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.
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:
The effectiveness ratings for BROMELAIN are as follows:
Possibly effective for...
- Arthritis (osteoarthritis) pain and knee function when used in combination with trypsin and rutin (Phlogenzym). This combination seems to be about as effective as some prescription painkillers.
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...
- Knee pain. There's some evidence that taking bromelain by mouth can reduce mild acute knee pain that’s lasted for less than three months in otherwise healthy people.
- Reducing swelling after surgery or injury. Some research suggests bromelain might reduce swelling and pain after surgery or injury. Interestingly, bromelain doesn’t seem to reduce swelling after mouth surgery.
- Severe burns.
- Inflammation.
- Improving antibiotic absorption.
- Hay fever.
- Preventing cancer.
- Shortening of labor.
- Ulcerative colitis.
- Other conditions.
How does it work?
Return to topBromelain 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 also contains chemicals that interfere with the growth of tumor cells and slow blood clotting.
Are there safety concerns?
Return to topBromelain 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.
Allergies: If you are allergic to pineapple, 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.
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, 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?
Return to topModerate
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.
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).
Some tetracyclines include demeclocycline (Declomycin), minocycline (Minocin), and tetracycline (Achromycin).
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.
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.
Are there interactions with herbs and supplements?
Return to topHerbs 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?
Return to topPotato
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?
Return to topThe following doses have been studied in scientific research:
BY MOUTH:
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
Return to topAnanas, 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
Return to top
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).
References
Return to topTo see all references for the Bromelain page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/895.html.
- 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.
- 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.
- 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.
- Taussig SJ, Batkin S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J Ethnopharmacol 1988;22:191-203.
- 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.
- Nettis E, Napoli G, Ferrannini A, Tursi A. IgE-mediated allergy to bromelain. Allergy 2001;56:257-8.
- 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.
- Kane S, Goldberg MJ. Use of bromelain for mild ulcerative colitis. Ann Intern Med 2000;132:680.
- Klein G, Kullich W. Short-term treatment of painful osteoarthritis of the knee with oral enzymes. Clin Drug Invest 2000;19:15-23.
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- Valueva TA, Revina TA, Mosolov VV. Potato tuber protein proteinase inhibitors belonging to the Kunitz soybean inhibitor family. Biochemistry (Mosc) 1997;62:1367-74.
- Hotz G, Frank T, Zoller J, Wiebelt H. [Antiphlogistic effect of bromelaine following third molar removal]. Dtsch Zahnarztl Z 1989;44:830-2.
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
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Last reviewed - 07/06/2011
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Copyright © 1995 - 2012 Therapeutic Research Faculty, publishers of Natural Medicines Comprehensive Database, Prescriber’s Letter, Pharmacist’s Letter. All rights reserved. For scientific data on natural medicines, professionals may consult the Professional Version of Natural Medicines Comprehensive DatabaseNatural Medicines Comprehensive Database (http://www.naturaldatabase.com/).
