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.<br/><br/>
Overview InformationBromelain 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 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.
Uses & Effectiveness
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 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. Some early research shows that taking bromelain after getting wisdom teeth removed reduces pain and swelling. Other research shows that taking bromelain along with a steroid medication can reduce pain and swelling better than taking the steroid alone. But other early research shows no benefit.
- 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.
- Preventing cancer.
- Shortening of labor.
- Other conditions.
Side Effects & SafetyBromelain 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) interacts with BROMELAIN
Taking bromelain might increase how much amoxicillin is in the body. Taking bromelain along with amoxicillin might increase effects and side effects of amoxicillin.
Antibiotics (Tetracycline antibiotics) interacts with BROMELAIN
Taking bromelain might increase how much antibiotic the body absorbs. Taking bromelain along with some antibiotics might increase effects and side effects of some antibiotics called tetracyclines.<br /><br /> Some tetracyclines include demeclocycline (Declomycin), minocycline (Minocin), and tetracycline (Achromycin).
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with BROMELAIN
Bromelain might slow blood clotting. Taking bromelain along with medications that also slow clotting might increase the chances of bruising and bleeding.<br /><br /> 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, warfarin (Coumadin), and others.
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.
- 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(43):1331-1333. View abstract.
- Zatuchni, G. I. and Colombi, D. J. Bromelains therapy for the prevention of episiotomy pain. Obstet Gynecol. 1967;29(2):275-278. View abstract.
- Bolten WW, Glade MJ, Raum S, et al. The safety and efficacy of an enzyme combination in managing knee osteoarthritis pain in adults: a randomized, double-blind, placebo-controlled trial. Arthritis. 2015;2015:251521.View abstract.
- Bormann KH, Weber K, Kloppenburg H, et al. Perioperative bromelain therapy after wisdom teeth extraction - a randomized, placebo-controlled, double-blinded, three-armed, cross-over dose-finding study. Phytother Res. 2016 Dec;30(12):2012-19. View abstract.
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- 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.
- Büttner L, Achilles N, Böhm M, et al. Efficacy and tolerability of bromelain in patients with chronic rhinosinusitis--a pilot study. B-ENT. 2013;9(3):217-25.View abstract.
- Cohen A, Goldman J. Bromelains therapy in rheumatoid arthritis. Pa Med J. 1964;67:27-30. View abstract.
- Conrozier T, Mathieu P, Bonjean M, et al. A complex of three natural anti-inflammatory agents provides relief of osteoarthritis pain. Altern Ther Health Med. 2014;20 Suppl 1:32-7.View abstract.
- de la Barrera-Núñez MC, Yáñez-Vico RM, Batista-Cruzado A, et al. Prospective double-blind clinical trial evaluating the effectiveness of Bromelain in the third molar extraction postoperative period. Med Oral Patol Oral Cir Bucal. 2014;19(2):e157-62. View abstract.
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- 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.
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- Klein G, Kullich W. Short-term treatment of painful osteoarthritis of the knee with oral enzymes. Clin Drug Invest 2000;19:15-23.
- Majid OW, Al-Mashhadani BA. Perioperative bromelain reduces pain and swelling and improves quality of life measures after mandibular third molar surgery: a randomized, double-blind, placebo-controlled clinical trial. J Oral Maxillofac Surg. 2014;72(6):1043-8. View abstract.
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- Müller S, März R, Schmolz M, et al. Placebo-controlled randomized clinical trial on the immunomodulating activities of low- and high-dose bromelain after oral administration - new evidence on the antiinflammatory mode of action of bromelain. Phytother Res. 2013;27(2):199-204. View abstract.
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- Taub SJ. The use of Ananase in sinusitis. A study of 60 patients. Eye Ear Nose Throat Mon 1966;45:96, 98. View abstract.
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- Kleef, R., Delohery, T. M., and Bovbjerg, D. H. Selective modulation of cell adhesion molecules on lymphocytes by bromelain protease 5. Pathobiology 1996;64(6):339-346. View abstract.
- Klein GK. Enzymatic debridement of third degree burns in animals with bromelains - a preliminary report. J Maine Med Assoc 1964;55:169-171.
- 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(1):25-30. View abstract.
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- 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(4):222-228. View abstract.
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- Kumakura, S., Yamashita, M., and Tsurufuji, S. Effect of bromelain on kaolin-induced inflammation in rats. Eur.J Pharmacol 6-10-1988;150(3):295-301. 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(4):413-424. View abstract.
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- Mader, H. [Comparative studies on the effect of bromelin and oxyphenbutazone in episiotomy pains]. Schweiz Rundsch.Med Prax. 8-28-1973;62(35):1064-1068. View abstract.
- Martin GJ, Ehrenreich J, and Asbell N. Bromelain: pineapple proteases with anti-edema activity. Exp Med Surg 1962;20:227-247.
- 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(5):404-409. 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(5):377-381. View abstract.
- 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.
- 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(4):207-210.
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- 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(6):55-59.
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