Bromelain
Common Name: Pineapple Enzyme
Clinical Name: Bromelain
Summary
Bromelain
synonym: Pineapple enzyme.
overview of interactions:
• nutrient affecting drug performance: Amoxicillin
chemistry/function: Proteolytic enzymes. The broad substrate specificity of bromelain enables the enzyme to easily and efficiently hydrolyze most soluble proteins.
source: Pineapple (Ananas comosus); usually extracted from stems and provided in supplemental form.
known or potential therapeutic uses: Pain, swelling and inflammations associated with a wide range of conditions; muscle injuries, post-surgical recovery, sprains and strains, trauma, wound healing; mucous membrane inflammation in conditions such as sinusitis and urinary tract infections; angina, asthma, rheumatoid arthritis,
thrombophlebitis.
mechanism: Anti-inflammatory agent.
deficiency: Since bromelain is not an essential nutrient no deficiency pattern is recognized.
dosing system: Bromelain's potency is measured in gelatin-digesting units (GDU). It is also sometimes measured in GDUs (gelatin dissolving units). 1.5 MCU approximately equals one
GDU.
therapeutic dose: 300 to 500 mg (based on 2,000 GDU/gram), one to three times daily.
side effects: Bromelain is generally considered safe and free of side effects when taken at customary dosage levels for short durations, except when contraindicated. Gutfreund et al have suggested that bromelain might contribute to an increased heart rate in some individuals.
(Gutfreund AE, et al. Hawaii Med J 1978;37:143-146.)
contraindications: Some individuals may be allergic to bromelain. Potentially contraindicated in combination with anticoagulants due to compounded blood-thinning effect.
Interactions
nutrient affecting drug performance: Amoxicillin
• mechanism:, When taken in conjunction with amoxicillin, bromelain increases absorption of the drug.
(Tinozzi S, Venegoni A. Drugs Exp Clin Res 1978;4:39-44; Luerti M, Vignali M.
Drugs Exp Clin Res 1978;4:45-48.)
• research: Research on humans has found that combining bromelain with amoxicillin in treating bronchitis, pneumonia, or other lung infections, appears to be more effective than using amoxicillin alone.
(Rimoldi R, et al. Drugs Exp Clin Res 1978;4:55-66; Komiya M. Nichidai Koko Kagaku. 1986 Sep;12(3):246-60; Takahashi K.
Shigaku. 1978 Feb;65(5):874-904.)
Earlier studies had reported that bromelain also enhanced the therapeutic efficacy of several antibiotics, including erythromycin, penicillin and chloramphenicol, in treating a variety of infections.
(Neubauer, RA. Exp Med Surg 1961;19:143-160.)
• nutritional synergy: A dosage of 2,400 gelatin dissolving units (listed as GDU on labels), or approximately 3,600 MCU (milk cloning units), of bromelain per day would typically be prescribed to take advantage of the beneficial effects of bromelain as an adjuvant to
amoxicillin.
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and limitations of the information provided here.
Do not rely solely on the information in this article.
The information presented in Interactions is for
informational and educational purposes only. It is based on scientific
studies (human, animal, or in vitro), clinical experience, case
reports, and/or traditional usage with sources as cited in each
topic. The results reported may not necessarily occur in all
individuals and different individuals with the same medical conditions
with the same symptoms will often require differing treatments. For
many of the conditions discussed, treatment with conventional medical
therapies, including prescription drugs or over-the-counter
medications, is also available. Consult your physician, an
appropriately trained healthcare practitioner, and/or pharmacist for
any health concern or medical problem before using any herbal products
or nutritional supplements or before making any changes in prescribed
medications and/or before attempting to independently treat a medical
condition using supplements, herbs, remedies, or other forms of
self-care.
References
Bradbrook ID, Morrison PJ, Rogers HJ. The effect of bromelain on the absorption of orally administered tetracycline.
Br J Clin Pharmacol 1978 Dec;6(6):552-554.
Felton GE. Does kinin released by pineapple stem bromelain stimulate production of prostaglandin E1-like compounds?
Hawaii Med J. 1977 Feb;36(2):39-47. (Review)
Gaby AR. The story of bromelain. Nutr Healing May 1995:3,4,11. (Review)
Gutfreund AE, Taussig SJ, Morris AK. Effect of oral bromelain on blood pressure and heart rate of hypertensive patients.
Hawaii Med J 1978 May;37(5):143-146.
Heinicke R, van der Wal L, Yokoyama M. Effect of bromelain (Ananase) on human platelet aggregation.
Experientia 1972;28:844-845.
Hine S, et al. [Clinical use of bromelain (Ananase) in chronic rhino-sinusitis].
Jibiinkoka. 1966 Apr;38(4):439-442. [Article in Japanese]
Kagitomi T, et al. [Effect of bromelain in chronic sinusitis]. Jibiinkoka. 1966 Apr;38(4):433-437. [Article in Japanese]
Kelly GS. Bromelain: a literature review and discussion of its therapeutic applications.
Alt Med Rev 1996;1:243-257. (Review)
Komiya M. [Pharmacokinetic analyses of the absorption of ampicillin and amoxicillin into the blood and experimentally infected skin after simultaneous administration of an antibiotic with bromelain and lysozyme].
Nichidai Koko Kagaku. 1986 Sep;12(3):246-60. [Article in Japanese]
Luerti, M, Vignali M. Influence of bromelain on penetration of antibiotics in uterus, salpinx and ovary.
Drugs Exp Clin Res 1978;4:45-48.
Neubauer RA. A plant protease for potentiation of and possible replacement of antibiotics.
Exp Med Surg 1961;19:143-160.
Nieper HA. Effect of bromelain on coronary heart disease and angina pectoris.
Acta Med Empirica 1978;5:274-278.
Perez-Jauregui J, Escate-Cavero A, Vega-Galina J, Ruiz-Arguelles GJ, Macip-Nieto G. [Probable coumarin poisoning upon ingestion of an anti-inflammatory agent].
Rev Invest Clin 1995 Jul-Aug;47(4):311-313. [Article in Spanish]
Abstract: Warfarin overdose leads to hypoprothrombinemia and bleeding diathesis. We report here the case of a 47 year old woman who ingested an overdose of a non-steroidal anti-inflammatory drug, sold in Mexico under the name of Wobenzym (R), and containing, according to the manufacturer: pancreatin, bromelin, papain, lipase, amylase, trypsin, alpha chymotrypsin and rutin. She developed skin, urinary and gastrointestinal bleeding and was found to be apparently under the effect of a coumadin overdose, i.e. prolonged prothrombin time, prolonged activated thromboplastin time, and low functional and antigenic levels of prothrombin. A platelet count, and the thrombin, reptilase and bleeding times were normal. All laboratory and clinical abnormalities reverted to normal by using fresh frozen plasma and parenteral vitamin K. In addition, we were able to show that the commercial preparation could prolong the prothrombin time in rabbits and, by high-performance liquid chromatography, a pike consonant with purified coumadin was found in the drug. It is concluded that this drug is probably contaminated by coumadin, and that physicians must be aware of its potential side effects.
Rimoldi R, Ginesu F, Giura R. The use of bromelain in pneumological therapy.
Drugs Exp Clin Res 1978;4:55-66.
Ryan RE. A double-blind clinical evaluation of bromelains in the treatment of acute sinusitis.
Headache. 1967 Apr;7(1):13-17.
Seltzer AP. Adjunctive use of bromelains in sinusitis: a controlled study. Eye Ear Nose Throat Mon. 1967 Oct;46(10):1281-1288.
Takahashi K.[Experimental study on the combined therapy of antibiotics and
bromelain]. Shigaku. 1978 Feb;65(5):874-904. (Review) [Article in Japanese]
Taub SJ. The use of Ananase in sinusitis. A study of 60 patients. Eye Ear Nose Throat Mon. 1966 Jun;45(6):96 passim.
Taub SJ. The use of bromelains in sinusitis: a double-blind clinical evaluation.
Eye Ear Nose Throat Mon. 1967 Mar;46(3):361-362 passim.
Tinozzi, S, Venegoni, A. Effect of bromelain on serum and tissue levels of
amoxicillin. Drugs Exp Clin Res 1978;4:39-44.