Drug & supplement interaction

Bromelain + Fondaparinux

Fondaparinux brand name: Arixtra.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Bromelain has a moderate interaction with Fondaparinux. Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Bromelain and Fondaparinux

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Fondaparinux

Fondaparinux falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Bromelain interacts with.

Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
There is one case report of a patient experiencing minor bruising while taking bromelain with naproxen. Bromelain is thought to have antiplatelet activity. Whether this interaction is of concern with topical bromelain is unclear. Interference with coagulation of burn wounds has been reported in a patient receiving bromelain-based enzymatic debridement. However, observational research has found that topical bromelain debridement is not associated with increases or decreases in laboratory markers of coagulation when compared with surgical debridement.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: fondaparinux is already a powerful blood thinner, given by injection to keep clots from forming after surgery. Bromelain, the pineapple enzyme, is thought to have a mild blood-thinning (antiplatelet) effect of its own. Stack the two together and you could, in theory, nudge your bleeding risk a little higher.

I want to be honest about the evidence here, though. This concern is mostly theoretical, based on how bromelain behaves in the lab, plus one report of minor bruising when it was paired with a different drug. Still, with a strong anticoagulant like this, I'd watch for things like easy bruising, nosebleeds, bleeding gums, or any unusual bleeding. Please check with your surgeon or pharmacist before combining them, especially around surgery.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Taussig SJ, Batkin S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J Ethnopharmacol 1988;22:191-203.. PubMed
  2. 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.
  3. Glaser D, Hilberg T. The influence of bromelain on platelet count and platelet activity in vitro. Platelets 2006;17:37-41. PubMed
  4. Heinicke R M, van der Wal L, Yokoyama M. Effect of bromelain (Ananase) on human platelet aggregation. Experientia 1972;28:844-5. PubMed
  5. Martin GJ, Ehrenreich J, and Asbell N. Bromelain: pineapple proteases with anti-edema activity. Exp Med Surg 1962;20:227-247.
  6. Pfister P, Garcia Wendel PD, Kim BS, et al. Coagulation side effects of enzymatic debridement in burned patients. Burns 2022. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Bromelain Also Interacts With Other Medications

Bromelain has 121 moderate, 19 minor known drug interactions in our database — the Fondaparinux one above is one of them. If you take anything else, check it against the full list below.

Moderate 121 Minor 19 No known interaction 2,690 (incl. Fondaparinux)
Taking anything else?

Check Another of Your Medications Against Bromelain

Covers the 2,830 medications we’ve checked against Bromelain. Pick one to open its full report.

From our Q&A

Questions About Bromelain or Fondaparinux

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Bromelain or Fondaparinux, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Fondaparinux

This page covers Bromelain only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Fondaparinux page lists 202 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Danshen (major), Piracetam (major), Aconite (moderate), Allspice (moderate) and Aloe (moderate).

By severity: 2 major · 183 moderate · 17 minor.

From our pharmacist’s overview on the Fondaparinux page

“Most people on fondaparinux (Arixtra) are recovering from surgery or treating a blood clot, exactly the moment supplements for circulation and recovery come out of the cabinet. This pairing deserves real care, because nearly all 202 ingredients on this list share one problem: they thin the blood a little on their own, so adding them to…”

Reviewed by 2 · Jul 18, 2026

Open the Fondaparinux interaction page

One more smart check

Taking Bromelain as Part of a Dietary Supplement Product? Check It for Interactions

We hold 6,336 real supplement products containing Bromelain, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bromelain. Your product may carry other ingredients that interact with Fondaparinux too, on top of Bromelain — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Bromelain and Fondaparinux Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Bromelain
Top 5%

#35 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Fondaparinux
Top 10%

#151 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Bromelain

What is Bromelain?

Bromelain
  • Inflammation and swelling
  • Sinus and nasal congestion
  • Digestion support
  • Post-surgery or injury recovery
  • Joint pain
  • Allergic rhinitis

Bromelain is a group of protein-digesting enzymes from pineapple that people take mainly for inflammation, swelling, and sinus problems. Some early studies are promising, but the overall evidence is limited and far from conclusive. It is generally well tolerated short-term, but pregnant and breastfeeding people should avoid it, and anyone with a pineapple allergy or bleeding concerns should check with a pharmacist first.

Read the full Bromelain monograph & all interactions
Medication

About Fondaparinux Injection

What Is Fondaparinux Injection Used For?

Brand name: Arixtra

Fondaparinux sodium injection is used to prevent deep vein thrombosis (DVT) — blood clots that form in the legs — in adults who are having hip fracture surgery, hip replacement surgery, knee replacement surgery, or abdominal surgery. Preventing these clots also lowers the risk of a clot traveling to the lungs (pulmonary embolism, or PE).

It is also used to treat acute DVT and acute pulmonary embolism in adults, typically started alongside warfarin. In children aged 1 year and older who weigh at least 10 kg (about 22 lbs), fondaparinux sodium injection is approved to treat venous thromboembolism (VTE) — blood clots in the veins.

See full Fondaparinux Injection drug information
Keep checking

Other Drugs & Bromelain

Browse every other medication we’ve checked against Bromelain — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
121Moderate
19Minor
2,689No known interaction
121 Moderate 19 Minor 2,689 No interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Bromelain page.

Minor

19 interactions

No interaction 2,689 drugs checked — show the list

We also checked Bromelain against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,689 medications checked with no known interaction — see the full Bromelain list.

See the full Bromelain interactions page
See every supplement checked against Fondaparinux, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Bromelain monograph › Uses, safety, and every drug interaction in one place Fondaparinux supplement interactions › Every supplement checked against Fondaparinux, ranked by severity Fondaparinux Injection drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Bromelain and Fondaparinux Together: Common Questions

Can you take Bromelain with Fondaparinux?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Bromelain and Fondaparinux interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Fondaparinux and Bromelain?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.