Double Strength Zymactive Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Double Strength Zymactive 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
Double Strength Zymactive is a dietary supplement by Natural Factors with 4 active ingredients. Its ingredients are commonly taken for inflammation and swelling, sinus and nasal congestion, digestion support.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.
Check Your Meds Against Double Strength Zymactive by Natural Factors
Ask about any prescription or over-the-counter medication and we check it for interactions with Double Strength Zymactive by Natural Factors — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Double Strength Zymactive by Natural Factors
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.
What’s inside
Partial disclosure
Double Strength Zymactive contains 6 active ingredients—digestive and pancreatic enzymes designed to help break down food. The main ones are bromelain (from pineapple), papain (from papaya), and a blend of pancreatic enzymes including amylase, protease, and lipase.
These are inactive ingredients: microcrystalline cellulose, an aqueous coating, croscarmellose sodium, and magnesium stearate.
Does it work?
Insufficient evidence
The evidence for bromelain and papain in these uses is not established in the data we hold. Bromelain has been studied for hay fever, burns, cancer, nerve pain from chemotherapy, chronic venous insufficiency, and diabetes, but the evidence we have is rated insufficient to judge whether it works.
Papain similarly shows insufficient evidence for cancer, dental cavities, radiation skin damage, exercise-related muscle soreness, shingles, and parasite infections. Lipase has insufficient evidence for inflammatory bowel disease and indigestion.
The product is marketed for digestive support, but we don't have effectiveness ratings for that use in our data.
How safe is it?
Well-documented data
Bromelain is generally well tolerated short-term; the evidence on long-term use is limited. Common side effects are diarrhea, flatulence, stomach upset, and headache.
Allergic reactions—including trouble swallowing, throat itching, eye irritation, and even asthma if inhaled—can occur in sensitive people. Papain is generally tolerated as a food but supplements may irritate the digestive tract and cause allergies; high doses may cause serious stomach inflammation or esophageal perforation.
Protease and lipase are generally well tolerated but may cause digestive upset or allergic reactions in some people. Because bromelain is not safe in pregnancy and papain is possibly unsafe, you should avoid this product if you're pregnant.
Safety while breastfeeding is not well established for bromelain and papain; talk with your doctor or pharmacist before using it.
Meds to double-check
Moderate interaction found
Check with your doctor or pharmacist before taking this product if you use any blood thinner or antiplatelet drug (such as warfarin, aspirin, or clopidogrel), because bromelain and papain may increase bleeding risk and papain may strengthen warfarin's effects dangerously. If you take tetracycline antibiotics, bromelain may increase how much your body absorbs.
We could not check two of the ingredients (Amylase Pancreatic and Serratia Peptidase) because we hold no interaction data for them.
The bottom line
Scorecard at a glancePartially disclosed formula with insufficient evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
This is a digestive-enzyme blend that may appeal to people looking for enzyme support, but the evidence for how well it works is not established in our data. The main concern is its interaction potential with blood thinners, antiplatelet drugs, and warfarin—if you take any of these, check with your doctor or pharmacist first.
It's not recommended in pregnancy or while breastfeeding. Discuss it with your own healthcare provider before starting, especially if you're on any prescription medications.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 4 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 24, 2020.
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
General information
Key facts about Double Strength Zymactive, straight from the product label.
| Brand | Natural Factors |
|---|---|
| Barcode (UPC) | 068958017525 |
| Net contents | 30 Enteric Coated Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Jun 24, 2020 |
| DSLD ID | 220823 |
| Product type | Non-nutrient/non-botanical |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar Free |
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 Double Strength Zymactive by Natural Factors, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Bromelain | 38.8 mg | -- |
| Enzyme Blend | 510 mg | -- |
| Papain | 171.44 mg | -- |
| Pancreatic Enzymes 11x | 292 mg | -- |
| Amylase, Pancreatic | 0 NP | -- |
| Protease, Pancreatic | 0 NP | -- |
| Lipase, Pancreatic | 0 NP | -- |
| Serratia Peptidase | 9.44 mg | -- |
Other ingredients: Microcrystalline Cellulose, Aqueous Coating solution, Croscarmellose Sodium, Magnesium Stearate
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Seals/Symbols
isura Non-GMO - Mass Spec Documentation Lab tested
Purity & Potency Guaranteed
Suggested/Recommended/Usage/Directions
Suggested Usage: 1-2 tablets 2-3 times per day or as directed by a health professional.
Precautions
Cautions: As with any supplement, consult your health professional before use if you are pregnant, breastfeeding, or trying to conceive, or if you are taking medication, have a medical condition, or anticipate a surgery.
Keep out of the reach of children.
Sealed for your protection. Do not use if seal is broken.
Formula
Zymactive is an advanced formula that provides systemic enzyme support for muscle, joint, and overall tissue health.
With serratia peptidase proteolytic enzymes
General Statements
Also available in regular strength.
Product of Canada Recyclable container and label.
USP (United States Pharmacopeia), FCC (Food Chemical Codex). PU (Papain Unit), SU (Serrapeptase Unit).
Formulation
Manufactured by Natural Factors to ensure safety and potency in accordance with Good Manufacturing Practices (GMP) of the FDA and Health Canada.
Contains no artificial colors, preservatives, or sweeteners; no dairy, sugar, wheat, gluten, yeast, soy, egg, fish, shellfish, salt, or GMOs.
Systemic enzyme support
Storage
For freshness, store in a cool, dry place.
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
FDA Statement of Identity
Dietary Supplement
Brand IP Statement(s)
Isura is a trademark of Isura.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Double Strength Zymactive by Natural Factors label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
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)The Ingredients in Double Strength Zymactive by Natural Factors
These are the 4 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Tablet(s) Dosage formTablet Or Pill Servings per container15 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.
Other (inactive) ingredients: Microcrystalline Cellulose, Aqueous Coating solution, Croscarmellose Sodium, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.
Double Strength Zymactive by Natural Factors Drug Interactions
HelloPharmacist Interaction Report
Double Strength Zymactive by Natural Factors contains enzymes—bromelain and papain primarily—that interact with medications you may be taking.
The most serious concern is papain's interaction with warfarin (Coumadin), a blood thinner: a case report documented a patient's blood-thinning effect spike dangerously after taking a papain-containing supplement, and papain may theoretically amplify warfarin's effects and side effects.
Read the full breakdown — every affected drug type, severity by severity
Bromelain carries a moderate interaction with blood thinners and antiplatelet drugs (like aspirin, clopidogrel, or prescription anticoagulants): it may have blood-thinning activity itself and could raise your bleeding risk if combined with these medications. There is one case report of minor bruising in someone taking bromelain with naproxen.
Bromelain also has a minor interaction with tetracycline antibiotics—laboratory work suggests it might increase how much of these antibiotics your body absorbs, though one human study found no difference in blood levels.
We could not check two ingredients—Amylase Pancreatic and Serratia Peptidase—because we hold no interaction data for them. Protease Pancreatic and Lipase Pancreatic have no interactions documented in our data.
Altogether, these interactions span 141 individual medications.
Before you start this product, run it through the search tool below with your exact medications, especially if you take any blood thinner or antiplatelet drug, warfarin, or tetracycline antibiotics. Talk with your doctor or pharmacist to make sure it's safe for you.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Double Strength Zymactive?
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 checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Double Strength Zymactive interact with 141 drugs. Click any drug to see the details.
2 of the 4 ingredients in Double Strength Zymactive interact with drugs. Each result below shows which ingredient is responsible. Bromelain Papain
AbciximabReoPro
How Abciximab interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Abciximab interactionAbrocitinibCibinqo
How Abrocitinib interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Abrocitinib interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Acenocoumarol interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, IbuprofenCombogesic
How Acetaminophen, Ibuprofen interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Acetaminophen, Ibuprofen interactionAcetylsalicylic AcidEntrophen
How Acetylsalicylic Acid interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Acetylsalicylic Acid interactionAlteplase, TpaActilyse, Activase
How Alteplase, Tpa interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Alteplase, Tpa interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAnacaulase-bcdbNexoBrid
How Anacaulase-bcdb interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Anacaulase-bcdb interactionAnagrelideAgrylin
How Anagrelide interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Anagrelide interactionAnisindioneMiradon
How Anisindione interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Anisindione interactionAntithrombin IiiThrombate III
How Antithrombin Iii interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Antithrombin Iii interactionApixabanEliquis
How Apixaban interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Apixaban interactionArgatrobanArgatroban
How Argatroban interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Argatroban interactionAspirinAngettes 75, ASA, Asaphen, Aspirin, Caprin, Cartia +8 more
How Aspirin interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aspirin interactionAspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #3
How Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interactionAspirin, ButalbitalAxotal
How Aspirin, Butalbital interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aspirin, Butalbital interactionAspirin, Butalbital, CaffeineFiorinal
How Aspirin, Butalbital, Caffeine interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aspirin, Butalbital, Caffeine interactionAspirin, Butalbital, Caffeine, Codeine PhosphateFiorinal w/ Codeine
How Aspirin, Butalbital, Caffeine, Codeine Phosphate interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aspirin, Butalbital, Caffeine, Codeine Phosphate interactionAspirin, Butalbital, Caffeine, PhenacetinMarnal
How Aspirin, Butalbital, Caffeine, Phenacetin interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aspirin, Butalbital, Caffeine, Phenacetin interactionAspirin, CaffeineAnacin
How Aspirin, Caffeine interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aspirin, Caffeine interactionAspirin, Caffeine, Codeine PhosphateAnacin w/ Codeine
How Aspirin, Caffeine, Codeine Phosphate interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aspirin, Caffeine, Codeine Phosphate interactionAspirin, Caffeine, Dihydrocodeine BitartrateSynalgos DC
How Aspirin, Caffeine, Dihydrocodeine Bitartrate interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aspirin, Caffeine, Dihydrocodeine Bitartrate interactionAspirin, Caffeine, Dover's PwdAcedoval, Dovacet
How Aspirin, Caffeine, Dover's Pwd interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aspirin, Caffeine, Dover's Pwd interactionAspirin, Caffeine, HydrocodoneDamason-P
How Aspirin, Caffeine, Hydrocodone interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aspirin, Caffeine, Hydrocodone interactionAspirin, Caffeine, Isobutylallylbarbituric Acid, PhenacetinLanorinal
How Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin interactionAspirin, Caffeine, OrphenadrineInvagesic, Invagesic Forte, Norgesic, Norgesic Forte, Orphengesic, Orphengesic Forte
How Aspirin, Caffeine, Orphenadrine interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aspirin, Caffeine, Orphenadrine interactionAspirin, Caffeine, Phenacetin, PropoxypheneMargesic Comp. 65
How Aspirin, Caffeine, Phenacetin, Propoxyphene interacts with Double Strength Zymactive — through 1 ingredient. Tap an ingredient for the detail:
BromelainAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Bromelain + Aspirin, Caffeine, Phenacetin, Propoxyphene interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Double Strength Zymactive 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.
Bromelain
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.
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.
Papain
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.
Brand information
Manufacturer and brand details for Double Strength Zymactive, from the product label.
Double Strength Zymactive by Natural Factors: Common Questions
Does Double Strength Zymactive by Natural Factors interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Can I take this if I'm pregnant or breastfeeding?
What are the most common side effects?
Is this safe to take long-term?
What are these enzymes supposed to do?
Can I take this with my antibiotics?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Double Strength Zymactive is safe with your meds?
Our pharmacists answer your medication & supplement questions — free.
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.
The Full Monographs Behind Double Strength Zymactive’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Bromelain
Interacts with 141 drugsBromelain 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 monographPapain
Interacts with 2 drugsPapain 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 →Sources & How We Checked
Double Strength Zymactive'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.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
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 34 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.
Bromelain 19 references
- Nettis E, Napoli G, Ferrannini A, Tursi A. IgE-mediated allergy to bromelain. Allergy 2001;56:257-8. PubMed
- 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
- 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
- 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.
- 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
- 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.
- Glaser D, Hilberg T. The influence of bromelain on platelet count and platelet activity in vitro. Platelets 2006;17:37-41. PubMed
- Heinicke R M, van der Wal L, Yokoyama M. Effect of bromelain (Ananase) on human platelet aggregation. Experientia 1972;28:844-5. PubMed
- 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
- 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.
- Galleguillos, F. and Rodriguez, J. C. Asthma caused by bromelin inhalation. Clin Allergy 1978;8(1):21-24. PubMed
- 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.
- Martin GJ, Ehrenreich J, and Asbell N. Bromelain: pineapple proteases with anti-edema activity. Exp Med Surg 1962;20:227-247.
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Papain 11 references
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Proteolytic Enzymes (proteases) 3 references
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See these in context on the Proteolytic Enzymes (proteases) monograph →
Lipase 1 reference
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