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.
Overview InformationBromelain is a group of enzymes found in pineapple juice and in the pineapple stem. People use it as a medicine.
Bromelain is used for pain, muscle soreness, and many other conditions, but there is no good scientific evidence to support 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.
Uses & Effectiveness
Possibly Ineffective for
- Muscle soreness caused by 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 for
- Burns. Early research shows that applying gel containing bromelain enzymes under a wound dressing helps remove dead tissue from second- and third-degree burns.
- Kidney stones. Early research found that adding bromelain to tamsulosin might help the body get rid of kidney stones.
- Knee pain. Early research shows that taking bromelain by mouth might reduce mild knee pain.
- Osteoarthritis. Taking bromelain by mouth alone doesn't seem to help arthritis pain.
- A skin condition that causes small, scaling, raised spots (pityriasis lichenoides chronica or PLC). Early research shows that bromelain might help treat episodes of PLC.
- Pain after surgery. Some research shows that bromelain slightly reduces pain after removal of wisdom teeth. But it doesn't seem to reduce lockjaw or swelling.
- Rheumatoid arthritis (RA). Early research shows that bromelain can reduce joint swelling in people with rheumatoid arthritis. But this research is not very reliable.
- Swelling (inflammation) of the nasal cavity and sinuses (rhinosinusitis). Early research shows that taking bromelain along with decongestants, antihistamines, or antibiotics helps reduce nasal swelling in people with sinusitis. But this research is not very reliable.
- A type of inflammatory bowel disease (ulcerative colitis). Early research shows that bromelain helps alleviate ulcerative colitis symptoms in people that do not get enough relief after standard therapy.
- An adverse skin reaction caused by cancer drug treatment (chemotherapy-induced acral erythema).
- Infections of the kidney, bladder, or urethra (urinary tract infections or UTIs).
- Painful conditions caused by overuse of tendons (tendinopathy).
- Hay fever.
- Improving antibiotic absorption.
- Preventing cancer.
- Shortening of labor.
- Other conditions.
Side Effects & SafetyWhen taken by mouth: Bromelain is POSSIBLY SAFE for most people when taken by mouth 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.
When applied to the skin: Bromelain is POSSIBLY SAFE for most people when applied to the skin in appropriate amounts.
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.
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.
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.
- Ako, H., Cheung, A. H., and Matsuura, P. K. Isolation of a fibrinolysis enzyme activator from commercial bromelain. Arch Int Pharmacodyn.Ther 1981;254(1):157-167. View abstract.
- Anonymous. Bromelain. Alternative Medicine Review 1998;3(4):302-305.
- 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(3):207-209. View abstract.
- 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.
- 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.
- Cohen A and Goldman J. Bromelains therapy in rheumatoid arthritis. Pennsylvania Med J 1964;67:27-30.
- 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(4):365-368. 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(6):403-407. View abstract.
- Felton, G. E. Does kinin released by pineapple stem bromelain stimulate production of prostaglandin E1-like compounds? Hawaii Med J 1977;36(2):39-47. View abstract.
- 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):1-6.
- Gailhofer, G., Wilders-Truschnig, M., Smolle, J., and Ludvan, M. Asthma caused by bromelain: an occupational allergy. Clin Allergy 1988;18(5):445-450. View abstract.
- Galleguillos, F. and Rodriguez, J. C. Asthma caused by bromelin inhalation. Clin Allergy 1978;8(1):21-24. View abstract.
- Hine, S. and Tamura, N. [Clinical use of bromelain (Ananase) in chronic rhino-sinusitis]. Jibiinkoka 1966;38(4):439-442. 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(6):2193-2198. 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(10):951-953. View abstract.
- 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(4):867-874.
- 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(3):227-237. View abstract.
- Izaka, K. I., Yamada, M., Kawano, T., and Suyama, T. Gastrointestinal absorption and antiinflammatory effect of bromelain. Jpn J Pharmacol 1972;22(4):519-534. View abstract.
- Kagitomi, T. and Shozuka, K. [Effect of bromelain in chronic sinusitis]. Jibiinkoka 1966;38(4):433-437. View abstract.
- Kelly GS. Bromelain: a literature review and discussion of its therapeutic applications. Alternative Medicine Review 1996;1(4):243-257.
- Klaue P, Dilbert G, Hinke G, and et al. [Experiments on the local treatment of subdermal burns with bromelain]. Therapiewoche 1979;29:796-797.
- 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.
- Kleine MW. Introduction to oral enzyme therapy. Int J Immunotherapy 1997;13(3-4):59-65.
- Kolac C, Streichhan P, and Lehr CM. Oral bioavailability of proteolytic enzymes. Eur J Pharm Biopharm 1996;42(222):232.
- Korlof, B., Ponten, B., and Ugland, O. Bromelain--a proteolytic enzyme. Scand.J.Plast.Reconstr.Surg. 1969;3(1):27-29. 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(4):222-228. View abstract.
- Kugener H, Bergmann D, and Beck K. [Efficacy of bromelain in pancreatogenic digestive insufficiency]. Zeitschrift fur Gastroenterologie 1968;6:430-433.
- 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.
- Lotz-Winter, H. On the pharmacology of bromelain: an update with special regard to animal studies on dose-dependent effects. Planta Med 1990;56(3):249-253. View abstract.
- 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.
- 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.
- 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(1):175-184. 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(1):28-32. View abstract.
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- 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.
- Seligman B. Bromelain: an anti-inflammatory agent. Angiology 1962;13:508-510.
- Seligman, B. Oral bromelains as adjuncts in the treatment of acute thrombophlebitis. Angiology 1969;20(1):22-26. 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.
- 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(4):594-616. 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(12):634-639. View abstract.
- 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(2):51-54.
- 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(2):73-77.
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- 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.
- 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.
- 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.
- 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.
- de Souza GM, Fernandes IA, Dos Santos CRR, Falci SGM. Is bromelain effective in controlling the inflammatory parameters of pain, edema, and trismus after lower third molar surgery? A systematic review and meta-analysis. Phytother Res. 2019;33(3):473-481. View abstract.
- Desideri I, Francolini G, Becherini C, et al. Use of an alpha lipoic, methylsulfonylmethane and bromelain dietary supplement (Opera) for chemotherapy-induced peripheral neuropathy management, a prospective study. Med Oncol. 2017 Mar;34(3):46.View abstract.
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- Glaser D, Hilberg T. The influence of bromelain on platelet count and platelet activity in vitro. Platelets 2006;17:37-41. View abstract.
- Gumina S, Passaretti D, Gurzì MD, et al. Arginine L-alpha-ketoglutarate, methylsulfonylmethane, hydrolyzed type I collagen and bromelain in rotator cuff tear repair: a prospective randomized study. Curr Med Res Opin. 2012 Nov;28:1767-74. 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.
- Heinicke R M, van der Wal L, Yokoyama M. Effect of bromelain (Ananase) on human platelet aggregation. Experientia 1972;28:844-5. 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.
- Inchingolo F, Tatullo M, Marrelli M, Inchingolo AM, Picciariello V, Inchingolo AD, Dipalma G, Vermesan D, Cagiano R. Clinical trial with bromelain in third molar exodontia. Eur Rev Med Pharmacol Sci. 2010 Sep;14(9):771-4. View abstract.
- Kane S, Goldberg MJ. Use of bromelain for mild ulcerative colitis. Ann Intern Med 2000;132:680. View abstract.
- Kasemsuk T, Saengpetch N, Sibmooh N, Unchern S. Improved WOMAC score following 16-week treatment with bromelain for knee osteoarthritis. Clin Rheumatol. 2016 Oct;35(10):2531-40. 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.
- 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.
- 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.
- 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.
- Mendes ML, do Nascimento-Júnior EM, Reinheimer DM, Martins-Filho PR. Efficacy of proteolytic enzyme bromelain on health outcomes after third molar surgery. Systematic review and meta-analysis of randomized clinical trials. Med Oral Patol Oral Cir Bucal. 2019 Jan 1;24(1):e61-e69. 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.
- 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.
- Nettis E, Napoli G, Ferrannini A, Tursi A. IgE-mediated allergy to bromelain. Allergy 2001;56:257-8. View abstract.
- Notarnicola A, Pesce V, Vicenti G, et al. SWAAT study: extracorporeal shock wave therapy and arginine supplementation and other nutraceuticals for insertional Achilles tendinopathy. Adv Ther. 2012 Sep;29:799-814. View abstract.
- Palmisano F, Spinelli MG, Luzzago S, et al. Medical Expulsive Therapy for Symptomatic Distal Ureter Stones: Is the Combination of Bromelain and Tamsulosin More Effective than Tamsulosin Alone? Preliminary Results of a Single-Center Study. Urol Int. 2019;102(2):145-152. 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.
- Rosenberg L, Krieger Y, Bogdanov-Berezovski A, et al. A novel rapid and selective enzymatic debridement agent for burn wound management: a multi-center RCT. Burns. 2014;40(3):466-74. 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.
- Ryan RE. A double-blind clinical evaluation of bromelains in the treatment of acute sinusitis. Headache 1967;7:13-17. View abstract.
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