What other names is Bromelain known by?

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.

What is Bromelain?

Bromelain is a group of enzymes found in pineapple juice and in the pineapple stem. People use it for medicine.

Bromelain is used for reducing pain and swelling, especially of the nose and sinuses, dental gums, and other body parts 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), rheumatoid arthritis, a skin condition called pityriasis lichenoides chronica, relaxing muscles, tendon injuries (tendinopathy), knee pain, stimulating muscle contractions, slowing clotting, improving the absorption of antibiotics, preventing cancer, shortening labor, preventing urinary tract infections, and helping the body get rid of fat.

It is also used for preventing muscle soreness after intense exercise.

Some people use a specific product (Phlogenzym, also known as Wobenzym) for arthritis (osteoarthritis) that combines bromelain with trypsin (a protein) and rutin (a substance found in buckwheat).

Possibly Ineffective for...

  • Preventing muscle soreness (myalgia) after exercise. Taking bromelain by mouth after intense exercise does not prevent muscle soreness. It also doesn't reduce pain or weakness or improve flexibility.

Insufficient Evidence to Rate Effectiveness for...

  • Severe burns. Early research shows that applying gel containing bromelain enzymes under a wound dressing helps remove dead tissue from second- and third-degree burns.
  • Knee pain. Early research shows that taking bromelain by mouth might reduce mild knee pain.
  • Osteoarthritis. Taking bromelain alone by mouth doesn't seem to help arthritis pain. But taking a combination of bromelain, trypsin, and rutin by mouth seems to reduce osteoarthritis pain as much as the prescription anti-inflammatory drug diclofenac. Another supplement containing bromelain, devil's claw, and turmeric also seems to decrease osteoarthritis pain.
  • A skin condition called pityriasis lichenoides chronica (PLC). Early research shows that bromelain might help treat episodes of PLC.
  • Pain after dental surgery. Taking bromelain by mouth after surgical removal of wisdom teeth seems to decrease pain and swelling. But bromelain does not reduce swelling or pain after dental surgery involving impacted teeth or dislocated wisdom teeth.
  • Pain after surgery. Early research shows that that taking bromelain by mouth might decreases pain and swelling after surgery. Also, taking a product containing bromelain and other ingredients (Tenosan, Agave) seems to decrease shoulder pain after surgery. But it does not improve shoulder function.
  • Rheumatoid arthritis. Early research shows that bromelain can reduce joint swelling in people with rheumatoid arthritis. However this research is not very reliable.
  • Sinusitis. Early research shows that taking bromelain along with decongestants, antihistamines, or antibiotics helps reduce nasal swelling in people with sinusitis. However, this research is not very reliable.
  • Tendon injuries (tendinopathy). Early research shows that taking a combination supplement containing bromelain improves function and pain in people with an injury to the Achilles tendon.
  • Ulcerative colitis. Early research shows that bromelain helps alleviate ulcerative colitis symptoms in people that do not get enough relief after standard therapy.
  • Urinary tract infections (UTIs). A small study shows that a combination of bromelain and trypsin does not affect urinary tract infections.
  • Hay fever.
  • Improving antibiotic absorption.
  • Inflammation.
  • Preventing cancer.
  • Shortening of labor.
  • Other conditions.
More evidence is needed to rate the effectiveness of bromelain for these uses.

How does Bromelain 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 by mouth or applied to the skin 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 any interactions with medications?

Amoxicillin (Amoxil, Trimox)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Taking bromelain with amoxicillin might increase how much amoxicillin is in the body. This might increase the effects and side effects of amoxicillin.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

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.

Antibiotics (Tetracycline antibiotics)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

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).

Dosing considerations for Bromelain.

The appropriate dose of bromelain depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for bromelain. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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Last Editorial Review: 3/29/2011