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

Digestive Enzyme Ingredients & Drug Interactions

by USANA

Digestive Enzyme label
See full label image
Tablet Or Pill Category: Other Combinations
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 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 USANA with 8 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, 488 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Artichoke extract, Bromelain, Papain. 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 USANA

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

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HelloPharmacist Scorecard of Digestive Enzyme by USANA

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 1 of its 8 active ingredients.
  • “Natural Enzyme Blend” is a proprietary blend — the label gives one combined amount (120 mg) without saying how much of each component you get.

This tablet contains eight active digestive enzymes: papain, bromelain, protease, lipase, and lactase, plus cellulase and alpha-amylase, all working to break down different foods in your digestive tract. The formula also includes artichoke extract, traditionally used to support digestion.

These are mixed with standard inactive ingredients like cellulose, starch, and silicon dioxide, which help form and stabilize the tablet.

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: Digestive enzyme support.
  • We looked for evidence on: Dyspepsia, Lactose intolerance, Exercise-induced muscle soreness, Postoperative swelling, Sprains, Wound healing — and 4 related terms.
  • The strongest evidence on file: Lactase is rated "Effective" for Lactose intolerance (Natural Medicines).
  • Also on file: Artichoke is rated "Possibly Effective" for Dyspepsia.
  • Also on file: Papain is rated "Insufficient Reliable Evidence To Rate" for Exercise-induced muscle soreness, Wound healing.

The data shows lactase is effective for lactose intolerance — if you can't digest milk sugar, this enzyme directly helps break it down. Artichoke extract is possibly effective for high cholesterol (hyperlipidemia) and indigestion (dyspepsia); small studies suggest it may modestly lower cholesterol and ease digestive discomfort.

For the other enzymes — papain, bromelain, protease, lipase, and cellulase — the evidence isn't established in the data we hold. Most of the conditions they're used for (like wound healing, inflammation, or specific digestive disorders) are rated insufficient reliable evidence, meaning we don't have solid proof they work for those purposes.

The evidence, ingredient by ingredient Papain Bromelain Proteolytic Enzymes (proteases) Lipase Lactase Artichoke

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.

Papain, bromelain, protease, and artichoke extract are generally well tolerated short-term when taken at standard doses, but digestive upset — diarrhea, gas, nausea, or abdominal pain — can happen, especially in people sensitive to these ingredients. Allergic reactions to papain or bromelain are possible but uncommon; if you have asthma or allergies to ragweed or related plants, you're at higher risk.

At high doses, papain may cause serious digestive damage, though this is rare. Lactase is generally well tolerated.

The safety data on long-term use of bromelain is limited. During pregnancy, papain and artichoke extract are best avoided — safety data raises concerns — while bromelain and protease should also be skipped unless your doctor advises otherwise.

During breastfeeding, safety data is insufficient for papain, bromelain, protease, and artichoke, so talk with your doctor or pharmacist before using.

Side effects, ingredient by ingredient Papain Bromelain Proteolytic Enzymes (proteases) Lipase Lactase Artichoke

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 — Papain, Artichoke, Bromelain.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications.
  • For scale: 488 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 with your doctor or pharmacist before taking this product if you use blood thinners or antiplatelet drugs like warfarin, clopidogrel, or aspirin (moderate risk of increased bleeding). Also flag any blood pressure medications, diabetes medications, tetracycline antibiotics, or drugs processed by your liver through CYP2C19 or CYP2B6 pathways — the artichoke and bromelain in this formula may affect how they work or their levels in your blood.

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.

If you have trouble digesting lactose, the lactase in this formula is a solid choice. Artichoke extract may help with indigestion or cholesterol if you're not sensitive to it.

But before you start, check with your own doctor or pharmacist — especially if you take blood thinners, blood pressure pills, diabetes medications, or tetracycline antibiotics, as this product interacts with all of those. If you're pregnant or breastfeeding, discuss it with your healthcare provider first.

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 Nov 21, 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 USANA
Net contents 56 Tablet(s)
Market status On market
Date entered into DSLD Nov 21, 2019
DSLD ID 201063
Product type Other Combinations
Supplement form Tablet Or Pill
Dietary claims / uses All Other
Intended target group(s) Vegetarian, 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 USANA, 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 Tablet(s)
Maximum serving Sizes:
3 Tablet(s)
Servings per container
56
IngredientAmount% DV
Papain0 NP--
Bromelain0 NP--
Protease0 NP--
Lipase0 NP--
Lactase0 NP--
Cellulase0 NP--
Alpha-Amylase0 NP--
Natural Enzyme Blend120 mg--
Artichoke extract25 mg--

Other ingredients: Microcrystalline Cellulose, Croscarmellose Sodium, pregelatinized Starch, Ascorbyl Palmitate, Silicon Dioxide, Dextrin, Vanilla extract, Dextrose, Soy Lecithin, Sodium Carboxymethylcellulose, Sodium Citrate

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.
Seals/Symbols

Potency Guaranteed

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Directions: Take one (1) to three (3) tablets with a meal or as needed.

Formula

Contains: Soy.

Precautions

Contains: Soy.

Keep out of reach of children.

Consult your physician if you are pregnant, nursing, taking a prescription drug, or have a medical condition.

There is a safety seal under the cap. Do not use if the seal is broken or missing.

Formulation

No animal derived ingredients.

General Statements

Laboratory tested, quality guaranteed. Meets USP specification for uniformity, potency, and disintegration where applicable.

Storage

Keep tablets in original container with the lid tightly closed between uses. Store in a cool, dry place. Store below 25(0) C

General

111.010102 LB.001209

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

See for yourself

Digestive Enzyme by USANA 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 USANA

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

Serving size1 Tablet(s) Dosage formTablet Or Pill Servings per container56 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.

Natural Enzyme Blend

120 mg per serving

Artichoke extract

Interacts with
363 drugs
25 mg per serving

Artichoke leaf extract is a generally well-tolerated supplement that may have a mild cholesterol-lowering effect and is often used for indigestion, th...

Artichoke extract monograph & interactions

Other (inactive) ingredients: Microcrystalline Cellulose, Croscarmellose Sodium, Pregelatinized Starch, Ascorbyl Palmitate, Silicon Dioxide, Dextrin, Vanilla extract, Dextrose, Soy Lecithin, Sodium Carboxymethylcellulose, Sodium Citrate. These complete the product’s ingredient list but are not active constituents.

Interaction report

Digestive Enzyme by USANA 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
488Drugs
469 Moderate 19 Minor

Ingredients driving the most interactions

Artichoke extract 363
Bromelain 141
Papain 2

Individual Drug Interactions

The ingredients in Digestive Enzyme interact with 488 drugs. Click any drug to see the details.

3 of the 8 ingredients in Digestive Enzyme interact with drugs. Each result below shows which ingredient is responsible. Artichoke extract Bromelain Papain

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.

Artichoke extract4 drug types · 363 drugs

Antidiabetes Drugs

Theoretically, artichoke leaf extract may increase the risk of hypoglycemia when taken with antidiabetes drugs.
A meta-analysis of small clinical studies shows that taking artichoke leaf extract for 8-12 weeks can modestly reduce fasting plasma glucose when compared with placebo.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, artichoke leaf extract may increase the risk of hypotension when taken with antihypertensive drugs.
A meta-analysis of small clinical studies in patients with hypertension shows that taking artichoke can reduce systolic blood pressure by around 3 mmHg and diastolic blood pressure by around 2 mmHg when compared with placebo.

Likelihood Possible Evidence D
Cytochrome P450 2B6 (Cyp2B6) Substrates

Theoretically, artichoke might increase serum levels of drugs metabolized by CYP2B6.
In vitro research shows that artichoke leaf extract inhibits CYP2B6 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, artichoke might increase serum levels of drugs metabolized by CYP2C19.
In vitro research shows that artichoke leaf extract inhibits CYP2C19 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Artichoke extract 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 Digestive Enzyme, from the product label.

USANA

See all USANA products
Name
USANA Health Sciences, Inc.
Street Address
3838 W. Parkway Blvd.
City
Salt Lake City
State
Utah
ZipCode
84120
Pharmacist Counseling Corner

Digestive Enzyme by USANA: Common Questions

Does Digestive Enzyme by USANA interact with any medications?
Yes. Based on its ingredients, Digestive Enzyme has a known interaction with 488 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 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.
Will this help my digestion?
It depends what's bothering you. Lactase definitely helps if you can't digest milk sugar. Artichoke extract is possibly effective for indigestion, and the other enzymes (papain, bromelain, protease, lipase, cellulase, and alpha-amylase) are widely used for digestion, but we don't have reliable evidence they work for specific digestive conditions. Your experience may vary.
Can I take this if I'm on warfarin?
Not without talking to your doctor first — papain and bromelain in this formula may increase warfarin's blood-thinning effects, raising your bleeding risk. One patient's blood-thinning level jumped after taking papain. Your doctor can check whether it's safe for you or suggest monitoring.
What are the most common side effects?
Mild digestive upset — diarrhea, gas, nausea, or stomach cramps — is most common. Allergic reactions like itchy eyes, runny nose, or rash can happen if you're sensitive to papain, bromelain, or artichoke. Serious effects are rare but possible at high doses.
Is it safe during pregnancy?
No. Papain and artichoke extract should be avoided in pregnancy due to safety concerns. Bromelain and protease also lack enough safety data and should be skipped unless your doctor advises you. Talk with your healthcare provider before taking this product if you're pregnant.
Can I take this with tetracycline antibiotics?
Bromelain in this formula may increase how much tetracycline your body absorbs, though a human study showed no significant effect. Still, it's best to check with your doctor or pharmacist — they can advise whether it's safe for you or whether you should space it out.
What if I'm allergic to ragweed?
Be cautious. Artichoke is related to ragweed and other plants in the same family, so you may be more likely to have an allergic reaction. If you've had reactions to ragweed, chrysanthemums, daisies, or marigolds, mention that to your doctor or pharmacist before taking this.

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

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

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

Artichoke

Interacts with 363 drugs

Artichoke leaf extract is a generally well-tolerated supplement that may have a mild cholesterol-lowering effect and is often used for indigestion, though the evidence is modest. It is not a...

Read the full Artichoke 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 51 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 →

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 →

Artichoke 16 references
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. Walker AF, Middleton RW, Petrowicz O. Artichoke leaf extract reduces symptoms of irritable bowel syndrome in a post-marketing surveillance study. Phytother Res 2001;15:58-61. PubMed
  3. Pittler MH, White AR, Stevinson C, Ernst E. Effectiveness of artichoke extract in preventing alcohol-induced hangovers: a randomized controlled trial. CMAJ 2003;169:1269-73.
  4. Romano, C., Ferrara, A., and Falagiani, P. A case of allergy to globe artichoke and other clinical cases of rare food allergy. J Investig.Allergol.Clin Immunol. 2000;10(2):102-104.
  5. Miralles, J. C., Garcia-Sells, J., Bartolome, B., and Negro, J. M. Occupational rhinitis and bronchial asthma due to artichoke (Cynara scolymus). Ann Allergy Asthma Immunol. 2003;91(1):92-95. PubMed
  6. Franck, P., Moneret-Vautrin, D. A., Morisset, M., Kanny, G., Megret-Gabeaux, M. L., and Olivier, J. L. Anaphylactic reaction to inulin: first identification of specific IgEs to an inulin protein compound. Int Arch Allergy Immunol 2005;136(2):155-158. PubMed
  7. Meding, B. Allergic contact dermatitis from artichoke, Cynara scolymus. Contact Dermatitis 1983;9(4):314.
  8. Quirce, S., Tabar, A. I., Olaguibel, J. M., and Cuevas, M. Occupational contact urticaria syndrome caused by globe artichoke (Cynara scolymus). J Allergy Clin Immunol. 1996;97(2):710-711. PubMed
  9. Held C. Von der 1. Deutsche-Ungarischen Phytopharmakon-Konferenz, Budapest, 20. November 1991. Z Klin Med 1992;47:92-93.
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See these in context on the Artichoke 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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