Interactions on record — worth a quick check against your medications. Based on 7 of 19 ingredients. Check your meds →
Dietary supplement

EnzymeMD Ingredients & Drug Interactions

by 1MD Nutrition

EnzymeMD 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 EnzymeMD 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

EnzymeMD is a dietary supplement by 1MD Nutrition with 19 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, 181 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Bromelain, Saccharomyces boulardii, 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 EnzymeMD by 1MD Nutrition

Ask about any prescription or over-the-counter medication and we check it for interactions with EnzymeMD by 1MD Nutrition — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of EnzymeMD by 1MD 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 23, 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 19 active ingredients.
  • “EnzymeMD Proprietary Blend” is a proprietary blend — the label gives one combined amount (420 mg) without saying how much of each component you get.

EnzymeMD contains 19 ingredients, most of them digestive enzymes. The active ones include papain and bromelain (both protein-digesting enzymes from plants), along with lipase (breaks down fat), lactase (breaks down milk sugar), and several other carbohydrate- and protein-splitting enzymes.

The blend also includes Saccharomyces boulardii, a beneficial yeast. Several ingredients—Cellulase, Peptidase, Invertase, Glucoamylase, Alpha-Galactosidase, Xylanase, Maltase, Beta-Glucanase, and Hemicellulase—are also enzyme-based digestive aids.

The inactive ingredients are rice flour, vegetable cellulose capsule, and silica.

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 digestive support and nutrient absorption.
  • We looked for evidence on: Dyspepsia, Lactose intolerance, Antibiotic-associated diarrhea, Travelers' diarrhea, Clostridioides difficile infection, Irritable bowel syndrome (IBS) — and 4 related terms.
  • The strongest evidence on file: Lactase is rated "Effective" for Lactose intolerance (Natural Medicines).
  • Also on file: Saccharomyces Boulardii is rated "Possibly Effective" for Antibiotic-associated diarrhea, Travelers' diarrhea, Clostridioides difficile infection.
  • Also on file: Papain is rated "Insufficient Reliable Evidence To Rate" for Exercise-induced muscle soreness.

The evidence for most ingredients in this product is not established. Lactase is effective for lactose intolerance—that's the clearest rating we have.

Saccharomyces boulardii is possibly effective for rotaviral diarrhea, travelers' diarrhea, antibiotic-associated diarrhea, necrotizing enterocolitis (a serious intestinal inflammation in premature infants), Clostridioides difficile infection, and Helicobacter pylori. For papain, bromelain, lipase, phytase, and the various proteases, the evidence is insufficient to rate their effectiveness for the conditions studied.

We don't have effectiveness data on file for several of the other enzymes in the blend.

The evidence, ingredient by ingredient Papain Bromelain Lipase Lactase Phytase Saccharomyces Boulardii 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 7 of the 7 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 7 of 7.
  • General safety write-ups exist for 7 of 7.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most of the active enzymes in this product are generally well tolerated at appropriate doses, though high oral doses of papain may not be safe. The most common side effects are digestive—diarrhea, flatulence, gastric upset, headache—and allergic reactions in people sensitive to any of the enzymes.

Papain in particular can cause itchy watery eyes, runny nose, sneezing, abdominal cramps, sweating, and diarrhea in sensitive individuals; it may also irritate the digestive tract. Bromelain can cause gastrointestinal disturbances, including nausea, vomiting, and abdominal pain.

Saccharomyces boulardii is generally safe for healthy adults but should be avoided if you're critically ill or immunocompromised—there are rare reports of fungemia (yeast in the bloodstream) in critically ill patients, especially those with central lines or on broad-spectrum antibiotics. All three proteases in the blend are generally well tolerated but may cause digestive upset or allergic reactions.

Side effects, ingredient by ingredient Papain Bromelain Lipase Lactase Phytase Saccharomyces Boulardii 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?
  • 3 of the 7 matched ingredients can interact with medications — Papain, Saccharomyces Boulardii, Bromelain.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs.
  • For scale: 181 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.

Before taking EnzymeMD, double-check with your doctor or pharmacist if you take warfarin or other blood thinners (Moderate severity concern with papain and bromelain), antiplatelet drugs like aspirin or clopidogrel (Moderate with bromelain), tetracycline antibiotics (Minor with bromelain), or antifungal medications (Minor with Saccharomyces boulardii). No interactions are documented for the other enzyme ingredients we were able to check.

Check your own medication Run your meds through the checker above

The bottom line

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

EnzymeMD is an enzyme blend that may help with digestive support and lactose intolerance, though most of its ingredients lack strong evidence. If you take warfarin or other blood thinners, or antifungal medications, talk with your doctor or pharmacist before starting this product—the interactions documented here matter.

If you're critically ill or have a weakened immune system, check with your healthcare provider first because of the Saccharomyces boulardii content.

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

Assessment coverage: 9 of 19 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 22, 2022.

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 EnzymeMD, straight from the product label.

Brand 1MD Nutrition
Barcode (UPC) X002YI3RU7
Net contents 60 Capsule(s)
Market status On market
Date entered into DSLD Nov 22, 2022
DSLD ID 274798
Product type Non-nutrient/non-botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for EnzymeMD by 1MD 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 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
30
UPC/BARCODE
X002YI3RU7
IngredientAmount% DV
Papain0 NP--
Bromelain0 NP--
Lipase0 NP--
Lactase0 NP--
Cellulase0 NP--
Peptidase0 NP--
Invertase0 NP--
Glucoamylase0 NP--
Alpha-Galactosidase0 NP--
Xylanase0 NP--
Maltase0 NP--
Beta-Glucanase0 NP--
Phytase0 NP--
Hemicellulase0 NP--
Saccharomyces boulardii0 NP--
Alpha-Amylase0 NP--
EnzymeMD Proprietary Blend420 mg--
Protease (pH 2-3)0 NP--
Protease (pH 3-6)0 NP--
Protease (pH 6-9)0 NP--

Other ingredients: Rice Flour, Vegetable Cellulose Capsule, Silica

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions

Suggested Use: As a dietary supplement, adults take one (1) or two (2) capsules 20 minutes before a meal, or as recommended by a healthcare practitioner.

Precautions

Warning: Consult a healthcare practitioner if you are pregnant or nursing, have a serious medical condition, or use any medications.

Keep out of reach of children.

Do not use if safety seal is damaged or missing.

Contains soy, wheat, and milk.

Storage

Store in a cool, dry place.

Formulation

Color may vary.

Non-GMO Shellfish-free Peanut-free

Broad-spectrum digestive support Promotes nutrient absorption

Manufactured in the USA from globally-sourced ingredients.

Formula

18 Digestive enzymes With S. boulardii probiotic

General Statements

Doctor formulated

Questions? Call: (888)-393-4030 | Email: [email protected] | Visit: www.1md.org

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.

Seals/Symbols

GMP Good Manufacturing Practice

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

See for yourself

EnzymeMD by 1MD Nutrition label

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

EnzymeMD 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 EnzymeMD by 1MD Nutrition

These are the 19 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 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.

EnzymeMD Proprietary Blend

420 mg per serving

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

Interaction report

EnzymeMD by 1MD Nutrition Drug Interactions

Want to check YOUR meds against EnzymeMD?

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
181Drugs
122 Moderate 59 Minor

Ingredients driving the most interactions

Bromelain 141
Saccharomyces boulardii 40
Papain 2

Individual Drug Interactions

The ingredients in EnzymeMD interact with 181 drugs. Click any drug to see the details.

3 of the 19 ingredients in EnzymeMD interact with drugs. Each result below shows which ingredient is responsible. Bromelain Saccharomyces boulardii Papain

Each ingredient & the kinds of drugs it affects

For each ingredient in EnzymeMD 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

Saccharomyces boulardii1 drug type · 40 drugs

Antifungals

Theoretically, taking antifungals with Saccharomyces boulardii might decrease the effectiveness of Saccharomyces boulardii.
S. boulardii is a live yeast. Therefore, simultaneously taking antifungals might kill a significant number of the organisms.

Likelihood Possible Evidence D
Saccharomyces boulardii 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 EnzymeMD, from the product label.

1MD Nutrition

See all 1MD Nutrition products
Name
1MD
City
Irvine
State
CA
ZipCode
92618
Phone Number
888-393-4030
Web Address
www.1md.org
Pharmacist Counseling Corner

EnzymeMD by 1MD Nutrition: Common Questions

Does EnzymeMD by 1MD Nutrition interact with any medications?
Yes. Based on its ingredients, EnzymeMD has a known interaction with 181 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
EnzymeMD contains 19 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.
Is EnzymeMD safe to take during pregnancy?
Papain should be avoided in pregnancy due to safety concerns. Bromelain is also best avoided. For the other ingredients—lipase, lactase, phytase, the various proteases, and Saccharomyces boulardii—there isn't enough safety data to say either way. Talk with your doctor before using this product if you're pregnant.
Is it safe while breastfeeding?
There isn't enough data on most of these ingredients during breastfeeding. Papain and bromelain should be avoided. Lactase is likely safe, but for the rest, check with your doctor or pharmacist first.
What's Saccharomyces boulardii and why is it in here?
It's a beneficial yeast strain that may help with certain types of diarrhea—travelers' diarrhea, antibiotic-associated diarrhea, and a few other conditions—though it's generally safe for healthy adults, critically ill patients should avoid it because of rare reports of serious yeast infections.
Will this help my digestion?
The enzymes in EnzymeMD are meant to aid digestion, but there isn't strong evidence for most of them in the conditions studied. Lactase will help if you can't digest milk sugar; Saccharomyces boulardii may help with certain diarrheal conditions. For the rest, the evidence is insufficient.
What are the most common side effects?
The most common ones are digestive—diarrhea, flatulence, gas, and stomach upset—and headache. Allergic reactions like itchy eyes, runny nose, or rash are possible if you're sensitive to any of the enzymes.
Can I take this long-term?
Most of these enzymes are generally well tolerated short-term, but evidence on long-term use is limited. If you're thinking of taking it regularly, talk it over with your doctor or pharmacist first.

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

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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.

EnzymeMD label
Go deeper

The Full Monographs Behind EnzymeMD’s Ingredients

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

Herb & supplement monograph

Papain

Interacts with 2 drugs

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

Read the full Papain monograph → Herb & supplement monograph

Bromelain

Interacts with 141 drugs

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

Read the full Bromelain monograph → Herb & supplement monograph

Lipase

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

Read the full Lipase monograph → Herb & supplement monograph

Lactase

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

Read the full Lactase monograph → Herb & supplement monograph

Phytase

Phytase is an enzyme that breaks down phytic acid (phytate) found in grains, beans, nuts, and seeds, which can free up minerals like iron, zinc, and calcium for absorption. It is widely used...

Read the full Phytase monograph → Herb & supplement monograph

Saccharomyces Boulardii

Interacts with 40 drugs

Saccharomyces boulardii is a beneficial yeast used as a probiotic, with the strongest evidence for preventing and treating certain types of diarrhea, including antibiotic-associated diarrhea...

Read the full Saccharomyces Boulardii 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

EnzymeMD'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 68 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 →

Saccharomyces Boulardii 26 references
  1. Niault M, Thomas F, Prost J, et al. Fungemia due to Saccharomyces species in a patient treated with enteral Saccharomyces boulardii. Clin Infect Dis 1999;28:930.
  2. Pletinex M, Legein J, Vandenplas Y. Fungemia with Saccharomyces boulardii in a 1-year-old girl with protracted diarrhea. J Pediatr Gastroenterol Nutr 1995;21:113-5. DOI
  3. Fredenucci I, Chomarat M, Boucaud C, et al. Saccharomyces boulardii fungemia in a patient receiving ultra-levure therapy. Clin Infect Dis 1998;27:222-3.
  4. Elmer GW, McFarland LV, Surawicz CM, et al. Behaviour of Saccharomyces boulardii in recurrent Clostridium difficile disease patients. Aliment Pharmacol Ther 1999;13:1663-8.
  5. Lewis SJ, Freedman AR. Review article: the use of biotherapeutic agents in the prevention and treatment of gastrointestinal disease. Aliment Pharmacol Ther 1998;12:807-22. PubMed
  6. Cesaro S, Chinello P, Rossi L, Zanesco L. Saccharomyces cerevisiae fungemia in a neutropenic patient treated with Saccharomyces boulardii. Support Care Cancer 2000;8:504-5. PubMed
  7. Hennequin C, Thierry A, Richard GF, et al. Microsatellite typing as a new tool for identification of Saccharomyces cerevisiae strains. J Clin Microbiol 2001;39:551-9.
  8. Plein K, Hotz J. Therapeutic effects of Saccharomyces boulardii on mild residual symptoms in a stable phase of Crohn's disease with special respect to chronic diarrhea - a pilot study. Z Gastroenterol 1993;31:129-34.
  9. Borriello SP, Hammes WP, Holzapfel W, et al. Safety of probiotics that contain lactobacilli or bifidobacteria. Clin Infect Dis 2003;36:775-80. PubMed
  10. Marteau P, Seksik P. Tolerance of probiotics and prebiotics. J Clin Gastroenterol 2004;38:S67-9. PubMed
  11. Munoz P, Bouza E, Cuenca-Estrella M, et al. Saccharomyces cerevisiae fungemia: an emerging infectious disease. Clin Infect Dis 2005;40:1625-34. PubMed
  12. Lherm, T., Monet, C., Nougiere, B., Soulier, M., Larbi, D., Le Gall, C., Caen, D., and Malbrunot, C. Seven cases of fungemia with Saccharomyces boulardii in critically ill patients. Intensive Care Med 2002;28(6):797-801. PubMed
  13. Riquelme, A. J., Calvo, M. A., Guzman, A. M., Depix, M. S., Garcia, P., Perez, C., Arrese, M., and Labarca, J. A. Saccharomyces cerevisiae fungemia after Saccharomyces boulardii treatment in immunocompromised patients. J Clin.Gastroenterol. 2003;36(1):41- PubMed
  14. Cherifi, S., Robberecht, J., and Miendje, Y. Saccharomyces cerevisiae fungemia in an elderly patient with Clostridium difficile colitis. Acta Clin Belg. 2004;59(4):223-224. PubMed
  15. Ellouze O, Berthoud V, Mervant M, Parthiot JP, Girard C. Septic shock due to Sacccaromyces boulardii. Med Mal Infect. 2016;46(2):104-105.
  16. Appel-da-Silva MC, Narvaez GA, Perez LRR, Drehmer L, Lewgoy J. Saccharomyces cerevisiae var. boulardii fungemia following probiotic treatment. Med Mycol Case Rep. 2017;18:15-7. PubMed
  17. Atici S, Soysal A, Karadeniz Cerit K, et al. Catheter-related Saccharomyces cerevisiae Fungemia Following Saccharomyces boulardii Probiotic Treatment: In a child in intensive care unit and review of the literature. Med Mycol Case Rep. 2017;15:33-35. PubMed
  18. Martin IW, Tonner R, Trivedi J, et al. Saccharomyces boulardii probiotic-associated fungemia: questioning the safety of this preventive probiotic's use. Diagn Microbiol Infect Dis. 2017;87(3):286-8. PubMed
  19. Romanio MR, Coraine LA, Maielo VP, Abramczyc ML, Souza RL, Oliveira NF. Saccharomyces cerevisiae fungemia in a pediatric patient after treatment with probiotics. Rev Paul Pediatr 2017;35(3):361-4.
  20. Roy U, Jessani LG, Rudramurthy SM, et al. Seven cases of Saccharomyces fungaemia related to use of probiotics. Mycoses 2017;60(6):375-380.
  21. Romanio MR, Coraine LA, Maielo VP, Abramczyc ML, Souza RL, Oliveira NF. Saccharomyces cerevisiae fungemia in a pediatric patient after treatment with probiotics. Rev Paul Pediatr. 2017 Jul-Sep;35(3):361-364. doi: 10.1590/1984-0462/;2017;35;3;00014.
  22. Flatley EA, Wilde AM, Nailor MD. Saccharomyces boulardii for the prevention of hospital onset Clostridium difficile infection. J Gastrointestin Liver Dis. 2015;24(1):21-4. PubMed
  23. Ventoulis I, Sarmourli T, Amoiridou P, et al. Bloodstream infection by Saccharomyces cerevisiae in two COVID-19 patients after receiving supplementation of Saccharomyces in the ICU. J Fungi (Basel). 2020;6(3):98. PubMed
  24. Wombwell E, Bransteitter B, Gillen LR. Incidence of Saccharomyces cerevisiae fungemia in hospitalised patients administered Saccharomyces boulardii probiotic. Mycoses 2021;64(12):1521-1526.
  25. Rannikko J, Holmberg V, Karppelin M, et al. Fungemia and Other Fungal Infections Associated with Use of Saccharomyces boulardii Probiotic Supplements. Emerg Infect Dis 2021;27(8):2090-6.
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See these in context on the Saccharomyces Boulardii 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.

© 2021 Therapeutic Research Center, LLC

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