Interactions on record — worth a quick check against your medications. Based on 6 of 12 ingredients. Check your meds →
Dietary supplement

Digestive Enzyme Ingredients & Drug Interactions

by Nutrilite

Digestive Enzyme label
See full label image
Capsule 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 Digestive Enzyme 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

Digestive Enzyme is a dietary supplement by Nutrilite with 12 active ingredients. Its ingredients are commonly taken for digestion and bloating, muscle soreness and exercise recovery, inflammation and swelling.Based on those ingredients, 578 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Parsley dehydrate, Spirulina concentrate, Bromelain. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Digestive Enzyme by Nutrilite

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

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HelloPharmacist Scorecard of Digestive Enzyme by Nutrilite

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 23, 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 2 of its 12 active ingredients.
  • “Proprietary Enzyme Blend” is a proprietary blend — the label gives one combined amount (302 mg) without saying how much of each component you get.
  • “Lipolytics” is listed as a grouped ingredient — the label doesn't break down how much of each component you get.
  • “Plant Concentrate Base” is listed as a grouped ingredient — the label gives one combined amount (33 mg) without saying how much of each component you get.

Nutrilite Digestive Enzyme is a 12-ingredient capsule that combines carbohydrate, protein, and fat-digesting enzymes. The main active enzymes are amylase (breaks down carbs), protease 3 and protease 4.5 (break down proteins), lipase (breaks down fats), lactase (breaks down milk sugar), and bromelain (a pineapple enzyme with additional properties).

The formula also includes glucoamylase, invertase, peptidase, cellulase, and spirulina concentrate, plus proprietary blends labeled lipolytics and carbohydrolytics whose exact contents are listed separately. Parsley dehydrate rounds out the active ingredients.

Three inactive ingredients—microcrystalline cellulose, gelatin, and maltodextrin—serve as the capsule and binder.

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: aid normal digestion and ease discomfort after eating.
  • We looked for evidence on: Dyspepsia, Lactose intolerance, Indigestion, Bloating, Gas, Digestive upset.
  • The strongest evidence on file: Lactase is rated "Effective" for Lactose intolerance (Natural Medicines).
  • Also on file: Lipase is rated "Insufficient Reliable Evidence To Rate" for Dyspepsia.
  • Also on file: Parsley is rated "Insufficient Reliable Evidence To Rate" for Dyspepsia.

The evidence for most of these ingredients is limited. Lactase is the one ingredient rated effective, specifically for lactose intolerance.

Spirulina concentrate shows possibly effective evidence for high blood pressure (hypertension). For the digestive enzymes themselves—amylase, protease, lipase, and bromelain—the data on file does not include effectiveness ratings for digestive support.

Lipase has insufficient evidence for inflammatory bowel disease and indigestion (dyspepsia), and bromelain's ratings are insufficient for a range of conditions including allergies and inflammation. Without stronger evidence in our data, we can't say this product will improve digestion across the board.

The evidence, ingredient by ingredient Proteolytic Enzymes (proteases) Bromelain Lipase Blue-green Algae Parsley Lactase

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.

Most individual enzymes in this formula are generally well tolerated in short-term use, though bromelain's long-term safety is limited. Common side effects include digestive upset—diarrhea, gas, bloating, nausea—and headache.

Rarely, allergic reactions occur; people sensitive to pineapple, eggs, or airborne enzymes should be cautious. Protease and parsley both carry rare reports of allergy, and spirulina can trigger allergic reactions including anaphylaxis (very uncommon but serious).

Parsley at very high doses carries serious risks we don't expect from this supplement dose, but concentrated parsley should be avoided. For pregnancy, the safety picture is mixed: protease 3, protease 4.5, and bromelain should be avoided unless prescribed.

Parsley in medicinal amounts is likely unsafe in pregnancy. Lipase and lactase have limited pregnancy data—check with your doctor.

During breastfeeding, protease 3, protease 4.5, bromelain, spirulina, and parsley all lack sufficient safety data; lipase and lactase are less clear. Talk with your healthcare provider before taking this product if you are pregnant or breastfeeding.

Side effects, ingredient by ingredient Proteolytic Enzymes (proteases) Bromelain Lipase Blue-green Algae Parsley Lactase

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 6 matched ingredients can interact with medications — Parsley, Bromelain, Blue-green Algae.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications.
  • For scale: 578 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 you take Nutrilite Digestive Enzyme, double-check with your own doctor or pharmacist if you use anticoagulants or antiplatelet drugs (blood thinners, including warfarin and aspirin)—bromelain, spirulina, and parsley all carry Moderate risk of bleeding. Also flag antidiabetes drugs, diuretics, immunosuppressants, CYP1A2-processed medications, barbiturate sedatives, and sirolimus, all of which have Moderate interactions with parsley or spirulina.

Tetracycline antibiotics have a Minor interaction with bromelain.

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.

This is a multi-enzyme formula best suited to people looking for general digestive support, particularly if they have trouble digesting milk (lactase is effective for that). If you take blood thinners, diabetes medication, diuretics, immunosuppressants, or sedatives, you need to check with your own doctor or pharmacist before starting—the interactions are real and dose matters.

Pregnant or breastfeeding? Same thing: talk it over with your healthcare provider first.

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

Assessment coverage: 7 of 12 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 23, 2019.

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 Digestive Enzyme, straight from the product label.

Brand Nutrilite
Barcode (UPC) A-8903
Net contents 90 Capsule(s)
Market status On market
Date entered into DSLD Oct 23, 2019
DSLD ID 207994
Product type Other Combinations
Supplement form Capsule
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 Digestive Enzyme by Nutrilite, 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)
UPC/BARCODE
A-8903
IngredientAmount% DV
Amylase0 NP--
Glucoamylase0 NP--
Invertase0 NP--
Protease 30 NP--
Lipase0 NP--
Protease 4.50 NP--
Lactase0 NP--
Bromelain0 NP--
Proprietary Enzyme Blend302 mg--
Peptidase0 NP--
Cellulase0 NP--
Lipolytics0 NP--
Plant Concentrate Base33 mg--
Spirulina concentrate17 mg--
Parsley dehydrate16 mg--
Carbohydrolytics0 NP--

Other ingredients: Microcrystalline Cellulose, Gelatin, Maltodextrin

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

Nutrilite Digestive Enzyme provides a unique and diverse blend of enzymes that aid the body in normal digestion of carbohydrates, proteins, starches, fats, and dairy products.

The Plant Concentrate base, which includes Spirulina and Parsley, provides additional support for dietary balance.

Contains ingredients sourced from milk, soy, wheat.

Precautions

Children under 12 years of age, pregnant women or nursing mothers, or anyone with a medical condition should consult with a physician before using this product.

Children under 12 years of age, pregnant women or nursing mothers, or anyone with a medical condition should consult with a physician before using this product.

Individuals with known allergies to aspergillus or other molds or enzymes should consult a physician prior to use.

Contains ingredients sourced from milk, soy, wheat.

Storage

Keep bottle tightly closed. Store in a cool, dry place.

Formulation

No artificial flavors or colors added.

Seals/Symbols

Quality you can trust since 1934

General Statements

Ease occasional discomfort after eating

Exclusively from Amway

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

1 capsule per meal

Suggested use: Take one capsule with water at the beginning of each meal as needed (or open capsule and sprinkle over food that is not hot). If meal is large or unusually high in fat or protein, a second capsule may be taken at end of meal.

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

Digestive Enzyme by Nutrilite label

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

Digestive Enzyme 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 Digestive Enzyme by Nutrilite

These are the 12 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule 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.

Proprietary Enzyme Blend

302 mg per serving

Lipolytics

0 NP per serving

Plant Concentrate Base

33 mg per serving

Carbohydrolytics

0 NP per serving
  • › Amylase
  • › Glucoamylase
  • › Invertase
  • › Lactase
  • › Cellulase

Other (inactive) ingredients: Microcrystalline Cellulose, Gelatin, Maltodextrin. These complete the product’s ingredient list but are not active constituents.

Interaction report

Digestive Enzyme by Nutrilite Drug Interactions

Want to check YOUR meds against Digestive Enzyme?

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
578Drugs
559 Moderate 19 Minor

Ingredients driving the most interactions

Parsley dehydrate 443
Spirulina concentrate 327
Bromelain 141

Individual Drug Interactions

The ingredients in Digestive Enzyme interact with 578 drugs. Click any drug to see the details.

3 of the 12 ingredients in Digestive Enzyme interact with drugs. Each result below shows which ingredient is responsible. Parsley dehydrate Spirulina concentrate Bromelain

Each ingredient & the kinds of drugs it affects

For each ingredient in Digestive Enzyme 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.

Parsley dehydrate8 drug types · 443 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, parsley might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Animal research suggests that parsley has antiplatelet effects.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, parsley might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research suggests that parsley might decrease blood glucose. Monitor blood glucose levels closely. Dose adjustments might be necessary.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, parsley might increase serum levels of CYP1A2 substrates.
Laboratory research suggests that parsley can inhibit CYP1A2.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, parsley might enhance or interfere with the effects of diuretic drugs.
Animal research suggests that parsley seed extract increases urine elimination. Parsley leaf and root might also interfere with diuretic therapy due their purported aquaretic effects.

Likelihood Possible Evidence D
Pentobarbital (Nembutal)

Theoretically, parsley might increase the duration of pentobarbital effects.
Animal research suggests that parsley juice prolongs the action of pentobarbital, perhaps by decreasing cytochrome P450 levels. It is not known if this occurs in humans or if this applies to other barbiturates or sedatives.

Likelihood Possible Evidence D
Sirolimus (Rapamune)

Theoretically, large quantities of parsley might increase sirolimus levels.
In one case report, an adult female with a history of kidney transplant presented with elevated blood sirolimus levels, approximately 4-7 times greater than previous measures, after daily consumption of a juice containing approximately 30 grams of parsley for 7 days. Sirolimus levels returned to normal a week after the parsley juice was discontinued.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, large amounts of parsley leaf and root might decrease the effects of warfarin.
Parlsey contains vitamin K.

Likelihood Possible Evidence D
Aspirin

Theoretically, aspirin might increase the severity of allergic reactions to parsley.
In one case, severe urticaria and swelling were reported after taking aspirin with parsley in an individual with a known mild parsley allergy.

Likelihood Unlikely Evidence D
Parsley dehydrate full monograph & interactions

Spirulina concentrate3 drug types · 327 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, spirulina blue-green algae might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs. However, this is unlikely.
Spirulina blue-green algae have shown antiplatelet and anticoagulant effects in vitro. However, one preliminary study in 24 patients receiving spirulina blue-green algae 2.3 grams daily for 2 weeks showed no effect on platelet activation or measures of clotting time.

Likelihood Unlikely Evidence D
Antidiabetes Drugs

Theoretically, taking blue-green algae with antidiabetes drugs might increase the risk of hypoglycemia.
Human research shows that spirulina blue-green algae can have hypoglycemic effects in patients with diabetes, at least some of whom were using antidiabetes drugs. However, blue-green algae does not seem to improve glycated hemoglobin (HbA1c) levels in patients with diabetes. A meta-analysis of animal studies also suggests that spirulina blue-green algae have hypoglycemic effects.

Likelihood Possible Evidence B
Immunosuppressants

Theoretically, concurrent use of blue-green algae might interfere with immunosuppressive therapy.
Blue-green algae have been shown to stimulate the immune system.

Likelihood Possible Evidence D
Spirulina concentrate 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
The maker

Brand information

Manufacturer and brand details for Digestive Enzyme, from the product label.

Nutrilite

See all Nutrilite products
Name
Amway Corp.
City
Ada
State
MI
ZipCode
49355
Phone Number
1-800-253-6500
Web Address
Amway.com/Nutrilite
Pharmacist Counseling Corner

Digestive Enzyme by Nutrilite: Common Questions

Does Digestive Enzyme by Nutrilite interact with any medications?
Yes. Based on its ingredients, Digestive Enzyme has a known interaction with 578 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Digestive Enzyme contains 12 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.
Is lactase in here actually effective for lactose intolerance?
Yes—lactase is rated effective for lactose intolerance specifically. It breaks down lactose (milk sugar) so your body can absorb it without the cramping and bloating. For that purpose, the evidence is solid.
What are the most common side effects?
Digestive upset is most likely: diarrhea, gas, bloating, nausea, and headache. These are usually mild and short-lived. Rarely, people allergic to pineapple or enzymes in general may have an allergic reaction.
Can I take this if I'm pregnant?
Not without checking first. Parsley in this product should be avoided in pregnancy, and the proteases and bromelain lack safety data. Lactase and lipase are less clear. Talk with your doctor or pharmacist before starting.
Does this product have fillers?
It has three inactive ingredients: microcrystalline cellulose (a binder), gelatin (the capsule), and maltodextrin (a binder). Those are the only inert materials in the capsule.
What does spirulina in this formula do?
Spirulina is a blue-green algae with possibly effective evidence for high blood pressure. In this digestive formula it likely adds nutrients, but the main digestive work is done by the enzymes—amylase, protease, and lipase.
Can I take this with blood thinners like warfarin?
Not safely without your doctor's approval. Bromelain, spirulina, and parsley all may increase bleeding risk with anticoagulants. Check with your own doctor or pharmacist before combining them.

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

Not sure if Digestive Enzyme 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.

Digestive Enzyme label
Go deeper

The Full Monographs Behind Digestive Enzyme’s Ingredients

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

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

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

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

Blue-green Algae

Interacts with 327 drugs

Blue-green algae are nutrient-rich aquatic microorganisms (such as spirulina and Klamath Lake algae) taken as a supplement for energy, nutrition, and general wellness. Evidence for most heal...

Read the full Blue-green Algae monograph → Herb & supplement monograph

Parsley

Interacts with 443 drugs

Parsley is a popular culinary herb that is safe to eat in normal food amounts and is a good source of vitamins K and C. It is traditionally used as a diuretic and for digestion, but solid hu...

Read the full Parsley 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 →
Sources

Sources & How We Checked

Digestive Enzyme'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 67 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.

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 →

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 →

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 →

Blue-green Algae 22 references
  1. Jensen GS, Ginsberg DJ, Huerta P, et al. Consumption of Aphanizomenon flos-aquae has rapid effects on the circulation and function of immune cells in humans. A novel approach to nutritional mobilization of the immune system. JANA 2000;2:50-6.
  2. Iwasa M, Yamamoto M, Tanaka Y, et al. Spirulina-associated hepatotoxicity. Am J Gastroenterol 2002;97:3212-13. PubMed
  3. Hayashi O, Katoh T, Okuwaki Y. Enhancement of antibody production in mice by dietary Spirulina platensis. J Nutr Sci Vitaminol (Tokyo) 1994;40:431-41.. PubMed
  4. Vitale S, Miller NR, Mejico LJ, et al. A randomized, placebo-controlled, crossover clinical trial of super blue-green algae in patients with essential blepharospasm or Meige syndrome. Am J Ophthalmol 2004;138:18-32. PubMed
  5. Mani UV, Desai S, Iyer U. Studies on the long-term effect of spirulina supplementation on serum lipid profile and glycated proteins in NIDDM patients. J Nutraceut 2000;2(3):25-32. DOI
  6. Chiu HF, Yang SP, Kuo YL, et al. Mechanisms involved in the antiplatelet effect of C-phycocyanin. Br J Nutr 2006;95:435-40. PubMed
  7. Hsiao G, Chou PH, Shen MY, et al. C-phycocyanin, a very potent and novel platelet aggregation inhibitor from Spirulina platensis. J Agric Food Chem 2005;53:7734-40.
  8. Katz M, Levine AA, Kol-Degani H, Kav-Venaki L. A compound herbal preparation (CHP) in the treatment of children with ADHD: a randomized controlled trial. J Atten Disord 2010;14:281-91. PubMed
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  12. Konno, T., Umeda, Y., Umeda, M., Kawachi, I., Oyake, M., and Fujita, N. [A case of inflammatory myopathy with widely skin rash following use of supplements containing Spirulina]. Rinsho Shinkeigaku 2011;51(5):330-333. PubMed
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  16. Marles RJ, Barrett ML, Barnes J, et al. United States Pharmacopeia safety evaluation of spirulina. Crit Rev Food Sci Nutr 2011;51(7):593-604. PubMed
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  18. Cha BG, Kwak HW, Park AR, et al. Structural characteristics and biological performance of silk fibroin nanofiber containing microalgae spirulina extract. Biopolymers 2014;101(4):307-18. PubMed
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  20. Hamedifard Z, Milajerdi A, Reiner Z, Taghizadeh M, Kolahdooz F, Asemi Z. The effects of spirulina on glycemic control and serum lipoproteins in patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized con
  21. Moradi S, Zobeiri M, Feizi A, Clark CCT, Entezari MH. The effects of spirulina (Arthrospira platensis) supplementation on anthropometric indices, blood pressure, sleep quality, mental health, fatigue status and quality of life in patients with ulcerative
  22. Ghanbari F, Amerizadeh A, Behshood P, Moradi S, Asgary S. Effect of microalgae arthrospira on biomarkers of glycemic control and glucose metabolism: a systematic Review and meta-analysis. Curr Probl Cardiol 2022;47(10):100942. PubMed

See these in context on the Blue-green Algae monograph →

Parsley 21 references
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See these in context on the Parsley 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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