Major interaction on record — check this product against your medications before combining. Based on 4 of 7 ingredients. Check your meds →
Dietary supplement

Extra Care Digest Smart Ingredients & Drug Interactions

by Renew Life

Capsule Category: Other Combinations
Most serious interaction: Major
The interaction bottom line Most serious interaction: Major

Extra Care Digest Smart is a dietary supplement by Renew Life with 7 active ingredients. Its ingredients are commonly taken for sugar substitute / sweetener, blood sugar support in diabetes, weight management.Based on those ingredients, 1,158 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Ginger extract, Peppermint extract, Stevia (leaf) Good & Sweet. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Extra Care Digest Smart by Renew Life

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

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 24 active ingredients.
  • “Stevia (leaf) Good & Sweet” is listed as a grouped ingredient — the label gives one combined amount (31 mg) without saying how much of each component you get.
  • “Protein Enzyme Activity Values” is listed as a grouped ingredient — the label doesn't break down how much of each component you get.
  • “Carbohydrate Enzyme Activity Values” is listed as a grouped ingredient — the label doesn't break down how much of each component you get.

Extra Care Digest Smart is a digestive enzyme supplement with 24 active ingredients. The main ones are digestive enzymes — papain (from papaya), bromelain (from pineapple), protease, lipase, lactase, and others — that help break down food into smaller pieces your body can absorb.

It also includes phytase and a blend called AstraGin, plus stevia as a sweetener. The capsule itself is made from vegetable material, and the inactive ingredients are maltodextrin and medium chain triglyceride.

Does it work?

Strong evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Strong

Clinical evidence supports at least one of this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: digestive wellness and occasional gas, bloating, indigestion.
  • We looked for evidence on: Dyspepsia, Irritable bowel syndrome (IBS), Lactose intolerance, Abdominal pain, Diarrhea, Constipation — and 3 related terms.
  • The strongest evidence on file: Lactase is rated "Effective" for Lactose intolerance (Natural Medicines).
  • Also on file: Peppermint is rated "Likely Effective" for Irritable bowel syndrome (IBS).
  • Also on file: Peppermint is rated "Possibly Effective" for Dyspepsia.

The effectiveness evidence for these enzymes is limited. Lactase is rated effective for lactose intolerance.

Papain and bromelain both carry ratings of insufficient reliable evidence for the conditions they're studied in — cancer, muscle soreness, parasites, and others — meaning the research isn't clear enough to say whether they work. The same goes for protease, lipase, and phytase: the data we hold shows insufficient evidence for their intended uses, including inflammatory bowel disease and poor digestion.

The evidence, ingredient by ingredient Stevia Adenosine Ginger Peppermint

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 9 of the 9 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 9 of 9.
  • General safety write-ups exist for 9 of 9.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Papain, bromelain, and protease are generally well tolerated short-term at appropriate doses, but sensitive people may experience allergic reactions, digestive upset, or itching and hives. High doses of papain can cause serious problems like severe inflammation of the stomach lining.

Lactase is generally well tolerated. Lipase carries no reported adverse effects in adults, though data on long-term safety are limited.

On pregnancy and breastfeeding: papain is possibly unsafe in pregnancy and safety data for breastfeeding are not reliable enough — talk with your doctor before use. Bromelain should be avoided in pregnancy and while breastfeeding due to lack of safety data.

Protease, lipase, and phytase have not been studied enough to know either way; check with your doctor before use if you're pregnant or nursing. Lactase is likely safe in pregnancy.

Side effects, ingredient by ingredient Stevia Adenosine Ginger Peppermint

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 5 of the 9 matched ingredients can interact with medications — Papain, Peppermint, Bromelain, Ginger, Adenosine.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications.
  • For scale: 1,035 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 before taking this product if you're on warfarin or other blood thinners (anticoagulants), antiplatelet drugs that prevent clots, or tetracycline antibiotics — papain and bromelain in this formula may increase bleeding risk or affect how your body absorbs tetracyclines.

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. Major medication interactions have been identified, and safety information is well characterized.

This product is a multi-enzyme digestive aid that works best for people with lactose intolerance or those seeking general digestive support — though evidence for most uses is limited. If you take blood thinners, antiplatelet medications, or tetracycline antibiotics, you need to check with your doctor or pharmacist first; the papain and bromelain here may not be compatible.

Anyone with a known enzyme allergy, serious digestive conditions, or who is pregnant or breastfeeding should talk it over with their own healthcare provider before starting.

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

Assessment coverage: 9 of 24 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jul 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 Extra Care Digest Smart, straight from the product label.

Brand Renew Life
Barcode (UPC) 631257156136
Net contents 45 Vegetable Capsule(s)
Market status On market
Date entered into DSLD Jul 25, 2018
DSLD ID 178671
Product type Other Combinations
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 Extra Care Digest Smart by Renew Life, 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:
1 Capsule(s)
Servings per container
45
UPC/BARCODE
631257156136
IngredientAmount% DV
Amylase0 NP--
Papain0 NP--
Bromelain0 NP--
Protease0 NP--
Lipase0 NP--
Lactase0 NP--
Cellulase0 NP--
Peptidase0 NP--
Invertase0 NP--
Glucoamylase0 NP--
Alpha-Galactosidase0 NP--
Xylanase0 NP--
Pectinase0 NP--
Maltase0 NP--
Superoxide Dismutase0 NP--
Beta-Glucanase0 NP--
Phytase0 NP--
Hemicellulase0 NP--
AstraGin0 NP--
Stevia (leaf) Good & Sweet31 mg--
Protein Enzyme Activity Values0 NP--
Actinidin0 NP--
Carbohydrate Enzyme Activity Values0 NP--
Fat Enzyme Activity Value0 NP--
Fiber Enzyme Activity Value0 NP--
ATP0 NP--
ElevATP0 NP--
Digestive Soothing Blend40 mg--
Ginger extract0 NP--
Plant-Based Enzyme Blend0 NP--
Peppermint extract0 NP--

Other ingredients: Vegetable Capsule, Maltodextrin, Medium Chain Triglyceride

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 Statements

Digestive wellness, naturally

At Renew Life, we believe a healthy gut is a happy gut.

For nearly two decades, we have pioneered superior-quality digestive care supplements to help people achieve optimal health from the inside out.

65273C

Good for your gut! Your gut is your engine, your digestive core.

Keep it running smoothly at every meal with Renew Life digestive enzymes.

Our plant-based, broad-spectrum blends promote optimal digestion and nutrient availability so you feel better, lighter, and more energized.

Benefits you can feel Today’s highly processed and cooked foods often lack digestive enzymes, so your body may have to work harder to break down and absorb nutrients, causing occasional gas, bloating, and indigestion. Our potent enzyme formulas work hard to reduce occasional digestive discomforts and unlock the nutrient goodness found in your food.

Targeted delivery Digest Smart ZymeGuard targeted-delivery capsules resist stomach acid to ensure more active enzymes reach your intestinal tract.

Live digestively.

Formulation

High potency enzyme for difficult digestion

Digest Smart high potency formulas are made with maximum enzyme activity values (EAV) so you can comfortably enjoy more of your favorite foods.

Enzyme activity values (EAV) are derived from specific, validated tests on the product to measure the ability to break down protein, carbohydrates, fats, and fiber. EAV is an indicator of ability to digest foods.

Plant-based enzyme High-potency

Helps digest all types of foods For occasional gas, bloating, & indigestion

No artificial ingredients

Quality, purity, and potency guaranteed through expiration.

Manufactured in USA in a GMP facility.

Formula

Extra care potency Food group EAV Power Protein 2,300,000 PU Carbohydrate 40,000 DP Fat 4,300 FIP Fiber 4,100 CU

Digest Smart Extra Care is formulated with 25 plant-based, raw enzymes that support the digestion of the most problematic foods, and may help prevent occasional gas, bloating, and indigestion.

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.

Precautions

Tamper Evident: Do not use if safety seal on bottle is broken or missing.

Contains sulfites and ingredients derived from tree nut (coconut). May contain traces of soy, milk, and wheat from ingredients used in the fermentation process to make enzymes.

Keep out of reach of children.

Consult your healthcare professional before using this or any product if you are pregnant, nursing, or under medical supervision.

FDA Statement of Identity

Enzyme Supplement

Suggested/Recommended/Usage/Directions

Directions: Take one capsule before each meal.

Storage

Store at 77 degrees F (25 degrees C) or below.

Brand IP Statement(s)

ElevATP is used under license from VDF FutureCeuticals, Inc. AstraGin is used under license from NuLiv Science USA.

See for yourself

Extra Care Digest Smart by Renew Life label

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

What’s inside

The Ingredients in Extra Care Digest Smart by Renew Life

These are the 7 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container45 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.

Stevia (leaf) Good & Sweet

Interacts with
259 drugs
31 mg per serving

Stevia is a plant-based, calorie-free sweetener that is widely used as a sugar alternative and is considered safe in normal food amounts by major regu...

Stevia (leaf) Good & Sweet monograph & interactions
  • › Superoxide Dismutase
  • › AstraGin
  • ATP
  • › ElevATP

Digestive Soothing Blend

40 mg per serving

Plant-Based Enzyme Blend

0 NP per serving
  • › Protein Enzyme Activity Values
  • › Carbohydrate Enzyme Activity Values
  • › Fat Enzyme Activity Value
  • › Fiber Enzyme Activity Value

Other (inactive) ingredients: Vegetable Capsule, Maltodextrin, Medium Chain Triglyceride. These complete the product’s ingredient list but are not active constituents.

Interaction report

Extra Care Digest Smart by Renew Life Drug Interactions

Want to check YOUR meds against Extra Care Digest Smart?

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
1,158Drugs
2 Major 930 Moderate 226 Minor

Ingredients driving the most interactions

Each ingredient & the kinds of drugs it affects

For each ingredient in Extra Care Digest Smart 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.

Ginger extract14 drug types · 1,007 drugs

Anticoagulant/Antiplatelet Drugs

Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Laboratory research suggests that ginger inhibits thromboxane synthetase and decreases platelet aggregation. However, this has not been demonstrated unequivocally in humans, with mixed results from clinical trials. Theoretically, excessive amounts of ginger might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
Animal and human research suggests that ginger might increase insulin levels and/or decrease blood glucose levels.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Ginger might increase or decrease the levels of CYP3A4 substrates.
In vitro research and some case reports suggest that ginger inhibits CYP3A4 activity. Three case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are CYP3A4 substrates (imatinib, dabrafenib, and crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Conversely, other in vitro research suggests that ginger induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Losartan (Cozaar)

Theoretically, ginger might increase levels of losartan and the risk of hypotension.
In animal research, ginger increased the levels and hypotensive effects of a single dose of losartan. It is not clear if ginger alters the concentration or effects of losartan when taken continuously. Additionally, this interaction has not been shown in humans.

Likelihood Possible Evidence D
Nifedipine (Procardia)

Ginger may have antiplatelet effects and increase the risk of bleeding if used with nifedipine.
Clinical research shows that combined treatment with ginger 1 gram plus nifedipine 10 mg significantly inhibits platelet aggregation when compared to nifedipine or ginger alone.

Likelihood Possible Evidence B
P-Glycoprotein Substrates

Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
In vitro research and case reports suggest that ginger inhibits drug efflux by P-gp, potentially increasing absorption and serum levels of P-gp substrates. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are P-gp substrates (trametinib, crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.

Likelihood Possible Evidence D
Phenprocoumon (Marcoumar, Others)

Ginger might increase the risk of bleeding with phenprocoumon.
Phenprocoumon, a warfarin-related anticoagulant, might increase the international normalized ratio (INR) when taken with ginger. There is one case report of a 76-year-old woman with a stable INR on phenprocoumon that increased to greater than 10 when she began consuming dried ginger and ginger tea.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Ginger might increase the risk of bleeding with warfarin.
Laboratory research suggests that ginger might inhibit thromboxane synthetase and decrease platelet aggregation. In one case report, ginger increased the INR when taken with phenprocoumon, which has similar pharmacological effects as warfarin. In another case report, ginger increased the INR when taken with a combination of warfarin, hydrochlorothiazide, and acetaminophen. A longitudinal analysis suggests that taking ginger increases the risk of bleeding in patients taking warfarin for at least 4 months. However, research in healthy people suggests that ginger has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. Until more is known, monitor INRs closely in patients taking large amounts of ginger.

Likelihood Possible Evidence B
Calcium Channel Blockers

Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
Some animal and in vitro research suggests that ginger has hypotensive and calcium channel-blocking effects. Another animal study shows that concomitant administration of ginger and the calcium channel blocker amlodipine leads to greater reductions in blood pressure when compared with amlodipine alone.

Likelihood Unlikely Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, when taken prior to cyclosporine, ginger might decrease cyclosporine levels.
In an animal model, ginger juice taken 2 hours prior to cyclosporine administration reduced the maximum concentration and area under the curve of cyclosporine by 51% and 40%, respectively. This effect was not observed when ginger juice and cyclosporine were administered at the same time.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, ginger might increase the levels of CYP1A2 substrates.
In vitro research shows that ginger inhibits CYP1A2 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2B6 (Cyp2B6) Substrates

Theoretically, ginger might increase the levels of CYP2B6 substrates.
In vitro research shows that ginger inhibits CYP2B6 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, ginger might increase the levels of CYP2C9 substrates.
In vitro research shows that ginger inhibits CYP2C9 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Metronidazole (Flagyl)

Theoretically, ginger might increase levels of metronidazole.
In an animal model, ginger increased the absorption and plasma half-life of metronidazole. In addition, the elimination rate and clearance of metronidazole was significantly reduced.

Likelihood Possible Evidence D

Peppermint extract5 drug types · 796 drugs

Cyclosporine (Neoral, Sandimmune)

Theoretically, peppermint oil might increase the levels and adverse effects of cyclosporine.
In animal research, peppermint oil inhibits cyclosporine metabolism and increases cyclosporine levels. Inhibition of cytochrome P450 3A4 (CYP3A4) may be partially responsible for this interaction. An interaction between peppermint oil and cyclosporine has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, peppermint might increase the levels of CYP2C19 substrates.
In vitro research shows that peppermint oil inhibits CYP2C19. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, peppermint might increase the levels of CYP2C9 substrates.
In vitro research shows that peppermint oil inhibits CYP2C9. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Clinical research in healthy volunteers shows that a single dose of peppermint oil 600 mg inhibits CYP3A4 enzymes and increases the AUC of felodipine, a CYP3A4 substrate. However, in vitro research suggests that peppermint oil only inhibits CYP3A4 at very high concentrations.

Likelihood Possible Evidence B
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, peppermint might increase the levels of CYP1A2 substrates.
In vitro and animal research shows that peppermint oil and peppermint leaf inhibit CYP1A2. However, in clinical research, peppermint tea did not significantly affect the metabolism of caffeine, a CYP1A2 substrate. It is possible that the 6-day duration of treatment may have been too short to identify a difference.

Likelihood Possible Evidence B

Stevia (leaf) Good & Sweet3 drug types · 259 drugs

Lithium

Theoretically, stevia might decrease clearance and increase levels of lithium.
Animal research suggests that stevia extracts might have diuretic activity. Theoretically, increased reabsorption of lithium along with sodium might reduce excretion and increase levels of lithium.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, stevia might increase the risk for hypoglycemia when combined with antidiabetes drugs.
Preliminary clinical research in patients with type 2 diabetes suggests that taking a single dose of stevia extract 1000 mg reduces postprandial blood glucose levels when taken with a meal. However, other clinical research in patients with type 1 or type 2 diabetes suggests that taking stevioside 250 mg three times daily does not significantly affect blood glucose levels or glycated hemoglobin (HbA1C) after three months of treatment.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, combining stevia or stevia constituents with antihypertensive agents might increase the risk of hypotension.
Stevia extract and stevioside might lower blood pressure in patients with hypertension. However, other clinical research suggests that stevioside does not significantly lower blood pressure in patients with hypertension.

Likelihood Possible Evidence D
The maker

Brand information

Manufacturer and brand details for Extra Care Digest Smart, from the product label.

Renew Life

Name
Renew Life Formulas
City
Palm Harbor
State
FL
ZipCode
34683
Phone Number
1-800-830-1800
Pharmacist Counseling Corner

Extra Care Digest Smart by Renew Life: Common Questions

Does Extra Care Digest Smart by Renew Life interact with any medications?
Yes. Based on its ingredients, Extra Care Digest Smart has a known interaction with 1,158 medications, including 2 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Extra Care Digest Smart contains 7 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 papain safe if I'm pregnant?
No — the safety data for papain in pregnancy are not reliable. Concentrated papain and unripe papaya products are best avoided during pregnancy. Talk with your doctor before using this product if you're pregnant or planning to become pregnant.
Can I take this while breastfeeding?
That depends on the specific ingredients. Lactase is okay, but papain, bromelain, protease, lipase, and phytase don't have enough safety data for breastfeeding to make a clear recommendation. Ask your doctor or pharmacist for personalized advice.
What's papain and what does it do?
Papain is an enzyme from papaya fruit that helps break down protein during digestion. The research on whether it actually improves digestion or treats other conditions isn't clear enough yet.
Does bromelain really help with digestion?
Bromelain is a protein-digesting enzyme from pineapple. We don't have reliable evidence yet that it helps with digestive issues, allergies, burns, or other conditions it's sometimes promoted for.
What about lactase — does that actually work?
Yes — lactase is rated effective for lactose intolerance. If you have trouble digesting milk sugar, lactase can help break it down so you don't get cramping, bloating, or diarrhea.
Are there any common side effects I should know about?
Most people tolerate these enzymes fine. The most common side effects are mild digestive upset like diarrhea, gas, or headache, and allergic reactions in people sensitive to the enzyme proteins. High doses of papain may cause stomach irritation or more serious effects.

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.

Extra Care Digest Smart label
Sources

Sources & How We Checked

Extra Care Digest Smart'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 167 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
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Proteolytic Enzymes (proteases) 3 references
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Lactase 1 reference
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Stevia 10 references
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Adenosine 10 references
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Ginger 64 references
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Peppermint 41 references
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See these in context on the Peppermint monograph →

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

© 2021 Therapeutic Research Center, LLC

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