Interactions on record — worth a quick check against your medications. Based on 6 of 18 ingredients. Check your meds →
Dietary supplement

Digestive Enzymes Ingredients & Drug Interactions

by Rise-N-Shine

Digestive Enzymes 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 Enzymes 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 Enzymes is a dietary supplement by Rise-N-Shine with 18 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, 141 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are 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 Enzymes by Rise-N-Shine

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

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HelloPharmacist Scorecard of Digestive Enzymes by Rise-N-Shine

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 0 of its 18 active ingredients.

Rise-N-Shine contains 18 active ingredients, most of them digestive enzymes that break down different components of food. Amylase breaks down starches, lipase handles fats, protease (two types) breaks down proteins, and lactase helps digest lactose in dairy—that one is actually rated effective for lactose intolerance.

You'll also find bromelain (an enzyme from pineapple), papain (from papaya), cellulase, aspergillopepsin, peptidase, invertase, glucoamylase, xylanase, pectinase, phytase, hemicellulase, beta glucanase, and alpha galactosidase, each theoretically helping your digestive system work through different food molecules. The inactive ingredients are maltodextrin, hypromellose, water, and medium chain triglycerides—standard capsule fillers and binders.

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

The evidence is thin for most of these enzymes. Lactase is rated effective for lactose intolerance—if you have trouble digesting dairy, this ingredient has solid backing.

For the rest—including papain, bromelain, lipase, the proteases, phytase, and the others—the evidence we hold is insufficient to rate whether they work. That doesn't mean they're useless, just that the studies backing them up aren't strong enough yet for us to make a reliable call.

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

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 is generally tolerated as a food, but supplements may irritate your digestive tract and can trigger allergic reactions in sensitive people—watch for itchy watery eyes, runny nose, sneezing, stomach cramps, sweating, or diarrhea. Concentrated papain and unripe papaya products should be avoided in pregnancy due to safety concerns; safety during breastfeeding hasn't been well studied, so check with your doctor first.

Bromelain is generally well tolerated short-term and causes mostly mild issues like diarrhea, flatulence, headache, or stomach upset, though allergic reactions including asthma are possible if you're sensitive. It should be avoided in pregnancy and breastfeeding due to insufficient safety data.

Lactase is rated likely safe in pregnancy and lactation, and is generally well tolerated at normal doses. Lipase hasn't been thoroughly evaluated for adverse effects in adults, and safety in pregnancy and breastfeeding hasn't been well studied, so talk to your doctor before using it if you're pregnant or nursing.

The proteases may cause digestive upset or allergic reactions and should be avoided in pregnancy unless prescribed; breastfeeding safety is unclear. Phytase is considered low-risk in foods but human supplement safety data are limited; avoid it in pregnancy unless your doctor advises it, and check with your doctor before use while breastfeeding.

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

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?
  • 2 of the 6 matched ingredients can interact with medications — Papain, Bromelain.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs.
  • For scale: 141 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 Rise-N-Shine, double-check with your doctor or pharmacist if you take blood thinners (anticoagulants) or antiplatelet drugs—papain and bromelain may increase bleeding risk (Moderate severity). If you're on tetracycline antibiotics, let them know as well, since bromelain may raise those drug levels (Minor severity).

No interactions are documented for the other ingredients we could check.

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 product is a multi-enzyme blend designed to support digestion, with lactase being the only ingredient rated effective (for lactose intolerance). If you take blood thinners like warfarin or any antiplatelet medication, or if you use tetracycline antibiotics, talk with your doctor or pharmacist before starting it—papain and bromelain may interfere with how those drugs work.

Pregnant or breastfeeding women should check with their healthcare provider first, especially because papain and bromelain safety data are limited in those situations. For everyone else, watch for allergic reactions or digestive upset, and discuss with your doctor or pharmacist if you have serious digestive conditions.

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

Assessment coverage: 7 of 18 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 24, 2023.

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 Enzymes, straight from the product label.

Brand Rise-N-Shine
Barcode (UPC) 850011384909
Net contents 30 Capsule(s)
Market status On market
Date entered into DSLD Oct 24, 2023
DSLD ID 297083
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Gluten Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Digestive Enzymes by Rise-N-Shine, 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 Vegetable Capsule(s)
Maximum serving Sizes:
1 Vegetable Capsule(s)
Servings per container
30
UPC/BARCODE
850011384909
IngredientAmount% DV
Amylase0 NP--
Papain0 NP--
Bromelain0 NP--
Lipase0 NP--
Lactase0 NP--
Cellulase0 NP--
Aspergillopepsin0 NP--
Peptidase0 NP--
Invertase0 NP--
Glucoamylase0 NP--
Xylanase0 NP--
Pectinase0 NP--
Phytase0 NP--
Hemicellulase0 NP--
Protease 10 NP--
Protease 20 NP--
Beta Glucanase0 NP--
Alpha galactosidase0 NP--

Other ingredients: Maltodextrin, Hypromellose, Water, Medium Chain Triglycerides

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.
Suggested/Recommended/Usage/Directions

Suggested Use: 1 capsule at the beginning of each meal as a dietary supplement, or as directed by a healthcare professional. Do not exceed six capsules daily.

Precautions

Caution: Do not exceed recommended dose. Do not use if safety seal is damaged or missing.

Pregnant or nursing mothers, children under 18, and individuals with a known medical condition should consult a physician before using this or any dietary supplement.

Pregnant or nursing mothers, children under 18, and individuals with a known medical condition should consult a physician before using this or any dietary supplement. Keep out of reach of children.

This product is manufactured and packaged in a facility which may also process milk, soy, wheat, egg, peanuts, tree nuts, fish and crustacean shellfish.

Allergen Warning: Contains dairy, soy and wheat (from a fermentation process including dairy, soy and wheat) Gluten-free formula.

Formula

Contains natural and synthetic/artificial ingredients.

Formulated with 18 Supreme Enzymes

Storage

Store in a cool, dry place.

FDA Disclaimer Statement

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

Seals/Symbols

Formulated In The USA GMP QUALITY Good Manufacturing Practice Certification

Brand IP Statement(s)

Rise-N-Shine Everyday Desires Met... Naturally Contains natural and synthetic/artificial ingredients.

FDA Statement of Identity

Dietary supplement

Formulation

Allergen Warning: Contains dairy, soy and wheat (from a fermentation process including dairy, soy and wheat) Gluten-free formula.

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

See for yourself

Digestive Enzymes by Rise-N-Shine label

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

Digestive Enzymes 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 Enzymes by Rise-N-Shine

These are the 18 active ingredients this product is made of. Select any to open its full monograph.

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

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

Amylase

0 NP per serving

Papain

Interacts with
2 drugs
0 NP 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
0 NP 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

Lipase

No known
interactions
0 NP 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

Lactase

No known
interactions
0 NP per serving

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 red...

Lactase monograph & interactions

Cellulase

0 NP per serving

Aspergillopepsin

0 NP per serving

Peptidase

0 NP per serving

Invertase

0 NP per serving

Glucoamylase

0 NP per serving

Xylanase

0 NP per serving

Pectinase

0 NP per serving

Phytase

No known
interactions
0 NP per serving

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

Phytase monograph & interactions

Hemicellulase

0 NP per serving

Protease 1

No known
interactions
0 NP per serving

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

Protease 1 monograph & interactions

Protease 2

No known
interactions
0 NP per serving

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

Protease 2 monograph & interactions

Beta Glucanase

0 NP per serving

Alpha galactosidase

0 NP per serving

Other (inactive) ingredients: Maltodextrin, Hypromellose, Water, Medium Chain Triglycerides. These complete the product’s ingredient list but are not active constituents.

Interaction report

Digestive Enzymes by Rise-N-Shine Drug Interactions

Want to check YOUR meds against Digestive Enzymes?

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
141Drugs
122 Moderate 19 Minor

Ingredients driving the most interactions

Bromelain 141
Papain 2

Individual Drug Interactions

The ingredients in Digestive Enzymes interact with 141 drugs. Click any drug to see the details.

2 of the 18 ingredients in Digestive Enzymes interact with drugs. Each result below shows which ingredient is responsible. Bromelain Papain

Each ingredient & the kinds of drugs it affects

For each ingredient in Digestive Enzymes 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.

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 Enzymes, from the product label.

Rise-N-Shine

See all Rise-N-Shine products
Name
Rise-N-Shine, LLC
Street Address
17 Woodport Road
City
Sparta
State
NJ
ZipCode
07871
Phone Number
973-729-4141
Web Address
www.rise-n-shine.com
Pharmacist Counseling Corner

Digestive Enzymes by Rise-N-Shine: Common Questions

Does Digestive Enzymes by Rise-N-Shine interact with any medications?
Yes. Based on its ingredients, Digestive Enzymes has a known interaction with 141 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Digestive Enzymes contains 18 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 with my digestive problems?
Lactase—one of the 18 enzymes here—is proven effective for lactose intolerance specifically. For the others, the evidence isn't strong enough for us to say whether they work. If you have a specific digestive condition or food intolerance, talk to your doctor about whether a digestive enzyme blend makes sense for you.
Is it safe if I'm pregnant?
Not without checking first. Papain should be avoided in pregnancy due to safety concerns, and bromelain doesn't have enough safety data so it's best avoided too. Lactase is rated likely safe in pregnancy. Talk with your doctor or pharmacist before taking this product while pregnant.
Can I take this while breastfeeding?
Safety during breastfeeding hasn't been well studied for papain, bromelain, lipase, phytase, or the proteases in this formula. Lactase is rated likely safe. Ask your doctor or pharmacist for personalized advice before using it while nursing.
What are the main side effects?
Most people tolerate it well, but you might experience mild digestive upset like diarrhea, flatulence, or stomach cramps. Allergic reactions are possible if you're sensitive to any of the enzymes—watch for itchy eyes, runny nose, sneezing, or rash. If you have severe allergies to papaya or pineapple, be cautious.
Does this interfere with any medications?
Yes—if you take blood thinners like warfarin or antiplatelet drugs, papain and bromelain may increase bleeding risk. If you're on tetracycline antibiotics, bromelain may raise their levels. Check with your doctor or pharmacist before starting if you take any prescription medications.
What exactly are all these enzymes for?
They break down different parts of food so your digestive system can absorb them better. Amylase handles starches, lipase breaks down fats, proteases work on proteins, and lactase helps with milk sugar. The others target various carbohydrates and plant compounds, though evidence for most of them is limited.

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

Not sure if Digestive Enzymes is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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 Enzymes label
Go deeper

The Full Monographs Behind Digestive Enzymes’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

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

Phytase

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

Read the full Phytase monograph → Herb & supplement monograph

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 →
Sources

Sources & How We Checked

Digestive Enzymes'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 42 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 →

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 →

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

See these in context on the Phytase monograph →

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

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

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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