Drug & supplement interaction

Proteolytic Enzymes (proteases) + Alpelisib

Alpelisib brand name: Piqray.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Proteolytic Enzymes (proteases) and Alpelisib in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Alpelisib states a food rule worth keeping to.

Know someone taking this? Share
Interaction report

Proteolytic Enzymes (proteases) and Alpelisib

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Alpelisib and Proteolytic Enzymes (proteases) in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Proteolytic Enzymes (proteases) at all — not against Alpelisib, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Proteolytic Enzymes (proteases) safety at a glance

Proteolytic Enzyme... overall Use caution Generally well tolerated for most adults, but may cause digestive upset or allergic reactions.
Pregnancy Avoid Safety has not been established, so it is best avoided during pregnancy unless prescribed.
Breastfeeding Use caution There is little safety data during breastfeeding, so use is not recommended without medical advice.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Alpelisib and Proteolytic Enzymes (proteases)? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

What Proteolytic Enzymes (proteases) Itself Has Been Linked To

This is not an interaction — nothing below involves Alpelisib. It is the side-effect record for Proteolytic Enzymes (proteases) on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Proteolytic Enzymes (proteases), this list is the first place to look. One entry is worth acting on rather than waiting out — marked below.

  • Wheezing Worth acting on Additional detail

    “Proteolytic enzymes are commonly found in laundry detergents and pre-spotter products. Rarely, protease specific IgE positive tests possibly related to these products have occurred. Exposure may be airborne or topical. In addition, in case reports, occupational exposure to the airborne proteolytic enzyme pepsin has resulted in allergic rhinoconjunctivitis or asthma.”

    Proteolytic Enzymes (proteases) · Natural Medicines adverse-effect record, reported in asthma.

    3 sources cited
    1. 102705. Weeks JA, Harper RA, Simon RA, Burdick JD. Assessment of sensitization risk of a laundry pre-spotter containing protease. Cutan Ocul Toxicol. 2011;30(4):272-9. PubMed
    2. 102706. Marquès LI, Lara S, Abós T, Bartolomé B. Occupational rhinitis due to pepsin. J Investig Allergol Clin Immunol. 2006;16(2):136-7. DOI
    3. 102707. Cartier A, Malo JL, Pineau L, Dolovich J. Occupational asthma due to pepsin. J Allergy Clin Immunol. 1984;73(5 Pt 1):574-7. PubMed

Everything above comes from the Natural Medicines adverse-effect record for Proteolytic Enzymes (proteases) — expand a row for the licensed statement it rests on. We read the ADVERSE REACTIONS section of Alpelisib’s FDA label too, and the two lists don’t meaningfully overlap — which is why no Alpelisib column appears here.

How to take them

Some Alpelisib Products Have a Food Rule — Proteolytic Enzymes (proteases) Should Not Break It

At least one FDA label for a product containing Alpelisib says to take it with food. If you take Proteolytic Enzymes (proteases) on an empty stomach out of habit, keep them separate — and take Alpelisib with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Alpelisib products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

2 DOSAGE AND ADMINISTRATION Recommended Dose: Pediatric patients (2 to less than 18 years of age): 50 mg taken orally once daily with food.

From the Dosage and Administration section of the FDA label we read for Alpelisib — where that label names a specific product, the instruction is that product's. See the Alpelisib drug page ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Alpelisib

This page covers Proteolytic Enzymes (proteases) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Alpelisib page lists 139 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 96 moderate · 40 minor.

From our pharmacist’s overview on the Alpelisib page

“Alpelisib (Piqray) treats PIK3CA-mutated breast cancer, and a drug doing that job leaves little room for supplements that shift its blood level. Yet that is what most of this list does: 121 of the 139 ingredients on file can raise or lower alpelisib through CYP3A4, the liver enzyme that clears it.”

Reviewed by 2 · Jul 18, 2026

Open the Alpelisib interaction page

One more smart check

Taking Proteolytic Enzymes (proteases) as Part of a Dietary Supplement Product? Check It for Interactions

We hold 713 real supplement products containing Proteolytic Enzymes (proteases), each one broken down to its full ingredient list — and combination products often carry several ingredients besides Proteolytic Enzymes (proteases). Even though Proteolytic Enzymes (proteases) itself has no known interaction with Alpelisib, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Proteolytic Enzymes (proteases) and Alpelisib 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 Proteolytic Enzymes (proteases)
Top 5%

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

29 days ago today
Medication Alpelisib
Top half

#1,403 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Proteolytic Enzymes (proteases) reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Proteolytic Enzymes (proteases) and Alpelisib records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Proteolytic Enzymes (proteases)

What is Proteolytic Enzymes (proteases)?

  • Digestion and bloating
  • Muscle soreness and exercise recovery
  • Inflammation and swelling
  • Sinus and respiratory congestion
  • Post-surgery or injury recovery

Proteolytic enzymes are proteins that help break down other proteins, and common examples include bromelain (from pineapple), papain (from papaya), trypsin, chymotrypsin, and pancreatin. People take them for digestion, inflammation, and muscle recovery, but the evidence is mixed and stronger for some uses (like aiding digestion in people who lack natural enzymes) than others. They are generally well tolerated, but talk with a pharmacist or doctor before use, especially if you have allergies, a bleeding risk, or are pregnant.

Enzymes sourced from fruit (pineapple, papaya), animal pancreas, or microbial/fungal fermentation · Capsules, tablets (often enteric-coated), powders

An interaction check asks whether these two react with each other — it does not ask whether Proteolytic Enzymes (proteases) is a good idea for someone in your situation. Here is what our Proteolytic Enzymes (proteases) record says about it on its own.

Proteolytic Enzymes (proteases): dosing

There is no single standardized dose for proteolytic enzyme supplements. Products vary widely in their source, strength, and how they measure enzyme activity (for example, units may be listed differently from one brand to another).Because of this, the best approach is to follow the directions on the product label and not exceed the recommended amount. Do not assume an over-the-counter product replaces a prescription pancreatic enzyme.

From our Proteolytic Enzymes (proteases) monograph — the full record covers uses, side effects and every documented interaction.

Read the full Proteolytic Enzymes (proteases) monograph & all interactions
Medication

About Alpelisib

What Is Alpelisib Used For?

Brand name: Piqray

Alpelisib is approved for two distinct uses, each tied to a specific brand. Piqray is used in combination with another drug called fulvestrant to treat adults with hormone receptor (HR)-positive, HER2-negative, advanced or metastatic breast cancer whose tumors carry a PIK3CA mutation — and only after the cancer has progressed on or after a hormone-based treatment. A companion diagnostic test is required before starting Piqray.

Vijoice is used to treat adults and children 2 years of age and older who have severe manifestations of PIK3CA-Related Overgrowth Spectrum (PROS) — a rare condition where PIK3CA gene mutations cause abnormal tissue, vascular, and bone overgrowth — and who need systemic (whole-body) therapy. Vijoice's approval for PROS was granted under the FDA's accelerated approval pathway based on response data, and continued approval may depend on confirmatory trials.

See full Alpelisib drug information
Keep checking

Other Drugs & Proteolytic Enzymes (proteases)

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

0Major
0Moderate
0Minor
2,829No known interaction
No interaction 2,829 drugs checked — show the list
Evidence & sources

Proteolytic Enzymes (proteases) References

The 3 references that drive our Proteolytic Enzymes (proteases) monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Weeks JA, Harper RA, Simon RA, Burdick JD. Assessment of sensitization risk of a laundry pre-spotter containing protease. Cutan Ocul Toxicol. 2011;30(4):272-9. PubMed
  2. Marquès LI, Lara S, Abós T, Bartolomé B. Occupational rhinitis due to pepsin. J Investig Allergol Clin Immunol. 2006;16(2):136-7. DOI
  3. Cartier A, Malo JL, Pineau L, Dolovich J. Occupational asthma due to pepsin. J Allergy Clin Immunol. 1984;73(5 Pt 1):574-7. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Proteolytic Enzymes (proteases) and Alpelisib Together: Common Questions

Is it safe to take Proteolytic Enzymes (proteases) with Alpelisib?
We do not list a known interaction between Proteolytic Enzymes (proteases) and Alpelisib. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Should I take Proteolytic Enzymes (proteases) and Alpelisib at the same time of day?
At least one FDA label for a product containing Alpelisib says to take it with food. If you take Proteolytic Enzymes (proteases) on an empty stomach out of habit, keep them separate and take Alpelisib with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Alpelisib products can differ — so check the directions on your own box. This is about absorption, not an interaction.
Does Alpelisib interact with any supplements?
Yes. Alpelisib has documented interactions with 139 supplements in our database — Proteolytic Enzymes (proteases) is not one of them. The Alpelisib interaction page linked on this page lists every one, ranked by severity.

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

Still Have a Question About Alpelisib and Proteolytic Enzymes (proteases)?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.