Drug & supplement interaction

Bromelain + Lepirudin

Lepirudin brand name: Refludan.

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

Bromelain has a moderate interaction with Lepirudin. 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 Lepirudin

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Lepirudin

Lepirudin 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

Lepirudin is a powerful injectable blood thinner, given in the hospital to people who can't safely take heparin. It works by directly blocking thrombin, a key player in clotting. Bromelain isn't a blood thinner, but it's thought to have mild antiplatelet activity, meaning it may make your platelets a little less sticky.

Stack that gentle effect on top of an already strong anticoagulant and the worry is simply more bleeding, things like easy bruising, nosebleeds, bleeding gums, or oozing from injection sites. Honestly, this concern is mostly theoretical, based on how bromelain behaves rather than solid studies. Still, since Lepirudin is closely monitored in a hospital setting, mention any supplements to your care team so they can watch for bleeding.

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 Lepirudin 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. Lepirudin)
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 Lepirudin

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 Lepirudin, 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 Lepirudin

This page covers Bromelain only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Lepirudin page lists 218 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 3 major · 190 moderate · 25 minor.

From our pharmacist’s overview on the Lepirudin page

“Lepirudin (Refludan) is a potent injectable blood thinner, typically given when heparin has caused a dangerous platelet reaction, and that makes this a list to read with real care. Of the 218 supplements and herbs with interactions on file, 202 can slow clotting on their own, piling extra bleeding risk onto a drug whose chief hazard is…”

Reviewed by 2 · Jul 18, 2026

Open the Lepirudin 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 Lepirudin 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 Lepirudin 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 Lepirudin
Steady interest

#2,641 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
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 Lepirudin, 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 Lepirudin supplement interactions › Every supplement checked against Lepirudin, ranked by severity 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 Lepirudin Together: Common Questions

Can you take Bromelain with Lepirudin?
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 Lepirudin 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 Lepirudin 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.