Interactions on record — worth a quick check against your medications. Based on 6 of 15 ingredients. Check your meds →
Dietary supplement

Enzyme Blend - AM Packet Ingredients & Drug Interactions

by GNC Preventive Nutrition

Enzyme Blend - AM Packet label
See full label image
Unknown 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 Enzyme Blend - AM Packet 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

Enzyme Blend - AM Packet is a dietary supplement by GNC Preventive Nutrition with 15 active ingredients. Its ingredients are commonly taken for improving mineral absorption, breaking down phytic acid (phytate) in grains and legumes, supporting digestion of plant-based foods.Based on those ingredients, 141 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Bromelain, Papain. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Enzyme Blend - AM Packet by GNC Preventive Nutrition

Ask about any prescription or over-the-counter medication and we check it for interactions with Enzyme Blend - AM Packet by GNC Preventive Nutrition — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Enzyme Blend - AM Packet by GNC Preventive Nutrition

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

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 0 of its 15 active ingredients.
  • “CereCalase Proprietary Blend” is a proprietary blend — the label gives one combined amount (18 mg) without saying how much of each component you get.
  • “n-zimes Proprietary Blend (Non-Nutrient/Non-Botanical)” is a proprietary blend — the label gives one combined amount (181 mg) without saying how much of each component you get.

Enzyme Blend - AM Packet contains 15 active ingredients, most of them digestive enzymes designed to help break down different types of food. Papain breaks down proteins; bromelain (from pineapple) does the same; lipase handles fats; and lactase breaks down milk sugar.

Amylase, cellulase, invertase, glucoamylase, alpha-galactosidase, beta-glucanase, phytase, hemicellulase, and three protease forms round out the blend, each targeting specific nutrients or carbohydrates. The packet also contains two proprietary enzyme blends (CereCalase and n-zimes) whose exact makeup isn't fully disclosed but whose individual components are listed separately.

Two inactive ingredients—dicalcium phosphate and gelatin—serve as binders and capsule material.

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

This product doesn't appear to be marketed for a specific use, so we graded its ingredients' overall clinical evidence instead.

Strong

Strong clinical evidence supports its ingredients for:

Why this rating?
  • We looked at the product name, claims, and label statements and couldn't find a stated purpose to grade.
  • Since the label doesn't commit to one use, we graded the ingredients' overall clinical evidence instead.
  • On file: Lactose intolerance — rated "Effective" (Lactase) (Natural Medicines).

Evidence for most uses of these enzymes isn't established in the data we hold. Lactase is rated effective for lactose intolerance—if you can't digest milk sugar, lactase supplements directly address that.

For everything else in this blend—cancer, dental issues, muscle soreness, shingles, parasites, hay fever, burns, and others—the science available to us shows insufficient reliable evidence to rate whether they work. That doesn't mean they don't; it means human trials confirming benefit aren't available in our records yet.

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

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 6 of the 6 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 6 of 6.
  • General safety write-ups exist for 6 of 6.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most of these enzymes are generally well tolerated at typical doses. Papain, bromelain, and the proteases may cause digestive upset, allergic reactions, or—in sensitive individuals—respiratory problems if inhaled as dust; allergic responses can include itching, rash, throat irritation, and breathing difficulty.

High doses of papain are unsafe. Papain is possibly unsafe in pregnancy and should be avoided; bromelain is also best avoided during pregnancy and lactation.

Lactase is likely safe in pregnancy and lactation. Lipase, phytase, and the proteases lack enough safety data during pregnancy and breastfeeding—talk with your doctor before using during either.

No serious adverse effects have been reported in adults at normal doses, but occupational exposure to enzyme powders (a different scenario from taking this packet) has caused allergic and respiratory reactions in some workers.

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

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

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

Why this rating?
  • 2 of the 6 matched ingredients can interact with medications — Papain, Bromelain.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs.
  • For scale: 141 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Blood thinners and blood-clotting preventers (anticoagulant and antiplatelet drugs) are the main concern—papain and bromelain both carry documented interactions here, with warfarin being specifically reported. Tetracycline antibiotics have a minor documented interaction with bromelain.

Check your exact medications with the tool on this page, then confirm with your own doctor or pharmacist before you start.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with strong clinical evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.

If you're taking a blood thinner or antiplatelet drug, check your exact medication against the interaction list on this page before starting—papain and bromelain may increase bleeding risk. For other uses, the digestive benefit isn't proven in studies we have on file.

If you're pregnant, breastfeeding, have a serious digestive condition, or take any regular medications, talk it over with your doctor or pharmacist before adding this to your routine.

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

Assessment coverage: 8 of 15 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 25, 2018.

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 Enzyme Blend - AM Packet, straight from the product label.

Brand GNC Preventive Nutrition
Net contents 7 AM Pack(s)
Market status On market
Date entered into DSLD Jan 25, 2018
DSLD ID 82601
Product type Non-nutrient/non-botanical
Supplement form Unknown
Dietary claims / uses Nutrient, 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 Enzyme Blend - AM Packet by GNC Preventive Nutrition, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Beige Hardshell(s)
Maximum serving Sizes:
1 Beige Hardshell(s)
IngredientAmount% DV
Amylase0 NP--
Papain0 NP--
Bromelain0 NP--
Lipase0 NP--
Lactase0 NP--
Cellulase0 NP--
Invertase0 NP--
Glucoamylase0 NP--
Alpha-Galactosidase0 NP--
Beta-Glucanase0 NP--
Phytase0 NP--
Hemicellulase0 NP--
Protease 4.50 NP--
Protease 30 NP--
Protease 6 Concentrate0 NP--
CereCalase Proprietary Blend18 mg--
n-zimes Proprietary Blend (Non-Nutrient/Non-Botanical)181 mg--

Other ingredients: Dicalcium Phosphate, Gelatin

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.
General

CODE 705922 KPG

General Statements

AM packet

Actual size

GNC Quality Commitment For more than 79 years, GNC has been the leader in the development of superior nutritional supplements. Our products are produced using only fresh, high-quality ingredients and are manufactured under the strictest quality controls. GNC Guarantee If you are not 100% completely satisfied, return the unused portion of the product with your receipt to a GNC store within 30 days. Our trained sales staff will either refund your purchase price or, if you prefer, assist you in finding a replacement product to help you live well.

Easy-to-use daily program designed to support digestive health Gently rids the body of toxins No fasting required Gentle enough for first-time users

7 - AM Packets 7 - PM Packets 7 - Fiber and Prebiotic Packets 7 - Probiotic Capsules

Detox

AM Formula Each AM formula packet contains a gastro formula, total cleanser and enzyme blend.

Suggested/Recommended/Usage/Directions

Directions: As a dietary supplement, take the contents of one AM packet first thing in the morning for seven days.

Formula

Contains: Fish, milk, soybeans and wheat.

This packet combines specialized herbs such as ginger, artichoke and pomegranate with fructooligosaccharides (FOS) to help promote intestinal health. It also provides digestive enzymes to help promote protein, carbohydrate and fat digestion.

Precautions

Contains: Fish, milk, soybeans and wheat.

Warning: Consult your physician prior to using this product if you are pregnant, nursing, taking medication, or have a medical condition.

Discontinue use two weeks prior to surgery.

Keep out of reach of children.

Brand IP Statement(s)

n-zimes and CereCalase are trademarks of National Enzyme Company.

Preventive Nutrition Complete Body Cleansing Program is a 7-day system designed to support overall wellness and digestive health.

Formulation

No artificial flavors, sodium free, yeast free.

Storage

Store in a cool dry place.

FDA Statement of Identity

Dietary Supplement

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.

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

See for yourself

Enzyme Blend - AM Packet by GNC Preventive Nutrition label

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

Enzyme Blend - AM Packet 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 Enzyme Blend - AM Packet by GNC Preventive Nutrition

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

Serving size1 Beige Hardshell(s) Dosage formUnknown 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.

CereCalase Proprietary Blend

18 mg per serving
  • › Beta-Glucanase
  • › Phytase
  • › Hemicellulase

N-zimes Proprietary Blend (Non-Nutrient/Non-Botanical)

181 mg per serving

Other (inactive) ingredients: Dicalcium Phosphate, Gelatin. These complete the product’s ingredient list but are not active constituents.

Interaction report

Enzyme Blend - AM Packet by GNC Preventive Nutrition Drug Interactions

Want to check YOUR meds against Enzyme Blend - AM Packet?

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 Enzyme Blend - AM Packet interact with 141 drugs. Click any drug to see the details.

2 of the 15 ingredients in Enzyme Blend - AM Packet 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 Enzyme Blend - AM Packet 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 Enzyme Blend - AM Packet, from the product label.

GNC Preventive Nutrition

See all GNC Preventive Nutrition products
Name
General Nutrition Corporation
City
Pittsburgh
State
PA
ZipCode
15222
Phone Number
1-888-462-2548
Web Address
gnc.com
Pharmacist Counseling Corner

Enzyme Blend - AM Packet by GNC Preventive Nutrition: Common Questions

Does Enzyme Blend - AM Packet by GNC Preventive Nutrition interact with any medications?
Yes. Based on its ingredients, Enzyme Blend - AM Packet 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?
Enzyme Blend - AM Packet 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 work for digestion?
These are digestive enzymes meant to help break down different parts of food. Lactase is proven effective for lactose intolerance, but evidence that the others improve digestion in healthy people isn't established in the data we hold.
Can I take this if I'm on warfarin?
Not without talking to your doctor or pharmacist first. Papain in this blend has a documented Moderate interaction with warfarin—it may increase warfarin's effects and your bleeding risk. The facts show a case report where a patient's blood-thinning level rose significantly after taking papain. Your healthcare provider needs to weigh the risks for you.
Is it safe in pregnancy?
Papain is possibly unsafe and should be avoided. Bromelain is also best avoided. Lactase is likely safe. The other enzymes don't have enough safety data, so you'd need to check with your doctor or pharmacist before using during pregnancy.
What are the most common side effects?
Most people tolerate these enzymes well at normal doses. The most common effects are mild digestive ones—diarrhea, bloating, gas, or stomach upset. Allergic reactions (itching, rash, runny nose, throat irritation) are possible in people sensitive to these enzymes, especially papain or bromelain.
Can I take this while breastfeeding?
Bromelain is best avoided while breastfeeding. Lactase is likely safe. Papain, lipase, phytase, and the proteases don't have enough safety data—check with your doctor or pharmacist first before using any of them while nursing.
What is papain?
Papain is an enzyme from papaya that breaks down proteins. It's generally well tolerated as a food, but supplements can irritate the digestive tract and trigger allergies in sensitive people. It's why it can interact with blood thinners like warfarin.

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

Not sure if Enzyme Blend - AM Packet 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.

Enzyme Blend - AM Packet label
Go deeper

The Full Monographs Behind Enzyme Blend - AM Packet’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

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

Papain

Interacts with 2 drugs

Papain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food and laboratory uses, strong human evidence...

Read the full Papain monograph → Herb & supplement monograph

Bromelain

Interacts with 141 drugs

Bromelain is a group of protein-digesting enzymes from pineapple that people take mainly for inflammation, swelling, and sinus problems. Some early studies are promising, but the overall evi...

Read the full Bromelain monograph → Herb & supplement monograph

Lipase

Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy for people who cannot make enough of their...

Read the full Lipase monograph → Herb & supplement monograph

Lactase

Lactase is a digestive enzyme supplement that helps people who lack enough natural lactase break down lactose, the sugar in milk and dairy. It can reduce gas, bloating, cramping, and diarrhe...

Read the full Lactase monograph → Herb & supplement monograph

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

Enzyme Blend - AM Packet's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 42 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Papain 11 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf 1997;17:342-56.
  3. Shuttleworth D, Hill S, Marks R, Connelly DM. Relief of experimentally induced pruritus with a novel eutectic mixture of local anaesthetic agents. Br J Dermatol 1988;119:535-40.
  4. Mansfield LE, Ting S, Haverly RW, Yoo TJ. The incidence and clinical implications of hypersensitivity to papain in an allergic population, confirmed by blinded oral challenge. Ann Allergy 1985;55:541-3.
  5. Martin, T., Uhder, K., Kurek, R., Roeddiger, S., Schneider, L., Vogt, H. G., Heyd, R., and Zamboglou, N. Does prophylactic treatment with proteolytic enzymes reduce acute toxicity of adjuvant pelvic irradiation? Results of a double-blind randomized trial PubMed
  6. Walker-Renard, P. Update on the medicinal management of phytobezoars. Am J Gastroenterol. 1993;88(10):1663-1666.
  7. Tymoszuk D, Wiszniewska M, Walusiak-Skorupa J. Papain-induced occupational rhinoconjunctivitis and asthma - A case report. Med Pr 2016;67(1):109-12. PubMed
  8. Soto-Mera MT, López-Rico MR, Filgueira JF, et al. Occupational allergy to papain. Allergy 2000;55(10):983-4. PubMed
  9. Tarlo SM, Shaikh W, Bell B, et al. Papain-induced allergic reactions. Clin Allergy 1978;8(3):207-15. PubMed
  10. Baur X, König G, Bencze K, Fruhmann G. Clinical symptoms and results of skin test, RAST and bronchial provocation test in thirty-three papain workers: Evidence for strong immunogenic potency and clinically relevant proteolytic e?ects of airborne papain. C
  11. Novey HS, Keenan WJ, Fairshter RD, Wells ID, Wilson AF, Culver BD. Pulmonary disease in workers exposed to papain: clinico-physiological and immunological studies. Clin Allergy 1980;10(6):721-31. PubMed

See these in context on the Papain monograph →

Bromelain 19 references
  1. Nettis E, Napoli G, Ferrannini A, Tursi A. IgE-mediated allergy to bromelain. Allergy 2001;56:257-8. PubMed
  2. Taussig SJ, Batkin S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J Ethnopharmacol 1988;22:191-203.. PubMed
  3. Bradbrook ID, Morrison PJ, Rogers HJ. The effect of bromelain on the absorption of orally administered tetracycline. Br J Clin Pharmacol 1978;6:552-4. PubMed
  4. Bush TM, Rayburn KS, Holloway SW, et al. Adverse interactions between herbal and dietary substances and prescription medications: a clinical survey. Altern Ther Health Med 2007;13:30-5.
  5. Brien S, Lewith G, Walker AF, et al. Bromelain as an adjunctive treatment for moderate-to-severe osteoarthritis of the knee: a randomized placebo-controlled pilot study. QJM 2006;99:841-50. PubMed
  6. Mori S, Ojima Y, Hirose T, et al. The clinical effect of proteolytic enzyme containing bromelain and trypsin on urinary tract infection evaluated by double blind method. Acta Obstet Gynaecol Jpn 1972;19:147-53.
  7. Glaser D, Hilberg T. The influence of bromelain on platelet count and platelet activity in vitro. Platelets 2006;17:37-41. PubMed
  8. Heinicke R M, van der Wal L, Yokoyama M. Effect of bromelain (Ananase) on human platelet aggregation. Experientia 1972;28:844-5. PubMed
  9. Gailhofer, G., Wilders-Truschnig, M., Smolle, J., and Ludvan, M. Asthma caused by bromelain: an occupational allergy. Clin Allergy 1988;18(5):445-450. PubMed
  10. Mattei, O., Fabri, G., and Farina, G. [Occupational health experience regarding four cases of asthma due to bromelain (author's transl)]. Medicina del Lavoro 1979;70(5):404-409.
  11. Galleguillos, F. and Rodriguez, J. C. Asthma caused by bromelin inhalation. Clin Allergy 1978;8(1):21-24. PubMed
  12. Perez-Camo I, Quirce S, Duran MA, and et al. Latex allergy: evidence of cross-reactivity with papain and bromelain [abstract]. Allergy 1996;51(suppl 31):48.
  13. Martin GJ, Ehrenreich J, and Asbell N. Bromelain: pineapple proteases with anti-edema activity. Exp Med Surg 1962;20:227-247.
  14. Kasemsuk T, Saengpetch N, Sibmooh N, Unchern S. Improved WOMAC score following 16-week treatment with bromelain for knee osteoarthritis. Clin Rheumatol. 2016 Oct;35(10):2531-40. PubMed
  15. Kutlu Ö, DemirbaS A, Elmas ÖF, Güvenç U, Metin A. Fixed drug eruption: a new side effect of bromelain. Contact Dermatitis 2020. Online ahead of print. PubMed
  16. Shoham Y, Shapira E, Haik J, et al. Bromelain-based enzymatic debridement of chronic wounds: Results of a multicentre randomized controlled trial. Wound Repair Regen 2021;29(6):899-907. PubMed
  17. Pfister P, Garcia Wendel PD, Kim BS, et al. Coagulation side effects of enzymatic debridement in burned patients. Burns 2022. PubMed
  18. Hasham S, Riyat H, Fletcher A, O'Boyle CP, Alexander S. To bleed or not to bleed? Case series and discussion of haemorrhage risk with enzymatic debridement in burn injuries. Scars Burn Heal 2023;9:20595131231168333. PubMed
  19. Leelakanok N, Petchsomrit A, Janurai T, Saechan C, Sunsandee N. Efficacy and safety of bromelain: A systematic review and meta-analysis. Nutr Health 2023. PubMed

See these in context on the Bromelain monograph →

Lipase 1 reference
  1. Casper C, Hascoet JM, Ertl T, et al. Recombinant bile salt-stimulated lipase in preterm infant feeding: A randomized phase 3 study. PLoS One. 2016;11(5):e0156071. PubMed

See these in context on the Lipase monograph →

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

See these in context on the Lactase monograph →

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

See these in context on the Phytase monograph →

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

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

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

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

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