Interactions on record — worth a quick check against your medications. Based on 9 of 23 ingredients. Check your meds →
Dietary supplement

Digestive Enzymes Prebiotics & Probiotics Ingredients & Drug Interactions

by Dr. Tobias

Digestive Enzymes Prebiotics & Probiotics 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 Prebiotics & Probiotics 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 Prebiotics & Probiotics is a dietary supplement by Dr. Tobias with 23 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, 306 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Probiotic Blend, 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 Prebiotics & Probiotics by Dr. Tobias

Ask about any prescription or over-the-counter medication and we check it for interactions with Digestive Enzymes Prebiotics & Probiotics by Dr. Tobias — 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 Prebiotics & Probiotics by Dr. Tobias

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

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 25 active ingredients.
  • “Probiotic Blend” is a proprietary blend — the label doesn't break down how much of each component you get.
  • “PreforPro” is listed as a grouped ingredient — the label gives one combined amount (7.50 mg) without saying how much of each component you get.

This product contains 25 ingredients: digestive enzymes (amylase, papain, bromelain, protease, lipase, lactase, cellulase, peptidase, invertase, glucoamylase, xylanase, pectinase, phytase, hemicellulase, and beta glucanase), two live probiotic blends (Bacillus coagulans and Bacillus subtilis DE-111), a prebiotic blend called PreforPro, yeast fermentate, alpha galactosidase, and four bacteriophages (LH01-Myoviridae, LL5-Siphoviridae, T4D-Myoviridae, and LL12-Myoviridae). The enzymes are meant to help break down food; the probiotics add beneficial bacteria to your gut; the prebiotic feeds those bacteria.

There are no inactive ingredients listed.

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 health and enzyme support.
  • We looked for evidence on: Constipation, Diarrhea, Dyspepsia, Flatulence, Irritable bowel syndrome (IBS), Lactose intolerance — and 4 related terms.
  • The strongest evidence on file: Lactase is rated "Effective" for Lactose intolerance (Natural Medicines).
  • Also on file: Bacillus Coagulans is rated "Possibly Effective" for Constipation, Irritable bowel syndrome (IBS).
  • Also on file: Bacillus Subtilis is rated "Possibly Effective" for Antibiotic-associated diarrhea.

For lactose intolerance, lactase is effective — the enzyme breaks down lactose so your body can digest dairy. Bacillus coagulans is possibly effective for constipation and irritable bowel syndrome (IBS).

Bacillus subtilis DE-111 is possibly effective for antibiotic-associated diarrhea. The other enzymes and ingredients — papain, bromelain, protease, lipase, phytase, and the PreforPro blend — don't have reliable evidence yet, so we can't say whether they work for their intended purposes based on the data we hold.

The evidence, ingredient by ingredient Papain Bromelain Proteolytic Enzymes (proteases) Lipase Lactase Phytase Lactobacillus Acidophilus Bacillus Coagulans

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 8 of the 8 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 8 of 8.
  • General safety write-ups exist for 8 of 8.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most people tolerate these ingredients well when taken at normal doses. Papain and bromelain may cause allergic reactions in sensitive individuals, including itching, rash, or digestive upset.

High doses of papain can be unsafe and may cause severe inflammation or perforation of the food pipe. Papain is not recommended in pregnancy due to safety concerns, and there isn't enough data to recommend bromelain during pregnancy or breastfeeding either.

The live probiotics are generally safe for healthy adults, but there's a small risk in very ill or immunocompromised people (like those on blood thinners or with central lines). Lactase is likely safe in pregnancy.

For Bacillus coagulans, Bacillus subtilis, phytase, and protease, there isn't enough safety data in pregnancy and breastfeeding — talk to your doctor or pharmacist before using if you're pregnant or nursing.

Side effects, ingredient by ingredient Papain Bromelain Proteolytic Enzymes (proteases) Lipase Lactase Phytase Lactobacillus Acidophilus Bacillus Coagulans

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 4 of the 8 matched ingredients can interact with medications — Papain, Bromelain, Bacillus Coagulans, Bacillus Subtilis.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs.
  • For scale: 306 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 pharmacist before taking this product if you're on warfarin or other blood thinners — papain and bromelain may increase bleeding risk. If you take antibiotic drugs, separate your antibiotic dose from this supplement by a few hours, since antibiotics can kill the live probiotic organisms and make them ineffective.

Tetracycline antibiotics taken with bromelain may have theoretically higher levels, though human studies show mixed results.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This is a multi-ingredient digestive aid best suited for people looking to support digestion and gut health without serious medical conditions. If you take warfarin or other blood thinners, or if you're on antibiotics, talk to your pharmacist before starting — timing matters.

Pregnant or breastfeeding women should check with their doctor first, especially because papain and bromelain safety data are limited in those situations.

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

Assessment coverage: 9 of 25 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Dec 21, 2024.

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 Prebiotics & Probiotics, straight from the product label.

Brand Dr. Tobias
Barcode (UPC) X0033J96QF
Net contents 60 Vegetable Capsule(s)
Market status On market
Date entered into DSLD Dec 21, 2024
DSLD ID 319420
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 Prebiotics & Probiotics by Dr. Tobias, 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:
2 Vegetable Capsule(s)
Maximum serving Sizes:
2 Vegetable Capsule(s)
Servings per container
30
UPC/BARCODE
X0033J96QF
IngredientAmount% DV
Amylase0 NP--
Papain0 NP--
Bromelain0 NP--
Protease0 NP--
Lipase0 NP--
Lactase0 NP--
Cellulase0 NP--
Peptidase0 NP--
Invertase0 NP--
Glucoamylase0 NP--
Xylanase0 NP--
Pectinase0 NP--
Phytase0 NP--
Hemicellulase0 NP--
Bacillus coagulans0 NP--
Probiotic Blend0 NP--
PreforPro7.5 mg--
Bacillus subtilis DE-1110 NP--
Beta Glucanase0 NP--
Yeast Fermentate, Dried30 mg--
Alpha galactosidase0 NP--
LH01-Myoviridae0 NP--
LL5-Siphoviridae0 NP--
T4D-Myoviridae0 NP--
LL12-Myoviridae0 NP--
MuniSpore0 NP--
Protease Blend0 NP--

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: Take 2 capsules daily, preferably with a meal, or as directed by a healthcare professional. For best results, take 1 capsule with lunch and 1 capsule with dinner.

Pairs well with our Adult Multivitamin

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 the reach of children.

Allergen Warning: Contains milk, soy and wheat (From a fermentation process including milk, soy and wheat).

Formulation

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

Sourced from an FDA Registered & Inspected and GMP-certified facility.

Supports digestive health Helps reduce gas & bloating Supports nutrient absorption

Storage

Store in a cool, dry place.

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.

Seals/Symbols

Tested product certified facility Sourced from a GMP certified facility

Formula

Includes Postbiotics

FDA Statement of Identity

Dietary Supplement

General Statements

(30 day supply)

New

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

See for yourself

Digestive Enzymes Prebiotics & Probiotics by Dr. Tobias label

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

Digestive Enzymes Prebiotics & Probiotics 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 Prebiotics & Probiotics by Dr. Tobias

These are the 23 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 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

Protease

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 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

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

Probiotic Blend

Interacts with
182 drugs
0 NP per serving

Lactobacillus acidophilus is a 'friendly' bacterium used as a probiotic to support gut and vaginal health. It is generally well tolerated in healthy p...

Probiotic Blend monograph & interactions

PreforPro

7.5 mg per serving
  • › LH01-Myoviridae
  • › LL5-Siphoviridae
  • › T4D-Myoviridae
  • › LL12-Myoviridae

Beta Glucanase

0 NP per serving

Yeast Fermentate, Dried

30 mg per serving Form: Saccharomyces cerevisiae, Dried, Fermentate

Alpha galactosidase

0 NP per serving

Protease Blend

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...

Protease Blend monograph & interactions
Interaction report

Digestive Enzymes Prebiotics & Probiotics by Dr. Tobias Drug Interactions

Want to check YOUR meds against Digestive Enzymes Prebiotics & Probiotics?

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
306Drugs
303 Moderate 3 Minor

Ingredients driving the most interactions

Probiotic Blend 182
Bromelain 141
Papain 2

Individual Drug Interactions

The ingredients in Digestive Enzymes Prebiotics & Probiotics interact with 306 drugs. Click any drug to see the details.

3 of the 23 ingredients in Digestive Enzymes Prebiotics & Probiotics interact with drugs. Each result below shows which ingredient is responsible. Probiotic Blend Bromelain Papain

Each ingredient & the kinds of drugs it affects

For each ingredient in Digestive Enzymes Prebiotics & Probiotics 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.

Probiotic Blend1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Lactobacillus acidophilus with antibiotic drugs might decrease the effectiveness of L. acidophilus.
L. acidophilus preparations usually contain live and active organisms. Therefore, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and L. acidophilus preparations by at least two hours.

Likelihood Probable Evidence D
Probiotic Blend 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 Enzymes Prebiotics & Probiotics, from the product label.

Dr. Tobias

See all Dr. Tobias products
Name
Dr. Tobias
State
Ahrensburg
Phone Number
877-959-5474
Web Address
DrTobias.com
Pharmacist Counseling Corner

Digestive Enzymes Prebiotics & Probiotics by Dr. Tobias: Common Questions

Does Digestive Enzymes Prebiotics & Probiotics by Dr. Tobias interact with any medications?
Yes. Based on its ingredients, Digestive Enzymes Prebiotics & Probiotics has a known interaction with 306 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Digestive Enzymes Prebiotics & Probiotics contains 23 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 digestive problems?
It depends what's bothering you. Lactase works well if you're lactose intolerant. Bacillus coagulans is possibly effective for constipation and IBS. For the other enzymes and ingredients, we don't have solid evidence yet that they improve digestion in people — most of the data is limited.
Can I take this with my blood thinner medication?
Not without checking with your pharmacist first. Papain and bromelain in this product may increase the effects of blood thinners like warfarin, raising your bleeding risk. Your pharmacist can tell you whether it's safe for your specific situation.
What if I'm on antibiotics?
Time your doses apart. Antibiotics can kill the live probiotic bacteria in this supplement, making them ineffective. Ask your pharmacist how many hours to wait between your antibiotic and this product.
Can I take this while pregnant?
Papain is best avoided in pregnancy due to safety concerns. Bromelain doesn't have enough safety data, so check with your doctor. Lactase is likely safe. For the other ingredients, there isn't enough information — talk to your doctor before using.
What side effects might I notice?
Most people tolerate it well. Some people feel digestive upset, gas, or diarrhea. Allergic reactions are rare but possible if you're sensitive to papain or bromelain — watch for rash, itching, or throat symptoms.
Is this safe for breastfeeding?
Lactase is likely safe. Papain and bromelain don't have enough safety data, so it's best to avoid them unless your doctor says otherwise. For the probiotics and other ingredients, there isn't enough information — ask your doctor or pharmacist first.

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

Not sure if Digestive Enzymes Prebiotics & Probiotics 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 Prebiotics & Probiotics label
Go deeper

The Full Monographs Behind Digestive Enzymes Prebiotics & Probiotics’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

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

Lactobacillus Acidophilus

Interacts with 182 drugs

Lactobacillus acidophilus is a 'friendly' bacterium used as a probiotic to support gut and vaginal health. It is generally well tolerated in healthy people, and there is reasonable evidence...

Read the full Lactobacillus Acidophilus monograph → Herb & supplement monograph

Bacillus Coagulans

Interacts with 182 drugs

Bacillus coagulans is a spore-forming probiotic that survives stomach acid well and may help with some digestive problems such as IBS, constipation, and certain types of diarrhea. The eviden...

Read the full Bacillus Coagulans monograph → Herb & supplement monograph

Bacillus Subtilis

Interacts with 182 drugs

Bacillus subtilis is a spore-forming probiotic bacterium found in soil and some fermented foods, and it is used mainly to support gut health and digestion. Early research is promising for ce...

Read the full Bacillus Subtilis monograph →
Sources

Sources & How We Checked

Digestive Enzymes Prebiotics & Probiotics'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 87 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
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See these in context on the Bromelain monograph →

Proteolytic Enzymes (proteases) 3 references
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  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
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See these in context on the Proteolytic Enzymes (proteases) monograph →

Lipase 1 reference
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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
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See these in context on the Phytase monograph →

Bacillus Coagulans 20 references
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  2. Tynkkynen S, Singh KV, Varmanen P. Vancomycin resistance factor of Lactobacillus rhamnosus GG in relation to enterococcal vancomycin resistance (van) genes. Int J Food Microbiol 1998;41:195-204. PubMed
  3. Klein G, Zill E, Schindler R, et al. Peritonitis associated with vancomycin-resistant Lactobacillus rhamnosus in a continuous ambulatory peritoneal dialysis patient; organism identification, antibiotic therapy, and case report. J Clin Microbiol 1998;36:
  4. Kalima P, Masterton RG, Roddie PH, et al. Lactobacillus rhamnosus infection in a child following bone marrow transplant. J Infect 1996;32:165-7. PubMed
  5. Goldin BR. Health Benefits of probiotics. Br J Nutr 1998;80:S203-7. DOI
  6. Rautio M, Jousimies-Somer H, Kauma H, et al. Liver abscess due to Lactobacillus rhamnosus strain indistinguishable from L. rhamnosus strain GG. Clin Infect Dis 1999;28:1159-60.
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  9. De Groote MA, Frank DN, Dowell E, et al. Lactobacillus rhamnosus GG bacteremia associated with probiotic use in a child with short gut syndrome. Pediatr Infect Dis J 2005;24:278-80. PubMed
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  14. Pasala S, Singer L, Arshad T, Roach K. Lactobacillus endocarditis in a healthy patient with probiotic use. IDCases. 2020;22:e00915. PubMed
  15. Agrawal S, Tuchman ES, Bruce MJ, Theodorou ME. Fatal Lactobacillus endocarditis in a patient with transcatheter aortic valve replacement. BMJ Case Rep. 2020;13(11):e236835.
  16. Antoun M, Hattab Y, Akhrass FA, Hamilton LD. Uncommon pathogen, Lactobacillus, causing infective endocarditis: Case report and review. Case Rep Infect Dis. 2020;2020:8833948. PubMed
  17. Rossi F, Amadoro C, Gasperi M, Colavita G. Lactobacilli infection case reports in the last three years and safety implications. Nutrients. 2022;14(6):1178. PubMed
  18. Franko B, Vaillant M, Recule C, Vautrin E, et al. Lactobacillus paracasei endocarditis in a consumer of probiotics. Med Mal Infect. 2013;43(4):171-3. PubMed
  19. Campbell RE, Miller A, Afroze A. Native valve endocarditis secondary to Lactobacillus paracasei bacteremia. Consultant. 2020;60(9):27-8. DOI
  20. Kato K, Funabashi N, Takaoka H, et al. Lactobacillus paracasei endocarditis in a consumer of probiotics with advanced and severe bicuspid aortic valve stenosis complicated with diffuse left ventricular mid-layer fibrosis. Int J Cardiol. 2016;224:157-161. PubMed

See these in context on the Bacillus Coagulans monograph →

Lactobacillus Acidophilus 15 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Begtrup LM, de Muckadell OB, Kjeldsen J, Christensen RD, Jarbøl DE. Long-term treatment with probiotics in primary care patients with irritable bowel syndrome--a randomised, double-blind, placebo controlled trial. Scand J Gastroenterol 2013;48(10):1127-35 PubMed
  3. Chatterjee S, Kar P, Das T, Ray S, Gangulyt S, Rajendiran C, Mitra M. Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12 for prevention of antibiotic-associated
  4. Shavakhi A, Tabesh E, Yaghoutkar A, Hashemi H, Tabesh F, Khodadoostan M,Minakari M, Shavakhi S, Gholamrezaei A. The effects of multistrain probiotic compound on bismuth-containing quadruple therapy for Helicobacter pylori infection: a randomized placebo-c
  5. Karamali M, Dadkhah F, Sadrkhanlou M, et al. Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Metab 2016;42(4):234-41. PubMed
  6. Badehnoosh B, Karamali M, Zarrati M, et al. The effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. J Matern Fetal Neonatal Med. 2018 May;31(9):1128-1136.
  7. Kumar S, Kumar R, Rohilla L, Jacob N, Yadav J, Sachdeva N. A high potency multi-strain probiotic improves glycemic control in children with new-onset type 1 diabetes mellitus: A randomized, double-blind, and placebo-controlled pilot study. Pediatr Diabete
  8. Shahriari A, Karimi E, Shahriari M, Aslani N, Khooshideh M, Arab A. The effect of probiotic supplementation on the risk of gestational diabetes mellitus among high-risk pregnant women: A parallel double-blind, randomized, placebo-controlled clinical trial PubMed
  9. Xiao SD, Zhang DZ, Lu H, et al. Multicenter, randomized, controlled trial of heat-killed Lactobacillus acidophilus LB in patients with chronic diarrhea. Adv Ther. 2003;20(5):253-60.
  10. Rossi F, Amadoro C, Gasperi M, Colavita G. Lactobacilli infection case reports in the last three years and safety implications. Nutrients. 2022;14(6):1178. PubMed
  11. Ozer M, Goksu SY, Shahverdiani A, Mustafa M. Lactobacillus acidophilus-induced endocarditis and associated splenic abscess. Case Rep Infect Dis 2020;2020:1382709.
  12. Sadrin S, Sennoune S, Gout B, et al. A 2-strain mixture of Lactobacillus acidophilus in the treatment of irritable bowel syndrome: A placebo-controlled randomized clinical trial. Dig Liver Dis 2020;52(5):534-540. PubMed
  13. Stoffer JN, Slingsby TJ, Giuliari GP. Lactobacillus acidophilus endophthalmitis after intravitreal bevacizumab injection requiring intraocular lens explantation. Can J Ophthalmol 2022;57(1):e21-e22. PubMed
  14. Cukovic-Cavka S, Likic R, Francetic I, Rustemovic N, Opacic M, Vucelic B. Lactobacillus acidophilus as a cause of liver abscess in a NOD2/CARD15-positive patient with Crohn's disease. Digestion 2006;73(2-3):107-10.
  15. Hui J, Ren Y, Wang Y, Han Q. Lactobacillus acidophilus endophthalmitis postcataract operation: A case report with a literature review. Ocul Immunol Inflamm 2023.

See these in context on the Lactobacillus Acidophilus monograph →

Bacillus Subtilis 10 references
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  2. Lampropoulos PK, Gkentzi D, Tzifas S, Dimitriou G. Neonatal sepsis due to Bacillus subtilis. Cureus 2021;13(9):e17692. PubMed
  3. La Jeon Y, Yang JJ, Kim MJ, et al. Combined Bacillus licheniformis and Bacillus subtilis infection in a patient with oesophageal perforation. J Med Microbiol 2012;61(Pt 12):1766-1769. PubMed
  4. Wallet F, Crunelle V, Roussel-Delvallez M, Fruchart A, Saunier P, Courcol RJ. Bacillus subtilis as a cause of cholangitis in polycystic kidney and liver disease. Am J Gastroenterol 1996;91(7):1477-8.
  5. Velasco E, Martins CA, Tabak D, Bouzas LF. "Bacillus subtilis" infection in a patient submitted to a bone marrow transplantation. Rev Paul Med 1992;110(3):116-7.
  6. Kato A, Yoshifuji A, Komori K, et al. A case of Bacillus subtilis var. natto bacteremia caused by ingestion of natto during COVID-19 treatment in a maintenance hemodialysis patient with multiple myeloma. J Infect Chemother 2022;28(8):1212-1215. PubMed
  7. Freedman KE, Hill JL, Wei Y, et al. Examining the gastrointestinal and immunomodulatory effects of the novel probiotic Bacillus subtilis DE111. Int J Mol Sci 2021;22(5):2453. PubMed
  8. Lefevre M, Racedo SM, Denayrolles M, et al. Safety assessment of Bacillus subtilis CU1 for use as a probiotic in humans. Regul Toxicol Pharmacol 2017;83:54-65. PubMed
  9. Hanifi A, Culpepper T, Mai V, et al. Evaluation of Bacillus subtilis R0179 on gastrointestinal viability and general wellness: a randomised, double-blind, placebo-controlled trial in healthy adults. Benef Microbes 2015;6(1):19-27. PubMed
  10. Tokano M, Tarumoto N, Imai K, et al. A case of bacterial meningitis caused by Bacillus subtilis var. natto. Intern Med. 2022. Epub ahead of print.

See these in context on the Bacillus Subtilis 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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