Interactions on record — worth a quick check against your medications. Based on 7 of 14 ingredients. Check your meds →
Dietary supplement

Isotonix Digestive Enzymes Ingredients & Drug Interactions

by Might-A-Mins Spectrum

Isotonix Digestive Enzymes label
See full label image
Powder Category: Other Combinations
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 Isotonix Digestive 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

Isotonix Digestive Enzymes is a dietary supplement by Might-A-Mins Spectrum with 14 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, 253 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Bromelain, Potassium, Glutamine. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Isotonix Digestive Enzymes by Might-A-Mins Spectrum

Ask about any prescription or over-the-counter medication and we check it for interactions with Isotonix Digestive Enzymes by Might-A-Mins Spectrum — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Isotonix Digestive Enzymes by Might-A-Mins Spectrum

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 Aug 6, 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 13 of its 13 active ingredients.
  • “Digezyme” is listed as a grouped ingredient — the label gives one combined amount (50 mg) without saying how much of each component you get.

This powder contains 13 active ingredients — a blend of digestive enzymes and supporting compounds. The main enzymes are amylase (which breaks down starch), papain (from papaya), bromelain (from pineapple), protease and proteolytic enzymes (which break down protein), lipase (which breaks down fat), lactase (which breaks down milk sugar), cellulase, maltase, and sucrase.

It also includes glutamine, an amino acid, and potassium. The product also contains inactive ingredients like fructose, citric acid, dextrose, magnesium carbonate, maltodextrin, silicon dioxide, calcium sulfate, apple fiber, apple cider, and lemon and lime flavoring.

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: promotes stomach comfort and digestive enzyme function.
  • We looked for evidence on: Dyspepsia, Lactose intolerance, Diarrhea, Irritable bowel syndrome (IBS), Inflammatory bowel disease (IBD), Crohn disease — and 4 related terms.
  • The strongest evidence on file: Lactase is rated "Effective" for Lactose intolerance (Natural Medicines).
  • Also on file: Glutamine is rated "Possibly Effective" for Pancreatitis.
  • Also on file: Glutamine is rated "Possibly Ineffective" for Crohn disease, Radiation-induced diarrhea.

The evidence for most of these ingredients is not well established in the data we hold. Lactase is effective for lactose intolerance — if you have trouble digesting dairy, this enzyme works.

Glutamine is effective for sickle cell disease and possibly effective for HIV/AIDS-related wasting, postoperative recovery, and critical illness from trauma. Papain, bromelain, protease, lipase, potassium, and the other enzymes have insufficient reliable evidence in our data to rate their effectiveness for any condition.

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

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 these enzymes are generally well tolerated at normal doses. Papain may irritate your digestive tract or trigger allergic reactions in sensitive people, including itchy watery eyes, sneezing, abdominal cramps, and diarrhea — concentrated papain and unripe papaya products are best avoided in pregnancy due to safety concerns, and there isn't enough safety data for bromelain during breastfeeding so it should be avoided.

Bromelain's most common side effects are diarrhea, flatulence, upset stomach, and headache. Glutamine may cause belching, bloating, constipation, flatulence, nausea, vomiting, and gastrointestinal pain, especially at higher doses.

Potassium can cause nausea, vomiting, abdominal pain, diarrhea, and flatulence; dangerously high potassium levels are rare but serious and can affect your heart rhythm and blood pressure, particularly in people with kidney disease.

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

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?
  • 4 of the 7 matched ingredients can interact with medications — Papain, Potassium, Glutamine, Bromelain.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; seizure medications.
  • For scale: 253 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 this product, double-check with your doctor or pharmacist if you take warfarin or other blood thinners (papain and bromelain may increase bleeding risk), anticonvulsant seizure medications (glutamine may reduce their effectiveness), potassium-sparing diuretics, ACE inhibitors, or ARBs — potassium in this supplement combined with these drugs raises your risk of dangerously high blood potassium levels. Also check if you take tetracycline antibiotics.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This product is mainly for people who want enzyme support for digestion. It's not for you if you take warfarin, blood thinners, antiplatelet drugs, anticonvulsants, potassium-sparing diuretics, or certain blood pressure medications without first checking with your doctor or pharmacist.

Pregnant and breastfeeding people should talk with their healthcare provider before starting, especially because safety data for papain and bromelain during pregnancy and nursing are limited or advise against use.

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

Assessment coverage: 9 of 13 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 23, 2012.

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 Isotonix Digestive Enzymes, straight from the product label.

Brand Might-A-Mins Spectrum
Net contents 300 g; 10.6 oz.
Market status On market
Date entered into DSLD Feb 23, 2012
DSLD ID 6194
Product type Other Combinations
Supplement form Powder
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Children 4 or More Years of Age, Adult (18 - 50 Years), Children more than 1 but less than 4
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 Isotonix Digestive Enzymes by Might-A-Mins Spectrum, 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:
3.3 Gram(s)
Maximum serving Sizes:
3.3 Gram(s)
Servings per container
90
IngredientAmount% DV
Calories10 {Calories}--
Total Carbohydrates2 g1%
Sugar2 g--
Amylase1200 DU--
Papain1500000 FCC--
Bromelain1024000 FCC--
Protease300 PC--
Lipase50 FIP--
Lactase200 LAC--
Cellulase10 CU--
Glutamine333 mg--
Maltase75 MWU--
Digezyme50 mg--
Potassium100 mg3%
Sucrase200 SU--
Caso-Glut SP 5005000 U--
Protease150 IU--

Other ingredients: Fructose, Citric Acid, Dextrose, Magnesium Carbonate, Maltodextrin, Silicon Dioxide, Calcium Sulfate, Apple Fiber, Apple Cider, Lemon flavor, Lime flavor

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.
FDA Statement of Identity

An Isotonic-Capable Dietary Supplement

Suggested/Recommended/Usage/Directions

Directions for use: For children 2 and older, pour 1 level, white bottle capful of powder into the overcap. Add water to the line on the overcap (60 ml/2 fl. oz.) and stir. As a dietary supplement, take with each meal, 3 times per day, or as directed by your physician. Additional servings may be taken if necessary. This product is isotonic only if the specified amounts of powder and water are used.

Precautions

KEEP OUT OF THE REACH OF CHILDREN.

Warning: If you are currently taking anticonvulsants, antibiotics, anti-coagulant/antiplatelet drugs or any other prescription medications, or have an ongoing medical condition, you should consult your physician before using this product. Women who are pregnant or nursing should not take this product.

Do not use if safety seal is broken or missing.

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.

Storage

Store in a cool, dry place.

General Statements

Made in the USA

DU, PC, LAC, FIP, CU, MWU, FCC, U, IU = Units of enzyme activity.

Promotes stomach comfort†

Provides enzymes that promote the absorption of nutrients†

Supports a healthy digestive tract†

Supports normal digestion†

Brand IP Statement(s)

DigeZyme is registered trademark of the Sabinsa Corporation.

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

See for yourself

Isotonix Digestive Enzymes by Might-A-Mins Spectrum label

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

Isotonix Digestive 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 Isotonix Digestive Enzymes by Might-A-Mins Spectrum

These are the 14 active ingredients this product is made of. Select any to open its full monograph.

Serving size3.3 Gram(s) Dosage formPowder 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.

Sugar

2 g per serving

Papain

Interacts with
2 drugs
1500000 FCC 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
1024000 FCC 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

Glutamine

Interacts with
50 drugs
333 mg per serving

Glutamine is the most abundant amino acid in the body and is usually made in your muscles. A prescription form is FDA-approved to help reduce sickle c...

Glutamine monograph & interactions

Maltase

75 MWU per serving

Digezyme

50 mg per serving

Potassium

Interacts with
62 drugs
100 mg per serving Form: Potassium Bicarbonate

Potassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanc...

Potassium monograph & interactions

Sucrase

200 SU per serving

Caso-Glut SP 500

No known
interactions
5000 U per serving Form: Protease

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

Caso-Glut SP 500 monograph & interactions

Protease

No known
interactions
150 IU per serving Form: Actinidin, Kiwi

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

Protease monograph & interactions

Other (inactive) ingredients: Fructose, Citric Acid, Dextrose, Magnesium Carbonate, Maltodextrin, Silicon Dioxide, Calcium Sulfate, Apple Fiber, Apple Cider, Lemon flavor, Lime flavor. These complete the product’s ingredient list but are not active constituents.

Interaction report

Isotonix Digestive Enzymes by Might-A-Mins Spectrum Drug Interactions

Want to check YOUR meds against Isotonix Digestive 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
253Drugs
234 Moderate 19 Minor

Ingredients driving the most interactions

Bromelain 141
Potassium 62
Glutamine 50
Papain 2

Individual Drug Interactions

The ingredients in Isotonix Digestive Enzymes interact with 253 drugs. Click any drug to see the details.

4 of the 14 ingredients in Isotonix Digestive Enzymes interact with drugs. Each result below shows which ingredient is responsible. Bromelain Potassium Glutamine Papain

Each ingredient & the kinds of drugs it affects

For each ingredient in Isotonix Digestive 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.

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

Potassium3 drug types · 62 drugs

Ace Inhibitors (Aceis)

Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
ACEIs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.

Likelihood Likely Evidence C
Angiotensin Receptor Blockers (Arbs)

Using ARBs with high doses of potassium increases the risk of hyperkalemia.
ARBs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.

Likelihood Likely Evidence C
Potassium-Sparing Diuretics

Concomitant use increases the risk of hyperkalemia.
Using potassium-sparing diuretics with potassium supplements increases the risk of hyperkalemia.

Likelihood Likely Evidence C
Potassium full monograph & interactions

Glutamine1 drug type · 50 drugs

Anticonvulsants

Theoretically, glutamine might antagonize the effects of anticonvulsant medications.
Glutamine is metabolized to the excitatory neurotransmitter glutamate. Glutamate might have antagonistic effects with anticonvulsant drugs. However, this interaction has not yet been reported in humans.

Likelihood Possible Evidence D
Glutamine 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 Isotonix Digestive Enzymes, from the product label.

Might-A-Mins Spectrum

See all Might-A-Mins Spectrum products
Name
Market America, Inc.
Street Address
1302 Pleasant Ridge Road
City
Greensboro
State
NC
ZipCode
27409
Pharmacist Counseling Corner

Isotonix Digestive Enzymes by Might-A-Mins Spectrum: Common Questions

Does Isotonix Digestive Enzymes by Might-A-Mins Spectrum interact with any medications?
Yes. Based on its ingredients, Isotonix Digestive Enzymes has a known interaction with 253 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Isotonix Digestive Enzymes contains 14 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Does this contain potassium, and is that a problem for me?
Yes, potassium is one of the 13 active ingredients. Potassium from food is fine for most people, but if you take potassium-sparing diuretics (like spironolactone), ACE inhibitors, or ARBs for blood pressure, or if you have kidney disease, tell your doctor or pharmacist before taking this — the potassium in this supplement could raise your blood potassium to unsafe levels.
Can I take this if I'm pregnant?
Check with your doctor first. Papain is best avoided in pregnancy due to safety concerns, and there isn't enough safety data for bromelain during pregnancy. Glutamine and lactase are likely safe in pregnancy, and potassium from a normal diet is fine, but supplements should only be used if your doctor recommends them.
Does this actually help with digestion?
The evidence isn't established in our data for most of these enzymes. Lactase definitely works if you have trouble digesting lactose (milk sugar). Glutamine has good evidence for sickle cell disease and possibly helps with recovery from surgery or critical illness, but we don't have strong evidence for the other digestive enzymes in this blend.
What are the most common side effects?
Bromelain may cause diarrhea, gas, upset stomach, or headache. Glutamine may cause bloating, flatulence, nausea, vomiting, or stomach pain, especially at higher doses. Potassium can cause nausea, vomiting, stomach pain, and diarrhea. Papain may trigger allergic reactions like sneezing, itchy eyes, or stomach cramps in sensitive people.
Is this safe to breastfeed while taking it?
There isn't enough safety data for bromelain while breastfeeding, so it's best avoided. Safety data for protease is also limited. Lactase is likely safe, and potassium from a normal diet is fine. Talk with your doctor or pharmacist before taking this while breastfeeding.
What if I take warfarin — can I use this?
No, not without checking first. Papain in this product may increase warfarin's effects and your bleeding risk — one case report documented someone whose blood-thinning level became dangerously high after taking a papain supplement. Talk with your doctor or pharmacist before using it.

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

Not sure if Isotonix Digestive Enzymes is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

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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.

Isotonix Digestive Enzymes label
Go deeper

The Full Monographs Behind Isotonix Digestive 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

Glutamine

Interacts with 50 drugs

Glutamine is the most abundant amino acid in the body and is usually made in your muscles. A prescription form is FDA-approved to help reduce sickle cell disease complications, but for most...

Read the full Glutamine 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 → 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

Potassium

Interacts with 62 drugs

Potassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanced diet rich in fruits and vegetables. P...

Read the full Potassium monograph →
Sources

Sources & How We Checked

Isotonix Digestive 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 58 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 →

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 →

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

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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 →

Glutamine 11 references
  1. Miller AL. Therapeutic considerations of L-glutamine: a review of the literature. Altern Med Rev 1999;4:239-48..
  2. Bozzetti F, Biganzoli L, Gavazzi C, et al. Glutamine supplementation in cancer patients receiving chemotherapy: a double-blind randomized study. Nutrition 1997;13:748-51.. PubMed
  3. Mebane AH. L-Glutamine and mania. Am J Psychiatry 984;141:1302-3.
  4. Meldrum BS. Glutamate as a neurotransmitter in the brain: review of physiology and pathology. J Nutr 2000;130:1007S-15S.. PubMed
  5. Garlick PJ. Assessment of the safety of glutamine and other amino acids. J Nutr 2001;131:2556S-61S.. PubMed
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  8. Laviano A, Molfino A, Lacaria MT, Canelli A, De Leo S, Preziosa I, Rossi Fanelli F. Glutamine supplementation favors weight loss in nondieting obese female patients. A pilot study. Eur J Clin Nutr. 2014 Nov;68(11):1264-6. PubMed
  9. Endari (l-glutamine) [package insert]. Torrance, CA: Emmaus Medical,Inc; 2017.
  10. Niihara Y, Miller ST, Kanter J, et al. A Phase 3 Trial of l-Glutamine in Sickle Cell Disease. N Engl J Med 2018;379(3):226-35. doi: 10.1056/NEJMoa1715971.
  11. Ogden HB, Child RB, Fallowfield JL, et al. Gastrointestinal Tolerance of Low, Medium and High Dose Acute Oral l-Glutamine Supplementation in Healthy Adults: A Pilot Study. Nutrients. 2020;12(10):2953. PubMed

See these in context on the Glutamine monograph →

Potassium 12 references
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. Gennaro A. Remington: The Science and Practice of Pharmacy. 19th ed. Lippincott: Williams & Wilkins, 1996.
  3. Whelton PK, He J, Cutler JA, et al. Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA 1997;277:1624-32. PubMed
  4. Phillips, C. O., Kashani, A., Ko, D. K., Francis, G., and Krumholz, H. M. Adverse effects of combination angiotensin II receptor blockers plus angiotensin-converting enzyme inhibitors for left ventricular dysfunction: a quantitative review of data from ra DOI
  5. Altieri, P. I., Herrero, C., Suero, R., and Ortiz, A. Bleeding duodenal ulcer in a patient taking slow-releasing potassium tablets. Bol.Asoc.Med P.R. 1977;69(8):276.
  6. Raf, L. E. Enteric-coated potassium chloride tablets and ulcer of the small intestine. Acta Chir Scand Suppl 1967;(374):1-87.
  7. Potassium chloride oral solution [package insert]. Allentown, PA: Lehigh Valley Technologies, Inc.; 2014.
  8. Potassium chloride injection [package insert]. Lake Forest, IL: Hospira Inc.; 2009.
  9. Patel RB, Tannenbaum S, Viana-Tejedor A, et al. Serum potassium levels, cardiac arrhythmias, and mortality following non-ST-elevation myocardial infarction or unstable angina: insights from MERLIN-TIMI 36. Eur Heart J Acute Cardiovasc Care 2017 Feb;6(1):1 PubMed
  10. Malta D, Arcand J, Ravindran A, Floras V, Allard JP, Newton GE. Adequate intake of potassium does not cause hyperkalemia in hypertensive individuals taking medications that antagonize the renin angiotensin aldosterone system. Am J Clin Nutr 2016 Oct;104(4 PubMed
  11. Keskin M, Kaya A, Tatlisu MA, et al. The effect of serum potassium level on in-hospital and long-term mortality in ST elevation myocardial infarction. Int J cardiol. 2016 Oct 15;221:505-10.
  12. Stallings VA, Harrison M, Oria M; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Washington (DC): National Acad

See these in context on the Potassium 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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