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Table of Contents > Supplements > Bromelain
Bromelain
Also Known As:  Ananas comosus, Bromelainum
 
Overview
Uses
Dietary Sources
Available Forms
How to Take It
Precautions
Possible Interactions
Supporting Research

Overview

Bromelain is a mixture of protein-digesting enzymes found in pineapples (Ananas comosus). Bromelain supplements contain active substances that aid digestion and help reduce inflammation.


Uses

Bromelain is useful in the treatment of a wide range of conditions, but it is particularly effective in relieving inflammation associated with infection and physical injuries.

Studies have shown that bromelain may help in the treatment of the following:

Surgical Procedures and Sports Injuries

Although studies show mixed results, bromelain supplements may reduce swelling, bruising, healing time, and pain following surgery and physical injuries. In fact an authoritative body in Germany called the Commission E (similar to the U.S. Food and Drug Administration) approved the use of bromelain for these purposes.

Wounds and Burns

Some studies of animals indicate that bromelain (applied to the surface of the skin) may be useful in removing dead tissue from third-degree burns (particularly burns that go through all layers of the skin). This application has not yet been tested on people, but traditional and current day practices in Japan, Hawaii and Taiwan include use of topical bromelain to clean wounds and burns. Similarly, some clinicians may recommend this topical agent to reduce swelling from insect bites or stings.

Nasal and Sinus Congestion

Although not all experts agree, bromelain supplements may help suppress cough, reduce nasal mucus associated with sinusitis, and relieve the swelling and inflammation caused by hay fever. Bromelain is approved by the German Commission E for the treatment of sinus and nasal swelling following ear, nose, and throat surgery or trauma.

Digestion

The protein-digesting enzymes found in bromelain help promote and maintain proper digestion and may relieve symptoms of stomach upset or heartburn, particularly when used in conjunction with other enzymes such as amylase (which digests starch) and lipase (which digests fat). Similarly, an animal study suggests that the antibacterial effects of bromelain may help to control diarrhea caused by bacteria. Studies in people are needed.

Arthritis and other Inflammatory Conditions

Bromelain supplements may be as effective as some commonly used nonsteroidal anti-inflammatory (NSAID) medications (such as ibuprofen and diclofenac) for reducing pain associated with osteoarthritis. Similarly, preliminary studies suggest that bromelain may also help reduce the pain associated with rheumatoid arthritis. Plus, long-standing use of bromelain suggests that this enzyme may be helpful as part of the treatment for other connective tissue disorders including scleroderma (build up of tough scar-like tissue in the skin and, at times, internal organs), bursitis, and tendinitis.

Infection

Some scientific evidence from test tubes and animals suggests that bromelain can fight against infectious agents such as viruses and bacteria. Therefore, bromelain may prove a useful addition to conventional treatment of bronchitis, pneumonia, and urinary tract infections. More research is needed.

Amyloidosis

Amyloid is a protein-like substance that can build up and cause damage to many organs in the body such as the kidneys, liver, or heart. This build-up of amyloid is called amyloidosis. In one laboratory study, researchers examined the tissue of one person with a strong family history of amyloidosis. They found that bromelain may help breakdown amyloid deposits in kidney tissue. This very preliminary finding does not indicate how this information will translate to treatment or prevention of amyloidosis for people in general. Much more research is needed.


Dietary Sources

Bromelain is found in the common pineapple plant.


Available Forms

Bromelain is available in tablet or capsule form for oral use. It may also be used topically to treat severe burns.


How to Take It

Pediatric

There are no known scientific reports on the pediatric use of bromelain. Therefore, use of this supplement is not currently recommended for children.

Adults

The German Commission E recommends 80 to 320 mg two to three times per day. For specific conditions, higher doses may be prescribed as follows:

  • Digestive aid: 500 mg per day in divided doses with meals
  • Traumatic injuries: 500 mg four times a day on an empty stomach
  • Joint inflammation: 500 to 2,000 mg a day in two divided doses

Precautions

Because supplements may have side effects or interact with medications, they should be taken only under the supervision of a knowledgeable healthcare provider. Bromelain is generally recommended for no longer than 8 to 10 days in a row.

Possible side effects from bromelain include nausea, vomiting, diarrhea, and excessive menstrual bleeding.

Individuals who are allergic to pineapples should not use bromelain supplements because skin reactions and/or asthma-like symptoms may occur.

Pregnant women and individuals with bleeding disorders, high blood pressure, and liver or kidney disease should consult a healthcare provider before taking bromelain.


Possible Interactions

If you are currently being treated with any of the following medications, you should not use bromelain without first talking to your healthcare provider.

Antibiotics
In a clinical study, the combination of bromelain and amoxicillin increased the levels of this antibiotic in the blood. Some studies suggest that bromelain may increase the body's ability to absorb tetracycline, but results of other studies have been conflicting. Until studies confirm these results, it would be wise to avoid combining bromelain and tetracycline.

Studies with bromelain and tetracycline have produced mixed results. Some research suggests that bromelain increases levels of tetracycline in the body, while others indicate that it may cause more of the antibiotic to be excreted in the urine.

Blood-thinning Medications
People taking aspirin, warfarin, or other medications that thin the blood should use bromelain with extreme caution because of a possible risk of bleeding when used together.


Supporting Research

Adachi N, Koh CS, Tsukada N, Shoji S, Yanagisawa N. In vitro degradation of amyloid material by four proteases in tissue of a patient with familial amyloidotic polyneuropathy. J Neurol Sci. 1988;84(2-3):295-299.

Blumenthal M, Goldberg A, Brinkman J, ed. Herbal Medicine. Expanded Commission E Monographs. Boston, Mass: Integrative Medicine Communications; 2000:33-35.

Bradbrook JD. The effect of bromelain on the absorption of orally administered tetracycline. Br J Clin Pharmacol. 1978;6(6):552-554.

Bromelain. Alt Med Rev. August 1998;3:302-305.

Brunton J. Pharmagnosy, Phytochemistry, Medicinal Plants. Paris: Lavoisier Publishing; 1995.

Desser L, Rehberger A, Kokron E, Paukovits W. Cytokine synthesis in human peripheral blood mononuclear cells after oral administration of polyenzyme preparations. Oncology. 1993;50:403-407.

Felton GE. Fibrinolytic and antithrombotic action of bromelain may eliminate thrombosis in heart patients. Med Hypotheses. 1980;6(11):1123-1133.

Harborne J, Baxter H, eds. Phytochemical Dictionary: A Handbook of Bioactive Compounds from Plants. London, England: Taylor & Francis; 1993:376.

Klein G, Kullich W. Short-term treatment of painful osteoarthritis of the knee with oral enzymes. A randomized, double-blind study versus diclofenec. Clin Drug Invest. 2000;19(1):15-23.

Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2nd ed. New York: John Wiley & Sons, Inc. 1996.

Majima M, Kawashima N, Hiroshi I, Katori M. Effects of an orally active non-peptide bradykinin B2 receptor antagonist, FR173657, on plasma exudation in rat carrageenan-induced pleurisy. Br J Pharmacol. 1997;121(4):723-730.

Masson M. Bromelain in blunt injuries of the locomotor system. A study of observed applications in general practice. Fortschr Med. 1995;113:303-306.

Mori S, Ojima Y, Hirose T, Sasaki T, Hashimoto Y. 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(3):147-153.

Murray MT, Pizzorno JE. Bromelain. In: Pizzorno JE, Murray MT, eds. Textbook of Natural Medicine. Vol 1. 2nd ed. Edinburgh: Churchill Livingstone; 1999:619-622.

Mynott TL, Guandalini S, Raimondi F, Fasano A. Bromelain prevents secretion cased by Vibrio cholerae and Escherichia coli enterotoxins in rabbit ileum in vitro. Gastroenterol. 1997;113(1):175-184.

Reynolds JEF, ed. Martindale: The Extra Pharmacopoeia. 31st ed. London, England: Royal Pharmaceutical Society; 1996:1681.

Rimoldi R, Ginesu F, Giura R. The use of bromelain in pneumological therapy. Drugs Exp Clin Res. 1978;4:55-56.

Sanders HJ. Therapy of chlamydia infections with tetracyclines. Int J Exp Clin Chemother. 1990;3(2):101-106.

Schulz V, Hänsel R, Tyler VE. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. New York: Springer; 1998.

Taussig SJ, Batkin S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J Ethnopharmacol. 1998;22:191-203.

Tinozzi S, Venegoni A. Effect of bromelain on serum and tissue levels of amoxicillin. Drugs Exptl Clin Res. 1978; 4(1):39-44.

Uhlig G, Seifert J. The effect of proteolytic enzymes (traumanase) on posttraumatic edema. Fortschr Med. 1981;99:554-556.

Walker JA, Cerny FJ, Cotter JR, Burton HW. Attentuation of contraction-induced skeletal muscle injury by bromelain. Med Sci Sports Exerc. 1992;24:20-25.


Review Date: April 2002
Reviewed By: Participants in the review process include: Ruth DeBusk, RD, PhD, Editor, Nutrition in Complementary Care, Tallahassee, FL; Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University and Senior Medical Editor Integrative Medicine, Boston, MA; Gary Kracoff, RPh (Pediatric Dosing section February 2001), Johnson Drugs, Natick, Ma; Steven Ottariono, RPh (Pediatric Dosing section February 2001), Veteran's Administrative Hospital, Londonderry, NH. All interaction sections have also been reviewed by a team of experts including Joseph Lamb, MD (July 2000), The Integrative Medicine Works, Alexandria, VA;Enrico Liva, ND, RPh (August 2000), Vital Nutrients, Middletown, CT; Brian T Sanderoff, PD, BS in Pharmacy (March 2000), Clinical Assistant Professor, University of Maryland School of Pharmacy; President, Your Prescription for Health, Owings Mills, MD; Ira Zunin, MD, MPH, MBA (July 2000), President and Chairman, Hawaii State Consortium for Integrative Medicine, Honolulu, HI.

Copyright © 2004 A.D.A.M., Inc

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.

 
RELATED INFORMATION
  Uses of this Supplement
Allergic Rhinitis
Amyloidosis
Bronchitis
Burns
Bursitis
Cough
Diarrhea
Insect Bites and Stings
Rheumatoid Arthritis
Scleroderma
Sinusitis
Tendinitis
Urinary Tract Infection in Women
Wounds
  Supplements with Similar Uses
View List by Use
  Drugs that Interact
Summary
Antibiotics
Blood-thinning Medications
  Supplements with Similar Side Effects
View List by Side Effect
  Supplements with Similar Warnings
View List by Warning
  Related Articles
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  Learn More About
Nutrition
 

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