Interactions on record — worth a quick check against your medications. Based on 5 of 15 ingredients. Check your meds →
Dietary supplement

Enzym-Complete/DDP-IV Ingredients & Drug Interactions

by Kirkman

Enzym-Complete/DDP-IV 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 Enzym-Complete/DDP-IV 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

Enzym-Complete/DDP-IV is a dietary supplement by Kirkman with 15 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.

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Check Your Meds Against Enzym-Complete/DDP-IV by Kirkman

Ask about any prescription or over-the-counter medication and we check it for interactions with Enzym-Complete/DDP-IV by Kirkman — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Enzym-Complete/DDP-IV by Kirkman

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 30, 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 15 of its 15 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Enzym-Complete/DDP-IV contains 15 active ingredients — a blend of digestive enzymes designed to help break down food. Papain and bromelain are protein-digesting enzymes from papaya and pineapple.

Lactase breaks down milk sugar. The rest — amylase, cellulase, glucoamylase, diastase, alpha-galactosidase, xylanase, and others — target starches, fiber, and complex carbohydrates.

Protease 3 and protease 6 are additional protein breakers. The capsule also contains vegetable cellulose and water as inactive ingredients.

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: broad spectrum digestion support.
  • We looked for evidence on: Lactose intolerance, protein digestion, enzyme deficiency, food intolerance.
  • The strongest evidence on file: Lactase is rated "Effective" for Lactose intolerance (Natural Medicines).

The evidence here is quite limited. Lactase is effective for lactose intolerance — if you have trouble digesting milk, it can help.

For the other enzymes in this product, the evidence we hold is insufficient to rate them. We don't have reliable data showing whether papain, bromelain, phytase, or the other enzymes work for the conditions they're marketed for — things like exercise soreness, allergies, or mineral absorption.

That doesn't mean they don't work; it means the science isn't settled yet in the data available to us.

The evidence, ingredient by ingredient Papain Bromelain 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 5 of the 5 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 5 of 5.
  • General safety write-ups exist for 5 of 5.
  • 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 normal doses. The biggest concern is allergy.

Papain and bromelain can trigger reactions in sensitive people — itchy eyes, runny nose, sneezing, stomach cramps, diarrhea, or in rare cases, severe stomach irritation. Bromelain commonly causes mild digestive upset like gas and loose stools.

If you inhale powdered forms of papain, bromelain, or phytase (unlikely from a capsule, but relevant in manufacturing settings), allergic breathing problems can occur. For pregnancy: papain is rated possibly unsafe, so avoid it if you're pregnant.

Bromelain should also be avoided in pregnancy — there isn't enough safety data. Lactase is likely safe in pregnancy.

For breastfeeding: papain and bromelain lack enough safety data, so your doctor should weigh the benefit first. Lactase is likely safe.

The safety of phytase and the proteases in pregnancy and lactation hasn't been well studied; talk with your doctor if you're considering this product.

Side effects, ingredient by ingredient Papain Bromelain 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 5 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.

Check with your doctor or pharmacist if you take warfarin (Coumadin) or any anticoagulant or antiplatelet drug — papain and bromelain may increase your bleeding risk. If you take tetracycline antibiotics, bromelain might theoretically raise their levels, though human evidence is mixed.

These are the medication types with documented interactions in our data.

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 is a multi-enzyme digestive aid that may help if you have lactose intolerance, though evidence for the other enzymes is unclear. If you take warfarin or any blood thinner or antiplatelet drug, check with your doctor or pharmacist before starting — papain and bromelain both raise bleeding risk.

If you're pregnant, breastfeeding, or have a history of enzyme allergies, talk it over with your healthcare provider first.

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

Assessment coverage: 6 of 15 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 23, 2013.

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 Enzym-Complete/DDP-IV, straight from the product label.

Brand Kirkman
Net contents 60 Capsule(s)
Market status On market
Date entered into DSLD Aug 23, 2013
DSLD ID 24101
Product type Non-nutrient/non-botanical
Supplement form Capsule
Dietary claims / uses All Other
Intended target group(s) Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Enzym-Complete/DDP-IV by Kirkman, 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 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
30
IngredientAmount% DV
Amylase100 DU--
Papain2000000 FCCPU--
Bromelain1280000 FCCPU--
Lactase1000 ALU--
Cellulase200 CU--
Peptidase50000 HUT--
Glucoamylase30 AGU--
Alpha-Galactosidase50 GaIU--
Xylanase100 XU--
Phytase10 FTU--
Diastase2.6 DP--
Protease 3100 SAPU--
Protease 6175 HUT--
Invertase400 SU--
n-zimesPA(R)110 mg--

Other ingredients: Vegetable Cellulose, Water

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.
Formulation

CASEIN & GLUTEN FREE

FREE OF: Sugar, soy, wheat, casein, gluten, milk, yeast, gelatin, flavorings, colorings, peanuts, tree nuts or fish.

General Statements

Broad Spectrum Digestion Formulation with Dipeptidyl Peptidase IV Analog

Best Used by March 2013

(503)694-1600

Suggested/Recommended/Usage/Directions

SUGGESTED USE: Start with one capsule with each snack or meal. Capsule may be opened and the contents mixed in food or drink. If well tolerated, two capsules may be taken if a larger quantity of food is eaten.

Precautions

CAUTION: DO NOT ALLOW THE POWDER IN THE CAPSULES TO GET INTO THE EYE OR CONTACT THE SKIN.

KEEP OUT OF THE REACH OF CHILDREN.

Storage

IMPORTANT: STORE IN A COOL DRY PLACE AND TIGHTLY CAPPED.

Brand IP Statement(s)

n*zimesPA(R) IS A REGISTERED TRADEMARK OF THE NATIONAL ENZYME COMPANY.

General

0234-060

FDA Statement of Identity

Enzyme Dietary Supplement

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

See for yourself

Enzym-Complete/DDP-IV by Kirkman label

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

Enzym-Complete/DDP-IV 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 Enzym-Complete/DDP-IV by Kirkman

These are the 15 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 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

100 DU per serving

Papain

Interacts with
2 drugs
2000000 FCCPU 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
1280000 FCCPU 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

Lactase

No known
interactions
1000 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

200 CU per serving

Peptidase

50000 HUT per serving

Glucoamylase

30 AGU per serving

Alpha-Galactosidase

50 GaIU per serving

Xylanase

100 XU 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

Diastase

2.6 DP per serving

Protease 3

No known
interactions
100 SAPU per serving

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

Protease 3 monograph & interactions

Protease 6

No known
interactions
175 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 6 monograph & interactions

Invertase

400 SU per serving Form: Sucrase

N-zimesPA(R)

110 mg per serving Form: Amylase, Lipase, Protease

Other (inactive) ingredients: Vegetable Cellulose, Water. These complete the product’s ingredient list but are not active constituents.

Interaction report

Enzym-Complete/DDP-IV by Kirkman Drug Interactions

Want to check YOUR meds against Enzym-Complete/DDP-IV?

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 Enzym-Complete/DDP-IV interact with 141 drugs. Click any drug to see the details.

2 of the 15 ingredients in Enzym-Complete/DDP-IV 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 Enzym-Complete/DDP-IV 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 Enzym-Complete/DDP-IV, from the product label.

Kirkman

See all Kirkman products
Name
Kirkman
City
Lake Oswego
State
OR
ZipCode
97035
Phone Number
(800) 245-8282
Web Address
www.kirkmangroup.com
Pharmacist Counseling Corner

Enzym-Complete/DDP-IV by Kirkman: Common Questions

Does Enzym-Complete/DDP-IV by Kirkman interact with any medications?
Yes. Based on its ingredients, Enzym-Complete/DDP-IV 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?
Enzym-Complete/DDP-IV contains 15 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.
Does this enzyme product work for digestion and bloating?
Lactase definitely helps if you're lactose intolerant — it breaks down milk sugar. For the other enzymes in here, we don't have solid evidence yet that they improve digestion or gas. The science just isn't settled in the data we hold.
What's papain, and why does it interact with warfarin?
Papain is a protein-digesting enzyme from papaya. It may theoretically increase how warfarin (a blood thinner) works in your body, raising your clot risk. One patient's blood thinner level got dangerously high after taking a papain supplement while stable on warfarin. That's why you need to check with your doctor first.
Can I take this while pregnant?
Papain should be avoided in pregnancy — it's rated possibly unsafe. Bromelain also lacks enough safety data in pregnancy, so it's best avoided too. Lactase is likely safe. Talk with your doctor before starting this product if you're pregnant or planning to be.
What are the most common side effects?
Bromelain often causes mild digestive upset — diarrhea, gas, or stomach discomfort. Papain and bromelain can both trigger allergic reactions in sensitive people, like itchy eyes, sneezing, runny nose, or stomach cramps. At high doses, papain may cause more serious stomach problems, but that's rare.
What if I'm allergic to pineapple or papaya?
Since this product contains bromelain (from pineapple) and papain (from papaya), you should avoid it if you're allergic to either fruit. Allergic reactions can range from mild (itching, sneezing) to more serious breathing or stomach problems. Check the full ingredients list and talk to your pharmacist if you're unsure.
Is this safe to take with my tetracycline antibiotic?
Bromelain might theoretically raise tetracycline levels, though a human study didn't find this happened in practice. Still, if you take a tetracycline antibiotic (like doxycycline), mention this product to your doctor or pharmacist before starting — they can monitor you if needed.

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

Not sure if Enzym-Complete/DDP-IV is safe with your meds?

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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.

Enzym-Complete/DDP-IV label
Go deeper

The Full Monographs Behind Enzym-Complete/DDP-IV’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

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

Enzym-Complete/DDP-IV'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 41 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 →

Lactase 1 reference
  1. Laukkanen A, Ruoppi P, Remes S, Koistinen T, Mäkinen-Kiljunen S. Lactase-induced occupational protein contact dermatitis and allergic rhinoconjunctivitis. Contact Dermatitis. 2007;57(2):89-93. PubMed

See these in context on the Lactase monograph →

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

See these in context on the Phytase monograph →

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

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

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

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