Interactions on record — worth a quick check against your medications. Based on 5 of 15 ingredients. Check your meds →
Dietary supplement

Break it Down Ingredients & Drug Interactions

by Ora

Break it Down label
See full label image
Capsule Category: Non-nutrient/non-botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 23, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Break it Down against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Moderate

Break it Down is a dietary supplement by Ora with 15 active ingredients. Its ingredients are commonly taken for digestive support for protein digestion, wound cleaning (debridement of dead tissue), sore throat and inflammation.Based on those ingredients, 306 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Bacillus Subtilis, Bromelain, Papain. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Break it Down by Ora

Ask about any prescription or over-the-counter medication and we check it for interactions with Break it Down by Ora — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Break it Down by Ora

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 12, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 0 of its 16 active ingredients.
  • “Vegetarian Pancreatin Alternative” is listed as a grouped ingredient — the label doesn't break down how much of each component you get.
  • “Ora Enzyme Blend” is a proprietary blend — the label gives one combined amount (300 mg) without saying how much of each component you get.

Break it Down by Ora contains 16 active ingredients, most of them digestive enzymes. The main players are papain (from papaya), bromelain (from pineapple), and a mix of other enzymes like lactase (breaks down milk sugar), lipase (breaks down fats), cellulase (breaks down fiber), and several others that help your body digest different food components.

It also includes Bacillus subtilis, a live beneficial bacterium, and a blend labeled Vegetarian Pancreatin Alternative—a plant-based stand-in for pancreatic digestive enzymes. The inactive ingredients are a vegan capsule and pineapple powder, so you're getting minimal fillers.

Does it work?

Strong evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Strong

Clinical evidence supports at least one of this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: support digestive system and nutrient absorption.
  • We looked for evidence on: Dyspepsia, Flatulence, Lactose intolerance, Diarrhea, Irritable bowel syndrome (IBS), Inflammatory bowel disease (IBD) — and 4 related terms.
  • The strongest evidence on file: Lactase is rated "Effective" for Lactose intolerance (Natural Medicines).
  • Also on file: Bacillus Subtilis is rated "Possibly Effective" for Antibiotic-associated diarrhea.
  • Also on file: Lipase is rated "Insufficient Reliable Evidence To Rate" for Inflammatory bowel disease (IBD), Dyspepsia, Celiac disease.

The evidence for most of Break it Down's ingredients isn't established in the data we hold. Papain, bromelain, and most of the other enzymes show insufficient reliable evidence to rate them for the conditions they're marketed for—cancer, muscle soreness, burns, hay fever, and others.

The one exception is lactase, which is rated Effective for lactose intolerance; if you can't digest milk sugar, lactase can help. Bacillus subtilis is rated Possibly Effective for antibiotic-associated diarrhea—that's the one condition where this ingredient has some backing.

The evidence, ingredient by ingredient Papain Bromelain Lactase Phytase Bacillus Subtilis

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 7 of the 7 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 7 of 7.
  • General safety write-ups exist for 7 of 7.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Papain is generally tolerated as a food but can irritate your digestive tract and trigger allergic reactions in sensitive people. High doses are unsafe.

Pregnancy is a concern: concentrated papain and unripe papaya products aren't safe in pregnancy, and there isn't enough data to recommend papain supplements while breastfeeding. Bromelain is well tolerated short-term, but long-term safety data are thin.

It's not safe in pregnancy and should be avoided while breastfeeding. The other enzymes are generally well tolerated, though data are limited.

Bacillus subtilis is safe in healthy adults overall, but quality and strain vary by product. If you have serious digestive conditions, check with your doctor before taking lipase.

None of the ingredients we checked show major safety flags in short-term use, but if you're pregnant or breastfeeding, talk to your doctor first.

Side effects, ingredient by ingredient Papain Bromelain Lactase Phytase Bacillus Subtilis

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 3 of the 7 matched ingredients can interact with medications — Papain, Bromelain, Bacillus Subtilis.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs.
  • For scale: 306 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check your medications if you take warfarin or other blood thinners (anticoagulants)—papain may boost their effect and bleeding risk (Moderate). If you're on antiplatelet drugs like clopidogrel or aspirin, bromelain poses a similar Moderate concern.

Tetracycline antibiotics may have Minor interaction with bromelain. And if you're taking any antibiotics, separate them from this supplement by a few hours, since the live Bacillus subtilis bacteria could be killed off (Moderate).

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

Break it Down is a broad-spectrum digestive enzyme blend. If you're lactose intolerant and looking for lactase, or if you've had antibiotic-related diarrhea and want to try Bacillus subtilis, there's some evidence behind those uses.

If you take warfarin or other blood thinners, or antibiotics, you need to check with your pharmacist before adding this—the interactions matter. Pregnant or breastfeeding?

Talk to your doctor first.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 7 of 16 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 23, 2022.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Break it Down, straight from the product label.

Brand Ora
Barcode (UPC) 850028725191
Net contents 30 Capsule(s)
Market status On market
Date entered into DSLD Feb 23, 2022
DSLD ID 259886
Product type Non-nutrient/non-botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegan, Vegetarian, Adult (18 - 50 Years), Dairy Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Break it Down by Ora, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
Servings per container
30
UPC/BARCODE
850028725191
IngredientAmount% DV
Papain0 NP--
Bromelain0 NP--
Lactase0 NP--
Lipase0 NP--
Aspergillopepsin0 NP--
Cellulase0 NP--
Phytase0 NP--
Peptidase0 NP--
Xylanase0 NP--
Hemicellulase0 NP--
Glucoamylase0 NP--
Pectinase0 NP--
Vegetarian Pancreatin Alternative0 NP--
Ora Enzyme Blend300 mg--
Bacterial Protease0 NP--
Fungal Amylase0 NP--
Beta Glucanase0 NP--
Bacillus Subtilis0 NP--

Other ingredients: Vegan Capsule, Pineapple powder

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formula

What am I? I'm a digestive enzymes supplement with 15 different digestive enzymes and 1 billion probiotics.

My enzymes include papain from papaya leaf and bromelain from pineapple and my hobbies include breakdancing and making your food more digestible!

Digestive Enzymes 15 plant-based enzymes and 1 billion probiotics to support optimal digestive health

Formulation

How can I help? Finding something a little hard to stomach? Let me help with that! I'm designed to support your digestive system by breaking down nutrients for absorption.

About Ora Organic We harness the earth's most powerful ingredients to create nutritional supplements that help transform your health.

We believe in clean, plant-based nutrition for a healthy body and a healthy planet!

Certified Vegan Vegan.org

Suggested/Recommended/Usage/Directions

You can take me on a regular basis or on occasion for hard-to-digest meals. I'm best taken just before or with a meal.

Suggested Use: Take 1 capsule daily or just before a meal.

FDA Statement of Identity

Dietary Supplement

Seals/Symbols

Certified Vegan Vegan.org

Storage

Storage: Store in a cool, dry place.

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Break it Down by Ora label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Break it Down label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Break it Down by Ora

These are the 15 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Ora Enzyme Blend

300 mg per serving
  • › Papain
  • › Bromelain
  • › Lactase
  • › Aspergillopepsin
  • › Cellulase
  • › Phytase
  • › Peptidase
  • › Xylanase
  • › Hemicellulase
  • › Glucoamylase
  • › Pectinase
  • › Vegetarian Pancreatin Alternative
  • › Fungal Amylase
  • › Beta Glucanase
  • › Bacillus Subtilis

Other (inactive) ingredients: Vegan Capsule, Pineapple powder. These complete the product’s ingredient list but are not active constituents.

Interaction report

Break it Down by Ora Drug Interactions

Want to check YOUR meds against Break it Down?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
306Drugs
303 Moderate 3 Minor

Ingredients driving the most interactions

Bacillus Subtilis 182
Bromelain 141
Papain 2

Individual Drug Interactions

The ingredients in Break it Down interact with 306 drugs. Click any drug to see the details.

3 of the 15 ingredients in Break it Down interact with drugs. Each result below shows which ingredient is responsible. Bacillus Subtilis Bromelain Papain

Each ingredient & the kinds of drugs it affects

For each ingredient in Break it Down with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Bacillus Subtilis1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Bacillus subtilis with antibiotic drugs might decrease the effectiveness of B. subtilis.
Since B. subtilis preparations usually contain live and active organisms, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and B. subtilis preparations by at least 2 hours.

Likelihood Probable Evidence D
Bacillus Subtilis full monograph & interactions

Bromelain2 drug types · 141 drugs

Anticoagulant/Antiplatelet Drugs

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.

Likelihood Possible Evidence D
Tetracycline Antibiotics

Theoretically, bromelain might increase levels of tetracycline antibiotics.
Laboratory research suggests that bromelain might increase the absorption of tetracycline antibiotics. However, a study in healthy adults reported no difference in tetracycline plasma levels when a 500 mg dose was taken with or without bromelain 80 mg.

Likelihood Possible Evidence B
Bromelain full monograph & interactions

Papain1 drug type · 2 drugs

Warfarin (Coumadin)

Theoretically, papain might increase the effects and side effects of warfarin.
In one case report, a patient previously stable on warfarin was found to have an international normalization ratio (INR) of 7.4, which was attributed to ingestion of a supplement containing papain from papaya extract.

Likelihood Possible Evidence D
Papain full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Break it Down, from the product label.

Ora

See all Ora products
Name
Ora Organic
City
San Diego
State
CA
ZipCode
92106
Phone Number
1 (858) 429-5591
Web Address
www.ora.organic
Pharmacist Counseling Corner

Break it Down by Ora: Common Questions

Does Break it Down by Ora interact with any medications?
Yes. Based on its ingredients, Break it Down has a known interaction with 306 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Break it Down contains 15 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Will this help me digest food better if I don't have a specific problem?
The evidence for whether these enzymes improve digestion in people without a diagnosed deficiency just isn't established. Lactase works for lactose intolerance specifically, and Bacillus subtilis may help with antibiotic-related diarrhea, but for general digestive support, we don't have solid data.
Is this safe if I'm pregnant or breastfeeding?
Papain is not safe in pregnancy (concentrated forms and unripe papaya products especially), and there isn't enough data to recommend papain supplements while breastfeeding. Bromelain should be avoided in both pregnancy and while breastfeeding. For the other enzymes, data are limited—talk to your doctor before taking this supplement if you're pregnant or nursing.
Can I take this with my antibiotics?
Don't take them at the same time. The antibiotics will kill off the live Bacillus subtilis bacteria in the product. Also, if you're on tetracycline antibiotics, bromelain might increase how much you absorb. Separate them by a couple of hours and check with your pharmacist on the timing for your specific antibiotic.
What are the most common side effects I might notice?
Bromelain may cause diarrhea, gas, or stomach upset. Papain can trigger allergic reactions in sensitive people—itchy eyes, sneezing, or abdominal cramps. Both enzymes can cause allergic skin reactions like itching or rash if you're sensitive. Most people tolerate it fine at normal doses, but high doses of papain are unsafe.
Is there a lot of filler in this?
No—just a vegan capsule and pineapple powder as inactive ingredients, so you're getting mostly the active enzymes.
I'm allergic to pineapple or papaya. Should I avoid this?
Yes. This product contains bromelain from pineapple and papain from papaya. If you're sensitive to either fruit, you're at risk for allergic reactions—including itchy eyes, sneezing, throat swelling, or digestive upset. Don't take it.

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

Not sure if Break it Down is safe with your meds?

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Break it Down label
Go deeper

The Full Monographs Behind Break it Down’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Papain

Interacts with 2 drugs

Papain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food and laboratory uses, strong human evidence...

Read the full Papain monograph → Herb & supplement monograph

Bromelain

Interacts with 141 drugs

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 evi...

Read the full Bromelain monograph → Herb & supplement monograph

Lactase

Lactase is a digestive enzyme supplement that helps people who lack enough natural lactase break down lactose, the sugar in milk and dairy. It can reduce gas, bloating, cramping, and diarrhe...

Read the full Lactase monograph → Herb & supplement monograph

Phytase

Phytase is an enzyme that breaks down phytic acid (phytate) found in grains, beans, nuts, and seeds, which can free up minerals like iron, zinc, and calcium for absorption. It is widely used...

Read the full Phytase monograph → Herb & supplement monograph

Bacillus Subtilis

Interacts with 182 drugs

Bacillus subtilis is a spore-forming probiotic bacterium found in soil and some fermented foods, and it is used mainly to support gut health and digestion. Early research is promising for ce...

Read the full Bacillus Subtilis monograph →
Sources

Sources & How We Checked

Break it Down's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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

The 52 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Papain 11 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf 1997;17:342-56.
  3. Shuttleworth D, Hill S, Marks R, Connelly DM. Relief of experimentally induced pruritus with a novel eutectic mixture of local anaesthetic agents. Br J Dermatol 1988;119:535-40.
  4. Mansfield LE, Ting S, Haverly RW, Yoo TJ. The incidence and clinical implications of hypersensitivity to papain in an allergic population, confirmed by blinded oral challenge. Ann Allergy 1985;55:541-3.
  5. Martin, T., Uhder, K., Kurek, R., Roeddiger, S., Schneider, L., Vogt, H. G., Heyd, R., and Zamboglou, N. Does prophylactic treatment with proteolytic enzymes reduce acute toxicity of adjuvant pelvic irradiation? Results of a double-blind randomized trial PubMed
  6. Walker-Renard, P. Update on the medicinal management of phytobezoars. Am J Gastroenterol. 1993;88(10):1663-1666.
  7. Tymoszuk D, Wiszniewska M, Walusiak-Skorupa J. Papain-induced occupational rhinoconjunctivitis and asthma - A case report. Med Pr 2016;67(1):109-12. PubMed
  8. Soto-Mera MT, López-Rico MR, Filgueira JF, et al. Occupational allergy to papain. Allergy 2000;55(10):983-4. PubMed
  9. Tarlo SM, Shaikh W, Bell B, et al. Papain-induced allergic reactions. Clin Allergy 1978;8(3):207-15. PubMed
  10. Baur X, König G, Bencze K, Fruhmann G. Clinical symptoms and results of skin test, RAST and bronchial provocation test in thirty-three papain workers: Evidence for strong immunogenic potency and clinically relevant proteolytic e?ects of airborne papain. C
  11. Novey HS, Keenan WJ, Fairshter RD, Wells ID, Wilson AF, Culver BD. Pulmonary disease in workers exposed to papain: clinico-physiological and immunological studies. Clin Allergy 1980;10(6):721-31. PubMed

See these in context on the Papain monograph →

Bromelain 19 references
  1. Nettis E, Napoli G, Ferrannini A, Tursi A. IgE-mediated allergy to bromelain. Allergy 2001;56:257-8. PubMed
  2. 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
  3. Bradbrook ID, Morrison PJ, Rogers HJ. The effect of bromelain on the absorption of orally administered tetracycline. Br J Clin Pharmacol 1978;6:552-4. PubMed
  4. 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.
  5. Brien S, Lewith G, Walker AF, et al. Bromelain as an adjunctive treatment for moderate-to-severe osteoarthritis of the knee: a randomized placebo-controlled pilot study. QJM 2006;99:841-50. PubMed
  6. Mori S, Ojima Y, Hirose T, et al. The clinical effect of proteolytic enzyme containing bromelain and trypsin on urinary tract infection evaluated by double blind method. Acta Obstet Gynaecol Jpn 1972;19:147-53.
  7. Glaser D, Hilberg T. The influence of bromelain on platelet count and platelet activity in vitro. Platelets 2006;17:37-41. PubMed
  8. Heinicke R M, van der Wal L, Yokoyama M. Effect of bromelain (Ananase) on human platelet aggregation. Experientia 1972;28:844-5. PubMed
  9. Gailhofer, G., Wilders-Truschnig, M., Smolle, J., and Ludvan, M. Asthma caused by bromelain: an occupational allergy. Clin Allergy 1988;18(5):445-450. PubMed
  10. Mattei, O., Fabri, G., and Farina, G. [Occupational health experience regarding four cases of asthma due to bromelain (author's transl)]. Medicina del Lavoro 1979;70(5):404-409.
  11. Galleguillos, F. and Rodriguez, J. C. Asthma caused by bromelin inhalation. Clin Allergy 1978;8(1):21-24. PubMed
  12. Perez-Camo I, Quirce S, Duran MA, and et al. Latex allergy: evidence of cross-reactivity with papain and bromelain [abstract]. Allergy 1996;51(suppl 31):48.
  13. Martin GJ, Ehrenreich J, and Asbell N. Bromelain: pineapple proteases with anti-edema activity. Exp Med Surg 1962;20:227-247.
  14. Kasemsuk T, Saengpetch N, Sibmooh N, Unchern S. Improved WOMAC score following 16-week treatment with bromelain for knee osteoarthritis. Clin Rheumatol. 2016 Oct;35(10):2531-40. PubMed
  15. Kutlu Ö, DemirbaS A, Elmas ÖF, Güvenç U, Metin A. Fixed drug eruption: a new side effect of bromelain. Contact Dermatitis 2020. Online ahead of print. PubMed
  16. Shoham Y, Shapira E, Haik J, et al. Bromelain-based enzymatic debridement of chronic wounds: Results of a multicentre randomized controlled trial. Wound Repair Regen 2021;29(6):899-907. PubMed
  17. Pfister P, Garcia Wendel PD, Kim BS, et al. Coagulation side effects of enzymatic debridement in burned patients. Burns 2022. PubMed
  18. Hasham S, Riyat H, Fletcher A, O'Boyle CP, Alexander S. To bleed or not to bleed? Case series and discussion of haemorrhage risk with enzymatic debridement in burn injuries. Scars Burn Heal 2023;9:20595131231168333. PubMed
  19. Leelakanok N, Petchsomrit A, Janurai T, Saechan C, Sunsandee N. Efficacy and safety of bromelain: A systematic review and meta-analysis. Nutr Health 2023. PubMed

See these in context on the Bromelain monograph →

Lactase 1 reference
  1. Laukkanen A, Ruoppi P, Remes S, Koistinen T, Mäkinen-Kiljunen S. Lactase-induced occupational protein contact dermatitis and allergic rhinoconjunctivitis. Contact Dermatitis. 2007;57(2):89-93. PubMed

See these in context on the Lactase monograph →

Lipase 1 reference
  1. Casper C, Hascoet JM, Ertl T, et al. Recombinant bile salt-stimulated lipase in preterm infant feeding: A randomized phase 3 study. PLoS One. 2016;11(5):e0156071. PubMed

See these in context on the Lipase monograph →

Phytase 7 references
  1. Lei XG, Weaver JD, Mullaney E, Ullah AH, Azain MJ. Phytase, a new life for an "old" enzyme. Annu Rev Anim Biosci. 2013;1:283-309. PubMed
  2. Smuts CM, Matsungo TM, Malan L, et al. Effect of small-quantity lipid-based nutrient supplements on growth, psychomotor development, iron status, and morbidity among 6- to 12-mo-old infants in South Africa: a randomized controlled trial. Am J Clin Nutr. 2 PubMed
  3. van Heemst RC, Sander I, Rooyackers J, et al. Hypersensitivity pneumonitis caused by occupational exposure to phytase. Eur Respir J. 2009;33(6):1507-9. PubMed
  4. Baur X, Melching-Kollmuss S, Koops F, Strassburger K, Zober A. IgE-mediated allergy to phytase -- a new animal feed additive. Allergy. 2002;57(10):943-5. PubMed
  5. Doekes G, Kamminga N, Helwegen L, Heederik D. Occupational IgE sensitisation to phytase, a phosphatase derived from Aspergillus niger. Occup Environ Med. 1999;56(7):454-9. PubMed
  6. Brnic M, Hurrell RF, Songré-Ouattara LT, et al. Effect of phytase on zinc absorption from a millet-based porridge fed to young Burkinabe children. Eur J Clin Nutr. 2017;71(1):137-141. PubMed
  7. Koshy JC, Sharabi SE, Feldman EM, Hollier LH Jr, Patrinely JR, Soparkar CN. Effect of dietary zinc and phytase supplementation on botulinum toxin treatments. J Drugs Dermatol. 2012;11(4):507-12.

See these in context on the Phytase monograph →

Proteolytic Enzymes (proteases) 3 references
  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

See these in context on the Proteolytic Enzymes (proteases) monograph →

Bacillus Subtilis 10 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Lampropoulos PK, Gkentzi D, Tzifas S, Dimitriou G. Neonatal sepsis due to Bacillus subtilis. Cureus 2021;13(9):e17692. PubMed
  3. La Jeon Y, Yang JJ, Kim MJ, et al. Combined Bacillus licheniformis and Bacillus subtilis infection in a patient with oesophageal perforation. J Med Microbiol 2012;61(Pt 12):1766-1769. PubMed
  4. Wallet F, Crunelle V, Roussel-Delvallez M, Fruchart A, Saunier P, Courcol RJ. Bacillus subtilis as a cause of cholangitis in polycystic kidney and liver disease. Am J Gastroenterol 1996;91(7):1477-8.
  5. Velasco E, Martins CA, Tabak D, Bouzas LF. "Bacillus subtilis" infection in a patient submitted to a bone marrow transplantation. Rev Paul Med 1992;110(3):116-7.
  6. Kato A, Yoshifuji A, Komori K, et al. A case of Bacillus subtilis var. natto bacteremia caused by ingestion of natto during COVID-19 treatment in a maintenance hemodialysis patient with multiple myeloma. J Infect Chemother 2022;28(8):1212-1215. PubMed
  7. Freedman KE, Hill JL, Wei Y, et al. Examining the gastrointestinal and immunomodulatory effects of the novel probiotic Bacillus subtilis DE111. Int J Mol Sci 2021;22(5):2453. PubMed
  8. Lefevre M, Racedo SM, Denayrolles M, et al. Safety assessment of Bacillus subtilis CU1 for use as a probiotic in humans. Regul Toxicol Pharmacol 2017;83:54-65. PubMed
  9. Hanifi A, Culpepper T, Mai V, et al. Evaluation of Bacillus subtilis R0179 on gastrointestinal viability and general wellness: a randomised, double-blind, placebo-controlled trial in healthy adults. Benef Microbes 2015;6(1):19-27. PubMed
  10. Tokano M, Tarumoto N, Imai K, et al. A case of bacterial meningitis caused by Bacillus subtilis var. natto. Intern Med. 2022. Epub ahead of print.

See these in context on the Bacillus Subtilis monograph →

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

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