity in the body.

What dose is used?

The following doses have been studied in scientific research:

BY MOUTH:
  • 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.

Other names

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.

Methodology

To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.

References

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Last reviewed - 02/14/2015