Interactions on record — worth a quick check against your medications. Based on 6 of 8 ingredients. Check your meds →
Dietary supplement

Chewable Super Papaya Enzyme Plus Ingredients & Drug Interactions

by Puritan's Pride Premium

Chewable Super Papaya Enzyme Plus label
See full label image
Other (e.g. Tea Bag) Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Chewable Super Papaya Enzyme Plus 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

Chewable Super Papaya Enzyme Plus is a dietary supplement by Puritan's Pride Premium with 8 active ingredients. Its ingredients are commonly taken for body and breath odor reduction, wound healing (topical), detoxification.Based on those ingredients, 519 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Chlorophyll, Bromelain, Papaya. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Chewable Super Papaya Enzyme Plus by Puritan's Pride Premium

Ask about any prescription or over-the-counter medication and we check it for interactions with Chewable Super Papaya Enzyme Plus by Puritan's Pride Premium — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Chewable Super Papaya Enzyme Plus by Puritan's Pride Premium

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

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 8 of its 8 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains 8 ingredients, six of which are digestive enzymes and plant compounds. The active ingredients are chlorophyll (a green plant pigment), papain and papaya extract (protein-digesting enzymes from papaya fruit), bromelain (a protein-digesting enzyme from pineapple), protease (a general protein-digesting enzyme), lipase (a fat-digesting enzyme), cellulase (a carbohydrate-digesting enzyme), and alpha-amylase (a starch-digesting enzyme).

The inactive ingredients include sorbitol, mannitol, calcium carbonate, stearic acid, magnesium stearate, silica, and peppermint oil.

Does it work?

Not established
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
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use.

Why this rating?
  • The label markets this product for: Enzymatic digestive care after meals.
  • We looked for evidence on: Dyspepsia, Constipation, Exercise-induced muscle soreness, Postoperative swelling, Sprains, Wound healing — and 4 related terms.
  • The closest evidence on file: Papain is rated "Insufficient Reliable Evidence To Rate" for Exercise-induced muscle soreness (Natural Medicines).
  • Also on file: Papain is rated "Insufficient Reliable Evidence To Rate" for Wound healing.
  • Also on file: Lipase is rated "Insufficient Reliable Evidence To Rate" for Inflammatory bowel disease (IBD), Dyspepsia.

The evidence for most of these ingredients is limited. Chlorophyll, papain, bromelain, and papaya all carry ratings of insufficient reliable evidence for their claimed uses—meaning we don't have solid proof they work as advertised.

Lipase likewise shows insufficient evidence for digestive disorders. No effectiveness data are on file for protease, cellulase, or alpha-amylase in our data.

If you're considering this product for a specific condition, talk with your pharmacist about what the science actually shows.

The evidence, ingredient by ingredient Chlorophyll Papain Bromelain Proteolytic Enzymes (proteases) Lipase Papaya

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 6 of the 6 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 6 of 6.
  • General safety write-ups exist for 6 of 6.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Chlorophyll is generally well tolerated short-term, though it can cause photosensitization (sun sensitivity) and in rare cases has led to pseudoporphyria (blistering). Papain may cause allergic reactions, digestive upset, or in high doses, severe gastritis or esophageal perforation.

Bromelain commonly causes diarrhea, gas, and stomach upset. Protease and lipase are generally tolerated but may trigger digestive upset or allergic reactions in sensitive people.

Do not use this product during pregnancy—chlorophyll, papain, bromelain, and protease all carry safety warnings against pregnancy use, while papaya itself is mixed (some forms are possibly unsafe). Breastfeeding is not recommended without talking to your doctor first, as safety data are limited across these ingredients.

Side effects, ingredient by ingredient Chlorophyll Papain Bromelain Proteolytic Enzymes (proteases) Lipase Papaya

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?
  • 4 of the 6 matched ingredients can interact with medications — Papain, Papaya, Chlorophyll, Bromelain.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications.
  • For scale: 519 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.

Before taking this product, check with your pharmacist if you take warfarin or other blood thinners, diabetes medications, amiodarone or other heart drugs, levothyroxine (thyroid medication), methotrexate, photosensitizing drugs, tetracycline antibiotics, or antiplatelet drugs like aspirin or clopidogrel. These carry Moderate or Minor interactions documented in the ingredients.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.

This enzyme blend may appeal to people looking for digestive support, but the evidence for it actually works is thin. If you take any prescription medications—especially blood thinners, diabetes drugs, heart medications, thyroid replacement, or cancer drugs—you must check your specific medications with the tool on this page before starting.

Avoid if you're pregnant or breastfeeding, and talk to your pharmacist if you have a history of sun sensitivity or digestive tract problems.

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

Assessment coverage: 6 of 8 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 25, 2018.

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 Chewable Super Papaya Enzyme Plus, straight from the product label.

Brand Puritan's Pride Premium
Net contents 90 Delicious Chewable Wafer(s)
Market status On market
Date entered into DSLD Jan 25, 2018
DSLD ID 82051
Product type Other Combinations
Supplement form Other (e.g. Tea Bag)
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
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 Chewable Super Papaya Enzyme Plus by Puritan's Pride Premium, 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:
3 Wafer(s)
Maximum serving Sizes:
3 Wafer(s)
Servings per container
30
IngredientAmount% DV
Chlorophyll1.5 mg--
Papain45 mg--
Bromelain3 mg--
Protease3 mg--
Lipase1.5 mg--
Cellulase3 mg--
Alpha-Amylase3 mg--
Papaya15 mg--

Other ingredients: Sorbitol, Mannitol, Calcium Carbonate, Stearic Acid, Vegetable Magnesium Stearate, Silica, Oil of Peppermint

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.
General

Item No. 980

Brand IP Statement(s)

The After Meal Supplement

Copyright 2015 Puritan's Pride, Inc.

General Statements

Enzymatic digestive care

Puritan's Pride provides these articles for information only. They are not approved or recommended by us, do not provide medical advice, diagnosis, or treatment, and are not meant to replace professional medical advice or apply to any products.

FDA Statement of Identity

Dietary Supplement

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

Suggested/Recommended/Usage/Directions

Directions: For adults, chew three (3) wafers following a meal, one to three times daily, or dissolve one (1) or two (2) wafers in mouth when needed.

Precautions

Warning: If you are pregnant, nursing or taking any medications, consult your doctor before use.

Discontinue use and consult your doctor if any adverse reactions occur.

Keep out of reach of children.

Do not use if seal under cap is broken or missing.

Storage

Store at room temperature.

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

See for yourself

Chewable Super Papaya Enzyme Plus by Puritan's Pride Premium label

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

Chewable Super Papaya Enzyme Plus 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 Chewable Super Papaya Enzyme Plus by Puritan's Pride Premium

These are the 8 active ingredients this product is made of. Select any to open its full monograph.

Serving size3 Wafer(s) Dosage formOther (e.g. Tea Bag) 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.

Chlorophyll

Interacts with
337 drugs
1.5 mg per serving

Chlorophyll is the green pigment found in plants and algae, and supplements often use a stable form called chlorophyllin. It is most studied for reduc...

Chlorophyll monograph & interactions

Papain

Interacts with
2 drugs
45 mg per serving

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 an...

Papain monograph & interactions

Bromelain

Interacts with
141 drugs
3 mg per serving

Bromelain is a group of protein-digesting enzymes from pineapple that people take mainly for inflammation, swelling, and sinus problems. Some early st...

Bromelain monograph & interactions

Protease

No known
interactions
3 mg per serving

Proteolytic enzymes are proteins that help break down other proteins, and common examples include bromelain (from pineapple), papain (from papaya), tr...

Protease monograph & interactions

Lipase

No known
interactions
1.5 mg per serving

Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy fo...

Lipase monograph & interactions

Cellulase

3 mg per serving

Alpha-Amylase

3 mg per serving

Papaya

Interacts with
92 drugs
15 mg per serving

Papaya is a tropical fruit that is nutritious and generally safe to eat as food, and it contains an enzyme called papain used as a digestive aid and m...

Papaya monograph & interactions

Other (inactive) ingredients: Sorbitol, Mannitol, Calcium Carbonate, Stearic Acid, Vegetable Magnesium Stearate, Silica, Oil of Peppermint. These complete the product’s ingredient list but are not active constituents.

Interaction report

Chewable Super Papaya Enzyme Plus by Puritan's Pride Premium Drug Interactions

Want to check YOUR meds against Chewable Super Papaya Enzyme Plus?

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
519Drugs
514 Moderate 5 Minor

Ingredients driving the most interactions

Chlorophyll 337
Bromelain 141
Papaya 92
Papain 2

Individual Drug Interactions

The ingredients in Chewable Super Papaya Enzyme Plus interact with 519 drugs. Click any drug to see the details.

4 of the 8 ingredients in Chewable Super Papaya Enzyme Plus interact with drugs. Each result below shows which ingredient is responsible. Chlorophyll Bromelain Papaya Papain

Each ingredient & the kinds of drugs it affects

For each ingredient in Chewable Super Papaya Enzyme Plus 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.

Chlorophyll2 drug types · 337 drugs

Methotrexate (Trexall, Others)

Theoretically, chlorophyll may reduce the clearance of methotrexate.
In one case report, a 54-year-old male developed delayed clearance of intravenous high-dose methotrexate with concomitant use of chlorophyll. When chlorophyll was stopped 2 days prior to methotrexate treatment, methotrexate clearance was unaffected.

Likelihood Possible Evidence B
Photosensitizing Drugs

Theoretically, concomitant use of chlorophyll with photosensitizing drugs may have additive effects.
Chlorophyll has been reported to cause photosensitization. In two case reports, pseudoporphyria developed after oral intake of chlorophyll. Theoretically, concomitant use with other photosensitizing drugs may exacerbate this effect.

Likelihood Probable Evidence B
Chlorophyll 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

Papaya4 drug types · 92 drugs

Amiodarone (Cordarone)

Theoretically, papaya extract may increase the levels and clinical effects of amiodarone.
Animal research in rats shows that a single oral dose of papaya extract, as well as multiple doses of papaya extract daily over 14 days, prior to a single dose of amiodarone delays the time to maximum amiodarone concentration. However, only the 14-day papaya extract regimen increases systemic amiodarone exposure by 60% to 70%. This interaction has not been reported in humans.

Likelihood Probable Evidence D
Antidiabetes Drugs

Concomitant use of antidiabetic drugs with fermented papaya can produce additive effects. It is unclear if other forms of papaya have the same effect.
A small low-quality clinical study in patients with type 2 diabetes who are taking glibenclamide shows that taking a fermented papaya preparation 3 grams daily for 2 months decreases fasting and postprandial blood glucose levels when compared to baseline. Additionally, of the 25 patients in the study, 9 required a reduction in glibenclamide dose.

Likelihood Probable Evidence B
Levothyroxine (Synthroid, Others)

Theoretically, consuming large quantities of papaya fruit can reduce the clinical effects of levothyroxine.
In one case-report, a 37-year-old male with a history of thyroidectomy who was stabilized on levothyroxine for 5 years presented with hypothyroidism after consuming 5-6 papaya fruits daily for 14 days during vacation. In a controlled re-challenge test involving 5-6 papayas daily, the patient remained euthyroid for 7 days, but developed mild hypothyroidism after 14 days. Both times, thyroid levels normalized 40-45 days after discontinuing papaya.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, concomitant use of warfarin with papain-containing papaya extract 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
Papaya 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 Chewable Super Papaya Enzyme Plus, from the product label.

Puritan's Pride Premium

See all Puritan's Pride Premium products
Name
Puritan's Pride
Street Address
1233 Montauk Highway, PO Box 9001
City
Oakdale
State
NY
ZipCode
11769-9001
Phone Number
1-800-645-1030
Web Address
www.puritan.com
Pharmacist Counseling Corner

Chewable Super Papaya Enzyme Plus by Puritan's Pride Premium: Common Questions

Does Chewable Super Papaya Enzyme Plus by Puritan's Pride Premium interact with any medications?
Yes. Based on its ingredients, Chewable Super Papaya Enzyme Plus has a known interaction with 519 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Chewable Super Papaya Enzyme Plus contains 8 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.
Can I take this if I'm on blood thinner medication?
No—not without checking with your pharmacist first. Papain and papaya extract both interact with warfarin, and one case report showed serious blood thinning when papain was added. Bromelain also increases bleeding risk with anticoagulants. Get your specific medication checked before using this product.
Is chlorophyll safe if I spend a lot of time in the sun?
Chlorophyll can cause photosensitization—increased sun sensitivity and skin reactions from sun exposure. If you're already sensitive to sunlight or take other photosensitizing drugs, tell your pharmacist before adding this product.
Will this actually help my digestion?
The evidence isn't established in our data. Papain, bromelain, and the other enzymes all show insufficient reliable evidence for digestive claims. Talk with your pharmacist about whether enzyme supplements are right for you.
Can I take this while breastfeeding?
No. Safety data during breastfeeding are limited or unknown for most of these ingredients. Talk with your doctor or pharmacist before using it.
What's the most common side effect?
Diarrhea, gas, and stomach upset are the most frequently reported side effects from bromelain. Allergic reactions to papain are also possible in sensitive people. Start with a low dose if you have a sensitive stomach.
If I take diabetes medication, can I use this?
Not without checking first. Fermented papaya can lower blood sugar and could add to the effects of diabetes drugs, raising the risk of low blood sugar. Ask your pharmacist to review your specific medication before using.

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

Not sure if Chewable Super Papaya Enzyme Plus is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

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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.

Chewable Super Papaya Enzyme Plus label
Go deeper

The Full Monographs Behind Chewable Super Papaya Enzyme Plus’s Ingredients

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

Herb & supplement monograph

Chlorophyll

Interacts with 337 drugs

Chlorophyll is the green pigment found in plants and algae, and supplements often use a stable form called chlorophyllin. It is most studied for reducing body and fecal odor and as a topical...

Read the full Chlorophyll monograph → 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

Proteolytic Enzymes (proteases)

Proteolytic enzymes are proteins that help break down other proteins, and common examples include bromelain (from pineapple), papain (from papaya), trypsin, chymotrypsin, and pancreatin. Peo...

Read the full Proteolytic Enzymes (proteases) monograph → Herb & supplement monograph

Lipase

Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy for people who cannot make enough of their...

Read the full Lipase monograph → Herb & supplement monograph

Papaya

Interacts with 92 drugs

Papaya is a tropical fruit that is nutritious and generally safe to eat as food, and it contains an enzyme called papain used as a digestive aid and meat tenderizer. Papaya leaf extract is b...

Read the full Papaya monograph →
Sources

Sources & How We Checked

Chewable Super Papaya Enzyme Plus'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 53 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.

Chlorophyll 5 references
  1. Mathews-Roth MM. Carotenoids in erythropoietic protoporphyria and other photosensitivity diseases. Ann N Y Acad Sci, 1993; 691:127-38. PubMed
  2. Belen'kii, G. B. and Krikun, B. L. [Treatment of herpes simplex and herpes zoster by chlorophyll preparations]. Sov.Med. 1971;34(1):151-152.
  3. Brooks SL, Sanders J, Seymour JF, Mellor JD. A case of delayed methotrexate clearance following administration of a complementary medication containing chlorophyll. J Oncol Pharm Pract. 2014 Jun;20(3):225-8. PubMed
  4. Rossi E, Borchard K, Cole JM. Pseudoporphyria following self-medication with chlorophyll. Australas J Dermatol. 2015 Feb;56(1):47-8. PubMed
  5. Zhao CY, Frew JW, Muhaidat J, et al. Chlorophyll-induced pseudoporphyria with ongoing photosensitivity after cessation - a case series of four patients. J Eur Acad Dermatol Venereol 2016;30(7):1239-42. PubMed

See these in context on the Chlorophyll monograph →

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 →

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 →

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 →

Papaya 14 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. 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.
  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. Blanco C, Diaz-Perales A, Collada C, et al. Class I chitinases as potential panallergens involved in the latex-fruit syndrome. J Allergy Clin Immunol 1999;103(3 Pt 1):507-13. PubMed
  6. Diaz-Perales A, Collada C, Blanco C, et al. Cross-reactions in the latex-fruit syndrome: A relevant role of chitinases but not of complex asparagine-linked glycans. J Allergy Clin Immunol 1999;104:681-7. PubMed
  7. Castillo, R., Delgado, J., Quiralte, J., Blanco, C., and Carrillo, T. Food hypersensitivity among adult patients: epidemiological and clinical aspects. Allergol.Immunopathol.(Madr.) 1996;24(3):93-97.
  8. Oderinde, O., Noronha, C., Oremosu, A., Kusemiju, T., and Okanlawon, O. A. Abortifacient properties of aqueous extract of Carica papaya (Linn) seeds on female Sprague-Dawley rats. Niger.Postgrad.Med J 2002;9(2):95-98. DOI
  9. Danese, C., Esposito, D., D'Alfonso, V., Cirene, M., Ambrosino, M., and Colotto, M. Plasma glucose level decreases as collateral effect of fermented papaya preparation use. Clin Ter. 2006;157(3):195-198.
  10. Iliev, D. and Elsner, P. Generalized drug reaction due to papaya juice in throat lozenges. Dermatology 1997;194(4):364-366. PubMed
  11. Andersen HA, Bernatz PE, Grindlay JH. Perforation of the esophagus after use of a digestant agent: report of case and experimental study. Ann Otol Rhinol Laryngol 1959;68:890-6. PubMed
  12. Deiana L, Marini S, Mariotti S. Ingestion of large amounts of papaya fruit and impaired effectiveness of levothyroxine therapy. Endocr Pract 2012;18(1):98-100. PubMed
  13. Rodrigues M, Alves G, Francisco J, Fortuna A, Falcão A. Herb-drug pharmacokinetic interaction between Carica papaya extract and amiodarone in rats. J Pharm Pharm Sci 2014;17(3):302-15. PubMed
  14. Rajapakse S, de Silva NL, Weeratunga P, Rodrigo C, Sigera C, Fernando SD. Carica papaya extract in dengue: a systematic review and meta-analysis. BMC Complement Altern Med. 2019;19(1):265. PubMed

See these in context on the Papaya monograph →

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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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