Interactions on record — worth a quick check against your medications. Based on 5 of 9 ingredients. Check your meds →
Dietary supplement

Full Spectrum Optimum Enzymes Ingredients & Drug Interactions

by Bluebonnet

Full Spectrum Optimum Enzymes label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Full Spectrum Optimum Enzymes 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

Full Spectrum Optimum Enzymes is a dietary supplement by Bluebonnet with 9 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, 365 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Anise, Powder, 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 Full Spectrum Optimum Enzymes by Bluebonnet

Ask about any prescription or over-the-counter medication and we check it for interactions with Full Spectrum Optimum Enzymes by Bluebonnet — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Full Spectrum Optimum Enzymes by Bluebonnet

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 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 9 of its 9 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains 9 ingredients, 6 of which are active enzymes and one herbal component. Papain and bromelain are proteases — enzymes that break down proteins.

Lipase breaks down fats, while amylase, glucoamylase, cellulase, and Protease 4.5 break down carbohydrates or other food components. Anise powder is included for its traditional use.

The remaining ingredients are inactive — hypromellose, purified water, beet root fiber, and magnesium stearate are fillers and capsule materials.

Does it work?

Not established
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
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use.

Why this rating?
  • The label markets this product for: digestive enzyme support for nutrient breakdown.
  • We looked for evidence on: Dyspepsia, Exercise-induced muscle soreness, Postoperative swelling, Sprains, Wound healing, Bloating — and 2 related terms.
  • The closest evidence on file: Papain is rated "Insufficient Reliable Evidence To Rate" for Exercise-induced muscle soreness (Natural Medicines).
  • Also on file: Papain is rated "Insufficient Reliable Evidence To Rate" for Wound healing.
  • Also on file: Lipase is rated "Insufficient Reliable Evidence To Rate" for Dyspepsia.

The evidence supporting these enzymes is limited. For papain, bromelain, and anise, the data we hold shows insufficient reliable evidence to rate their use for the conditions they're traditionally used for — papain for cancer, dental health, and muscle soreness; bromelain for allergies, burns, and diabetes; anise for migraines, menopause symptoms, and period pain.

Lipase and the other enzymes also lack established evidence in our data. Before relying on this product for any specific health goal, talk with your pharmacist or doctor about what the research actually shows.

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

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 5 of the 5 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 5 of 5.
  • General safety write-ups exist for 5 of 5.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Papain is generally tolerated as a food but may irritate the digestive tract or trigger allergic reactions in sensitive people. High doses can rarely cause severe stomach damage or esophageal perforation.

Avoid concentrated papain and unripe papaya products in pregnancy; safety data for breastfeeding is too limited. Bromelain is generally well tolerated short-term; long-term safety data is limited.

Common side effects include diarrhea, gas, and stomach upset. It's best avoided in pregnancy and while breastfeeding.

Anise is generally safe as a food or tea but should not be used in medicinal amounts during pregnancy. Lipase and Protease 4.5 are generally well tolerated, though little pregnancy and breastfeeding data exists — check with your doctor if you're pregnant or nursing.

Side effects, ingredient by ingredient Papain Bromelain Lipase Anise 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 5 matched ingredients can interact with medications — Papain, Anise, Bromelain.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications.
  • For scale: 365 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 pharmacist if you take warfarin or other blood thinners — papain and bromelain both carry Moderate risks. Also flag any use of birth control pills, estrogen replacement therapy, diabetes medications, fluoxetine (Prozac), imipramine (Tofranil), codeine, diazepam (Valium), caffeine, or tetracycline antibiotics — anise has Moderate interactions with most of these.

Blood thinner (anticoagulant or antiplatelet) and tetracycline users are the top priority.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.

This enzyme product is not suitable if you take warfarin or other blood thinners without checking with your pharmacist first. If you take diabetes medications, birth control, antidepressants, or sedatives, review your medications before starting — anise in particular has multiple theoretical interactions.

Women who are pregnant or breastfeeding should talk with their doctor or pharmacist before use.

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

Assessment coverage: 5 of 9 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 25, 2024.

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 Full Spectrum Optimum Enzymes, straight from the product label.

Brand Bluebonnet
Barcode (UPC) 743715009042
Net contents 90 Vegetable Capsule(s)
Market status On market
Date entered into DSLD Sep 25, 2024
DSLD ID 317133
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegan, Vegetarian, Adult (18 - 50 Years), Kosher, No Allergies, Gluten Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Full Spectrum Optimum Enzymes by Bluebonnet, 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
90
UPC/BARCODE
743715009042
IngredientAmount% DV
Papain25 mg--
Bromelain21.3 mg--
Lipase9.4 mg--
Cellulase3.8 mg--
Amylase21 mg--
Glucoamylase10 mg--
CereCalase10 mg--
Anise, Powder22.5 mg--
Protease 4.512.5 mg--

Other ingredients: Hypromellose, Water, Purified, Beet root Fiber, Magnesium Stearate

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

Directions: As a dietary supplement, take one capsule at the beginning of a meal or as directed by a healthcare practitioner.

Storage

Store tightly closed in a cool, dry place.

Formula

Bluebonnet's Full Spectrum Optimum Enzymes Vegetable Capsules are formulated with a combination of plant-based enzymes that help support the breakdown of a balanced diet of protein, carbohydrates, and fats for digestive health.

Bluebonnet's KOF-K Certification #K-0000700

K Parve (Kosher)

Formulation

Free of milk, egg, fish, crustacean shellfish, tree nuts, peanuts, wheat, soybeans and sesame. Also free of gluten, barley, sodium and sugar.

Made in USA from domestic and imported ingredients.

Digestive support

V Vegan

Gluten free

Precautions

Caution: Do not use in cases of stomach pain or ulcers.

Keep out of reach of children.

Contains: sulfites (papaya)

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.

Brand IP Statement(s)

N-Zimes

Seals/Symbols

V Vegan K Parve (Kosher)

FDA Statement of Identity

Dietary Supplement

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

See for yourself

Full Spectrum Optimum Enzymes by Bluebonnet label

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

Full Spectrum Optimum Enzymes 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 Full Spectrum Optimum Enzymes by Bluebonnet

These are the 9 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container90 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.

Papain

Interacts with
2 drugs
25 mg per serving

Papain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food an...

Papain monograph & interactions

Bromelain

Interacts with
141 drugs
21.3 mg per serving

Bromelain is a group of protein-digesting enzymes from pineapple that people take mainly for inflammation, swelling, and sinus problems. Some early st...

Bromelain monograph & interactions

Lipase

No known
interactions
9.4 mg per serving

Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy fo...

Lipase monograph & interactions

Cellulase

3.8 mg per serving

Amylase

21 mg per serving

Glucoamylase

10 mg per serving

CereCalase

10 mg per serving

Anise, Powder

Interacts with
245 drugs
22.5 mg per serving

Anise is a fragrant, licorice-flavored seed used for centuries to ease digestion and soothe coughs. Most of its health claims are based on tradition a...

Anise, Powder monograph & interactions

Protease 4.5

No known
interactions
12.5 mg per serving

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

Protease 4.5 monograph & interactions

Other (inactive) ingredients: Hypromellose, Water, Purified, Beet root Fiber, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.

Interaction report

Full Spectrum Optimum Enzymes by Bluebonnet Drug Interactions

Want to check YOUR meds against Full Spectrum Optimum Enzymes?

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
365Drugs
297 Moderate 68 Minor

Ingredients driving the most interactions

Anise, Powder 245
Bromelain 141
Papain 2

Individual Drug Interactions

The ingredients in Full Spectrum Optimum Enzymes interact with 365 drugs. Click any drug to see the details.

3 of the 9 ingredients in Full Spectrum Optimum Enzymes interact with drugs. Each result below shows which ingredient is responsible. Anise, Powder Bromelain Papain

Each ingredient & the kinds of drugs it affects

For each ingredient in Full Spectrum Optimum Enzymes 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.

Anise, Powder11 drug types · 245 drugs

Antidiabetes Drugs

Theoretically, anise seed might increase the risk of hypoglycemia when taken with antidiabetes drugs.
A small clinical study shows that anise seed powder decreases fasting blood glucose levels by 36% when compared to baseline.

Likelihood Possible Evidence B
Caffeine

Theoretically, anise oil might decrease the efficacy of caffeine.
Animal research shows that taking anise oil with caffeine decreases the bioavailability of caffeine. Whether this interaction will occur in humans is unclear.

Likelihood Possible Evidence D
Codeine

Theoretically, anise oil might increase the effects and adverse effects of codeine.
Animal research shows that anise oil increases the analgesic effects of codeine, possibly by inducing its phase I metabolism and increasing conversion to morphine. Whether this interaction occurs in humans is unclear.

Likelihood Possible Evidence D
Contraceptive Drugs

Theoretically, anise might interfere with contraceptive drug therapy.
Some in vitro research suggests that anise has estrogenic effects, while other in vitro research suggests that anise has antiestrogenic effects.

Likelihood Possible Evidence D
Diazepam (Valium)

Theoretically, anise oil might increase the effects and adverse effects of diazepam.
Animal research shows that taking anise oil with diazepam increases the motor impairment associated with diazepam, possibly by inhibiting its breakdown by cytochrome P450 3A4. Whether this interaction occurs in humans is unclear.

Likelihood Possible Evidence D
Estrogens

Theoretically, anise might interfere with estrogen-based hormone replacement therapy.
Some in vitro research suggests that anise has estrogenic effects, while other in vitro research suggests that anise has antiestrogenic effects.

Likelihood Possible Evidence D
Fluoxetine (Prozac)

Theoretically, anise oil might decrease the efficacy of fluoxetine.
Animal research shows that taking anise oil with fluoxetine reduces the antidepressant effects of fluoxetine, possibly by promoting its breakdown by cytochrome P450 2D6. Whether this interaction occurs in humans is unclear.

Likelihood Possible Evidence D
Imipramine (Tofranil)

Theoretically, anise oil might decrease the efficacy of imipramine.
Animal research shows that taking anise oil with imipramine reduces the antidepressant effects of imipramine, possibly by promoting its breakdown by cytochrome P450 2D6. Whether this interaction occurs in humans is unclear.

Likelihood Possible Evidence D
Midazolam (Versed)

Theoretically, anise oil might increase the effects and adverse effects of midazolam.
Animal research shows that taking anise oil with midazolam increases the motor impairment associated with midazolam, possibly by inhibiting its breakdown by cytochrome P450 3A4. Whether this interaction occurs in humans is unclear.

Likelihood Possible Evidence D
Tamoxifen (Nolvadex)

Theoretically, anise might interfere with tamoxifen therapy.
Some in vitro research suggests that anise has estrogenic effects, while other in vitro research suggests that anise has antiestrogenic effects.

Likelihood Possible Evidence D
Acetaminophen (Tylenol, Others)

Theoretically, anise oil might decrease the levels and clinical effects of acetaminophen.
Animal research shows that taking anise oil with acetaminophen decreases peak plasma levels of acetaminophen but does not reduce overall bioavailability. Whether this interaction will occur in humans is unclear.

Likelihood Possible Evidence D
Anise, Powder full monograph & interactions

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 Full Spectrum Optimum Enzymes, from the product label.

Bluebonnet

Name
Bluebonnet Nutrition Corporation
Street Address
12915 Dairy Ashford
City
Sugar Land
State
Texas
ZipCode
77478
Web Address
www.bluebonnetnutrition.com
Pharmacist Counseling Corner

Full Spectrum Optimum Enzymes by Bluebonnet: Common Questions

Does Full Spectrum Optimum Enzymes by Bluebonnet interact with any medications?
Yes. Based on its ingredients, Full Spectrum Optimum Enzymes has a known interaction with 365 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Full Spectrum Optimum Enzymes contains 9 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 this safe to take if I'm pregnant or breastfeeding?
The safety data for these ingredients during pregnancy and breastfeeding is very limited. Papain and bromelain are best avoided in pregnancy, and there isn't enough data on most of these enzymes during either pregnancy or breastfeeding. Talk with your doctor or pharmacist before using this product if you're pregnant, planning to become pregnant, or nursing.
What are the most common side effects?
Papain and bromelain may cause digestive upset — diarrhea, gas, stomach cramps — or allergic reactions in sensitive people. Anise is well tolerated but can rarely cause allergic reactions. Lipase and the other enzymes haven't reported common side effects in the data we hold, though digestive upset is possible.
Does this product actually help with digestion?
The evidence in our data is insufficient to rate how well these enzymes work for digestion or any other condition. While enzymes are thought to aid breakdown of food, we don't have reliable studies showing this product helps you digest better.
Can I take this with my tetracycline antibiotic?
Bromelain in this product may theoretically increase tetracycline levels, though human studies show mixed results. It's rated Moderate for caution. Check with your pharmacist — they can tell you whether it's safe in your case or if timing doses differently would help.
Why does anise have so many interactions?
Anise contains compounds that may affect how your body breaks down certain medications or how hormones and blood sugar are managed. Most of these interactions come from animal studies, so it's unclear if they happen in humans — but they're serious enough to flag. Your pharmacist can help you figure out which ones matter for your medications.
Are there any fillers or extra ingredients I should know about?
Yes — the capsule contains hypromellose, purified water, beet root fiber, and magnesium stearate as inactive ingredients. These are standard capsule materials and don't count as active ingredients.

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

Not sure if Full Spectrum Optimum Enzymes is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

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.

Full Spectrum Optimum Enzymes label
Go deeper

The Full Monographs Behind Full Spectrum Optimum Enzymes’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

Anise

Interacts with 245 drugs

Anise is a fragrant, licorice-flavored seed used for centuries to ease digestion and soothe coughs. Most of its health claims are based on tradition and small or laboratory studies rather th...

Read the full Anise 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

Full Spectrum Optimum Enzymes'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 46 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 →

Anise 12 references
  1. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
  2. Kassi E, Papoutsi Z, Fokialakis N, et al. Greek plant extracts exhibit selective estrogen receptor modulator (SERM)-like properties. J Agric Food Chem 2004;52:6956-61. PubMed
  3. Mumcuoglu KY, Miller J, Zamir C, et al. The in vivo pediculicidal efficacy of a natural remedy. Isr Med Assoc J 2002;4:790-3.
  4. Garcia-Gonzalez JJ, Bartolome-Zavala B, Fernandez-Melendez S, et al. Occupational rhinoconjunctivitis and food allergy because of aniseed sensitization. Ann Allergy Asthma Immunol 2002;88:518-22. . PubMed
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  6. Gonzalez-Gutierrez, M. L., Sanchez-Fernandez, C., Esteban-Lopez, M. I., Sempere-Ortells, J. M., and Diaz-Alperi, P. Allergy to anis. Allergy 2000;55(2):195-196.
  7. Anliker, M. D., Borelli, S., and Wuthrich, B. Occupational protein contact dermatitis from spices in a butcher: a new presentation of the mugwort-spice syndrome. Contact Dermatitis 2002;46(2):72-74. PubMed
  8. Poon, T. S. and Freeman, S. Cheilitis caused by contact allergy to anethole in spearmint flavoured toothpaste. Australas.J Dermatol. 2006;47(4):300-301. PubMed
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See these in context on the Anise 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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