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 Zenesis Labs

Digestive Enzymes label
See full label image
Capsule Category: Non-nutrient/non-botanical
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 Zenesis Labs 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 Zenesis Labs

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

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Digestive Enzymes by Zenesis Labs

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 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 18 of its 18 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains 18 active enzymes designed to support digestion. Amylase breaks down carbohydrates, lipase handles fats, and proteases (protease 1 and 2) break down proteins.

Papain and bromelain are proteases sourced from papaya and pineapple, respectively. You'll also find lactase (which helps digest milk sugar in people with lactose intolerance), cellulase, aspergillopepsin, peptidase, invertase, glucoamylase, xylanase, pectinase, beta-glucanase, phytase, hemicellulase, and alpha-galactosidase — all enzymes that break down different components of food.

The capsule also contains inactive ingredients: maltodextrin, hypromellose, water, and medium chain triglyceride.

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, Rhinosinusitis, Allergic rhinitis (hay fever) — 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 for most of these enzymes is not established in the data we hold. Lactase is the exception — it's rated effective for lactose intolerance.

For the others, including papain, bromelain, lipase, and the proteases, the facts show insufficient reliable evidence for their intended uses, which range from digestive support to managing specific conditions. That doesn't mean they don't work; it means large, high-quality studies backing their use aren't yet in our records.

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.

Most of these enzymes are generally well tolerated at standard doses. Papain and bromelain can cause allergic reactions in sensitive people — itching, hives, digestive upset, or in rare cases with high doses, severe gastritis or even esophageal damage.

Bromelain commonly causes diarrhea, gas, and stomach upset. Lactase is generally well tolerated and rated likely safe in pregnancy.

For papain, the safety data advises against concentrated forms and unripe papaya products in pregnancy, and there isn't enough data to recommend supplemental papain while breastfeeding. Bromelain should be avoided in pregnancy and breastfeeding because of insufficient safety data.

For lipase and phytase, there's limited pregnancy and breastfeeding data, so check with your doctor before regular use.

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.

If you take warfarin (Coumadin) or other blood thinners (anticoagulants), stop and check with your pharmacist — papain may increase bleeding risk (Moderate). If you're on antiplatelet drugs like aspirin, bromelain carries a similar Moderate concern.

If you take tetracycline antibiotics like doxycycline, bromelain might affect how much you absorb (Minor).

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This product may help with digestion if enzyme deficiency or poor digestion is your issue, and lactase specifically works for lactose intolerance. If you're on a blood thinner like warfarin or an antiplatelet drug, or if you take tetracycline antibiotics, check with your pharmacist before starting.

Pregnant or breastfeeding? Talk to your doctor first, especially if you're considering the papain or bromelain content.

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 May 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 Zenesis Labs
Barcode (UPC) X000PQNZ9X
Net contents 90 Vegetable Capsule(s)
Market status On market
Date entered into DSLD May 24, 2023
DSLD ID 282422
Product type Non-nutrient/non-botanical
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 Enzymes by Zenesis Labs, 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:
2 Capsule(s)
Servings per container
90
UPC/BARCODE
X000PQNZ9X
IngredientAmount% DV
Amylase5000 DU--
Papain500000 PU--
Bromelain500000 PU--
Lipase1250 FIP--
Lactase500 ALU--
Cellulase500 CU--
Aspergillopepsin100 SAPU--
Peptidase160 DPP-IV--
Invertase200 SU--
Glucoamylase50 AGU--
Xylanase250 XU--
Pectinase16.9 PGU--
Beta-Glucanase65 BGU--
Phytase10 FTU--
Hemicellulase1000 HCU--
Alpha-Galactosidase50 GALU--
Protease 120000 HUT--
Protease 24000 HUT--

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

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, taken 1 to 2 times at the beginning of each meal as a dietary supplement, or as directed by a health care professional.

Precautions

Do not exceed six capsules daily. Caution: Do not exceed recommended dose.

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.

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

Keep out of the reach of children.

Do not use if safety seal is damaged or missing.

Allergen warning: Contains dairy, soy and wheat (from a fermentation process including dairy, soy and wheat).

Storage

Store in a cool, dry place.

Seals/Symbols

Sourced from a GMP Certified Facility

Made in the USA

General Statements

100% Lifetime Guarantee

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.

Formulation

Gluten free formula

Supports intestinal health May help reduce gas & bloating

FDA Statement of Identity

Dietary Supplement

Formula

With 18 enzymes that help digest: Fat, fiber, carbs, protein, lactose, gluten...and more.

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

See for yourself

Digestive Enzymes by Zenesis Labs 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 Zenesis Labs

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

Serving size1 Capsule(s) Dosage formCapsule Servings per container90 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

5000 DU per serving

Papain

Interacts with
2 drugs
500000 PU 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
500000 PU 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
1250 FIP 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
500 ALU 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

500 CU per serving

Aspergillopepsin

100 SAPU per serving

Peptidase

160 DPP-IV per serving

Invertase

200 SU per serving

Glucoamylase

50 AGU per serving

Xylanase

250 XU per serving

Pectinase

16.9 PGU per serving

Beta-Glucanase

65 BGU per serving

Phytase

No known
interactions
10 FTU 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

1000 HCU per serving

Alpha-Galactosidase

50 GALU per serving

Protease 1

No known
interactions
20000 HUT 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
4000 HUT 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

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

Interaction report

Digestive Enzymes by Zenesis Labs 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.

Zenesis Labs

See all Zenesis Labs products
Name
Zenesis Labs
City
Deerfield Beach
State
FL
ZipCode
33442
Phone Number
800-808-6057
Pharmacist Counseling Corner

Digestive Enzymes by Zenesis Labs: Common Questions

Does Digestive Enzymes by Zenesis Labs 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 my digestion?
This product contains enzymes meant to support digestion, but the evidence for most of them isn't established in our data. Lactase is the one we know works — for lactose intolerance specifically. For general digestive support, the science isn't clear yet.
Can I take this if I'm on warfarin?
No, not without checking with your pharmacist first. Papain in this product may increase how warfarin works, which could raise your bleeding risk. One patient's blood-thinning level got dangerously high after taking a papain supplement.
What are the most common side effects?
Bromelain commonly causes diarrhea, gas, and stomach upset. Papain may cause allergic reactions like itching, hives, or digestive cramping in people sensitive to it. Most people tolerate these enzymes well at standard doses.
Is this safe in pregnancy?
It depends on the ingredient. Papain should be avoided in pregnancy, and there isn't enough data to recommend bromelain either. For the other enzymes, there's limited pregnancy data, so talk with your doctor before taking this regularly while pregnant.
What is lactase and why is it in here?
Lactase is an enzyme that breaks down lactose, the sugar in milk. It's in this product to help people with lactose intolerance digest dairy better — and it actually works for that purpose.
Can I take this while breastfeeding?
There isn't enough safety data for most of these enzymes during breastfeeding. Papain and bromelain both lack solid safety information for nursing, so check with your doctor or pharmacist before using this product regularly.

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 →

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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.

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