Major interaction on record — check this product against your medications before combining. Check your meds →
Dietary supplement

Joint Flex Ingredients & Drug Interactions

by Priority One Nutritional Supplements

Joint Flex label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Joint Flex 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: Major

Joint Flex is a dietary supplement by Priority One Nutritional Supplements with 5 active ingredients. Its ingredients are commonly taken for inflammation and swelling, sinus and nasal congestion, digestion support.Based on those ingredients, 1,147 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Indian Frankincense Resin Extract, Glucosamine Hydrochloride, Bromelain. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Joint Flex by Priority One Nutritional Supplements

Ask about any prescription or over-the-counter medication and we check it for interactions with Joint Flex by Priority One Nutritional Supplements — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Joint Flex by Priority One Nutritional Supplements

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 13, 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 5 of its 5 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Joint Flex contains five active ingredients. Bromelain is an enzyme from pineapple that may help with inflammation.

Chondroitin sulfate and glucosamine hydrochloride are compounds naturally found in cartilage that some people take for joint health. Manganese is a mineral, and Indian frankincense resin extract (from Boswellia serrata) is a plant-based anti-inflammatory ingredient.

The product also contains inactive ingredients—silicon dioxide, maltodextrin, sodium sulfate, and the capsule material itself—which serve as fillers and binders.

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: Joint pain and cartilage support.
  • We looked for evidence on: Joint pain, Knee pain, Osteoarthritis, Rheumatoid arthritis (RA), Exercise-induced muscle soreness, Postoperative pain — and 3 related terms.
  • The strongest evidence on file: Glucosamine is rated "Likely Effective" for Osteoarthritis (Natural Medicines).
  • Also on file: Boswellia Serrata is rated "Possibly Effective" for Osteoarthritis.
  • Also on file: Chondroitin Sulfate is rated "Possibly Effective" for Osteoarthritis.

Glucosamine is listed as likely effective for osteoarthritis. Chondroitin sulfate and Indian frankincense resin extract are both rated possibly effective for osteoarthritis.

Manganese is effective for treating manganese deficiency, though that's not a typical reason people take joint supplements. For the other uses these ingredients are sometimes marketed for—hay fever, burns, cancer, back pain, and skin aging—the evidence in our data is insufficient to rate them, which means we don't have enough reliable data to say whether they work.

The evidence, ingredient by ingredient Bromelain Chondroitin Sulfate Glucosamine Manganese Boswellia Serrata

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.

Bromelain, chondroitin sulfate, and glucosamine are generally well tolerated short-term, though long-term safety data is limited for bromelain and chondroitin. The most common side effects are digestive: diarrhea, constipation, bloating, nausea, and abdominal pain.

Bromelain may rarely cause allergic reactions, including IgE-mediated reactions and, if inhaled, asthma. Glucosamine has been associated with hypersensitivity reactions in some people, and there are rare case reports of severe reactions and anaphylaxis.

Both glucosamine and chondroitin have rare reports of asthma exacerbation when taken together. Manganese is safe in normal dietary amounts but can cause serious neurotoxicity (Parkinson-like symptoms) and liver damage at high doses.

Indian frankincense resin extract is generally well tolerated, though dizziness, headache, and vertigo have been reported, and one case of bezoar (an intestinal blockage) occurred in someone who chewed large amounts of the raw resin. Pregnancy and breastfeeding safety data are limited for bromelain, chondroitin, glucosamine, and Indian frankincense—the facts advise against them in pregnancy.

For breastfeeding, bromelain and chondroitin safety is unknown; glucosamine safety is also unknown; manganese lactation ratings in the data are conflicting; and Indian frankincense is rated likely safe. Talk with your doctor or pharmacist about your individual pregnancy or breastfeeding situation before taking this product.

Side effects, ingredient by ingredient Bromelain Chondroitin Sulfate Glucosamine Manganese Boswellia Serrata

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 5 matched ingredients can interact with medications — Boswellia Serrata, Manganese, Chondroitin Sulfate, Glucosamine, Bromelain.
  • 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: 1,148 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.

If you take warfarin or other blood thinners (anticoagulants), talk with your doctor or pharmacist before starting Joint Flex—glucosamine carries a Major interaction risk. Also check before taking if you use antipsychotic drugs, tetracycline or quinolone antibiotics, immunosuppressant drugs, or any medication your liver metabolizes (your pharmacist can tell you which ones those are), because Indian frankincense resin extract and manganese in this product may affect them.

No interactions are documented for the other active ingredient we could check.

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

Joint Flex may be worth considering if you're looking for osteoarthritis support, since glucosamine and two other ingredients have some evidence behind them. However, if you take warfarin or other blood thinners, antipsychotic drugs, tetracycline or quinolone antibiotics, immunosuppressants, or any medication processed by your liver, you'll need to check this product carefully against your specific drugs—the interaction potential is real.

Pregnant and breastfeeding people should talk with their doctor or pharmacist before starting it. Run your medications through the checker on this page, then discuss the results with your own healthcare provider.

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

Assessment coverage: 5 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 22, 2022.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Joint Flex, straight from the product label.

Brand Priority One Nutritional Supplements
Barcode (UPC) 815354020778
Net contents 120 Capsule(s)
Market status On market
Date entered into DSLD Nov 22, 2022
DSLD ID 277377
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 Joint Flex by Priority One Nutritional Supplements, 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:
2 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
60
UPC/BARCODE
815354020778
IngredientAmount% DV
Bromelain20 mg--
Chondroitin Sulfate600 mg--
Glucosamine Hydrochloride750 mg--
Manganese24 mg1043%
Indian Frankincense Resin Extract50 mg--

Other ingredients: Silicon Dioxide, Maltodextrin, Sodium Sulfate, Capsule

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.
Precautions

Warning: If you are pregnant or breast feeding, consult your physician before using this product.

Some ingredients derived from shellfish.

Keep out of reach of children.

Contains crustacean shellfish (crayfish).

Suggested/Recommended/Usage/Directions

Recommendations: Take two (2) capsules in the morning and two (2) capsules in the evening for the first 60 days, then adjust according to needs, or as directed by your physician.

Storage

Keep container tightly closed, store in a cool, dry place.

Formulation

Contains no preservatives.

Non-GMO

General Statements

Bisphenol-A (BPA) & Phthalate Free

For professional use only.

Seals/Symbols

GMP Certified

Brand IP Statement(s)

Priority One Nutritional Supplements Inc since 1988

FDA Statement of Identity

A Dietary Supplement

FDA Disclaimer Statement

This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.

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

See for yourself

Joint Flex by Priority One Nutritional Supplements label

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

Joint Flex 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 Joint Flex by Priority One Nutritional Supplements

These are the 5 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Capsule(s) Dosage formCapsule Servings per container60 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.

Bromelain

Interacts with
141 drugs
20 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

Chondroitin Sulfate

Interacts with
2 drugs
600 mg per serving

Chondroitin sulfate is a naturally occurring building block of cartilage that is widely taken, often with glucosamine, for osteoarthritis joint pain....

Chondroitin Sulfate monograph & interactions

Glucosamine Hydrochloride

Interacts with
170 drugs
750 mg per serving

Glucosamine is a natural compound found in cartilage and joint fluid, and it is one of the most popular supplements for osteoarthritis, especially of...

Glucosamine Hydrochloride monograph & interactions

Manganese

Interacts with
83 drugs
24 mg per serving Form: Manganese Ascorbate, Manganese Carbonate

Manganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get...

Manganese monograph & interactions

Indian Frankincense Resin Extract

Interacts with
952 drugs
50 mg per serving Form: Boswellic Acid

Boswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoart...

Indian Frankincense Resin Extract monograph & interactions

Other (inactive) ingredients: Silicon Dioxide, Maltodextrin, Sodium Sulfate, Capsule. These complete the product’s ingredient list but are not active constituents.

Interaction report

Joint Flex by Priority One Nutritional Supplements Drug Interactions

Want to check YOUR meds against Joint Flex?

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
1,147Drugs
2 Major 1,076 Moderate 69 Minor

Ingredients driving the most interactions

Indian Frankincense Resin Extract 952
Glucosamine Hydrochloride 170
Bromelain 141
Manganese 83
Chondroitin Sulfate 2

Individual Drug Interactions

The ingredients in Joint Flex interact with 1,147 drugs. Click any drug to see the details.

5 of the 5 ingredients in Joint Flex interact with drugs. Each result below shows which ingredient is responsible. Indian Frankincense Resin Extract Glucosamine Hydrochloride Bromelain Manganese Chondroitin Sulfate

Each ingredient & the kinds of drugs it affects

For each ingredient in Joint Flex 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.

Indian Frankincense Resin Extract6 drug types · 952 drugs

Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP1A2 enzymes.

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

Theoretically, Boswellia serrata might increase the levels of CYP2C19 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C19 enzymes.

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

Theoretically, Boswellia serrata might increase the levels of CYP2C9 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C9 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2D6 enzymes.

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

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP3A4 enzymes. Other in vitro research shows that Boswellia serrata extract inhibits CYP3A4 enzymes at most concentrations, although it may modestly induce enzyme activity at low concentrations.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, Boswellia serrata might alter the effects of immunosuppressive drugs.
Some in vitro research suggests that Boswellia serrata extracts might inhibit mediators of autoimmune disorders such as leukotrienes and reduce production of antibodies and cell-mediated immunity. However, other in vitro research suggests that, when coupled with calcium ions, boswellic acids containing the keto group have immunostimulant properties within specific cell signaling pathways.

Likelihood Possible Evidence D
Indian Frankincense Resin Extract full monograph & interactions

Glucosamine Hydrochloride4 drug types · 170 drugs

Warfarin (Coumadin)

Glucosamine might increase the anticoagulant effects of warfarin and increase the risk of bruising and bleeding.
In two individual case reports, glucosamine/chondroitin combinations were associated with a significant increase in international normalized ratio (INR) in patients previously stabilized on warfarin. In one case, the increase in INR occurred only after tripling the dose of a glucosamine/chondroitin supplement from 500 mg/400 mg daily to 1500/1200 mg daily. Additionally, 20 voluntary case reports to the U.S. Food & Drug Administration (FDA) have linked glucosamine plus chondroitin with increased INR, bruising, and bleeding in patients who were also taking warfarin. There have also been 20 additional case reports to the World Health Organization (WHO) that link glucosamine alone to increased INR in patients taking warfarin. The mechanism of this interaction is unclear. Glucosamine is a small component of heparin, but is not thought to have anticoagulant activity; however, animal research suggests that it might have antiplatelet activity.

Likelihood Probable Evidence D
Topoisomerase Ii Inhibitors

Theoretically glucosamine may induce resistance to topoisomerase II inhibitors.
In vitro research suggests that glucosamine might induce resistance to etoposide (VP16, VePesid) and doxorubicin (Adriamycin) by reducing inhibition of topoisomerase II, an enzyme required for DNA replication in tumor cells. This effect has not been reported in humans.

Likelihood Possible Evidence D
Acetaminophen (Tylenol, Others)

Acetaminophen might interfere with the activity of glucosamine sulfate by interacting with the sulfate portion.
Anecdotal reports suggest that adding glucosamine to an acetaminophen regimen might decrease pain control in patients with osteoarthritis. Some research suggests that the sulfate portion of glucosamine sulfate might contribute to its effect in osteoarthritis. Since acetaminophen metabolism requires sulfur and reduces serum sulfate concentrations, acetaminophen could theoretically interfere with the action of glucosamine sulfate. Conversely, the administration of sulfate could theoretically decrease the effectiveness of acetaminophen in sulfate-deficient people by increasing its clearance.

Likelihood Possible Evidence B
Antidiabetes Drugs

Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
In vitro and animal research has suggested that glucosamine might increase insulin resistance or decrease insulin production. This has raised concerns that taking glucosamine might worsen diabetes and decrease the effectiveness of diabetes drugs. However, clinical research suggests that glucosamine does not have adverse effects on blood glucose or glycated hemoglobin (HbA1C) in healthy, obese, or type 2 diabetes patients.

Likelihood Unlikely Evidence B
Glucosamine Hydrochloride 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

Manganese3 drug types · 83 drugs

Antipsychotic Drugs

Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Hallucinations and behavioral changes have been reported in a patient with liver disease who was taking haloperidol and manganese. Researchers speculate that taking manganese along with haloperidol, phenothiazine-derivatives, or other antipsychotic medications might increase the risk of manganese toxicity in some patients.

Likelihood Possible Evidence D
Quinolone Antibiotics

Theoretically, manganese might reduce the absorption of quinolone antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced quinolone absorption have been reported between quinolones and other multivalent cations, such as calcium and iron.

Likelihood Probable Evidence D
Tetracycline Antibiotics

Theoretically, manganese might reduce the absorption of tetracycline antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced tetracycline absorption have been reported between tetracyclines and other multivalent cations, such as calcium and iron.

Likelihood Probable Evidence D
Manganese full monograph & interactions

Chondroitin Sulfate1 drug type · 2 drugs

Warfarin (Coumadin)

Taking chondroitin in combination with glucosamine might increase the anticoagulant effects of warfarin. However, the effect of chondroitin alone is unclear.
There have been multiple reports of increased international normalized ratio (INR) in patients taking warfarin with glucosamine, with or without chondroitin. The lack of reports with chondroitin alone seem to suggest that the interactions occurring in these reports may have been due to glucosamine. In two individual case reports, glucosamine/chondroitin combinations were associated with a significant increase in INR in patients previously stabilized on warfarin. Additionally, 20 voluntary case reports to the US Food & Drug Administration (FDA) have linked glucosamine plus chondroitin with increased INR, bruising, and bleeding in patients who were also taking warfarin. There have also been 20 additional case reports to the World Health Organization (WHO) that link glucosamine alone, without chondroitin, to increased INR in patients taking warfarin.

Likelihood Unlikely Evidence D
Chondroitin Sulfate full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Joint Flex, from the product label.

Priority One Nutritional Supplements

See all Priority One Nutritional Supplements products
Name
Priority One Nutritional Supplements, Inc.
Pharmacist Counseling Corner

Joint Flex by Priority One Nutritional Supplements: Common Questions

Does Joint Flex by Priority One Nutritional Supplements interact with any medications?
Yes. Based on its ingredients, Joint Flex has a known interaction with 1,147 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?
Joint Flex contains 5 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 bromelain safe if I take aspirin or other blood thinners?
Bromelain may increase your bleeding risk if you take anticoagulants or antiplatelet drugs like aspirin, warfarin, or clopidogrel. There's even a case report of minor bruising in someone taking bromelain with naproxen. Check with your doctor or pharmacist before combining this product with any blood thinner or antiplatelet drug.
Can I take Joint Flex if I'm on warfarin?
Glucosamine in Joint Flex can increase warfarin's blood-thinning effects and your bruising and bleeding risk. There are case reports of people's blood test results (INR levels) going dangerously high when taking glucosamine or glucosamine-chondroitin with warfarin. Don't start this product without checking with your doctor or pharmacist first.
What are the most common side effects?
The most common side effects are digestive: diarrhea, constipation, bloating, nausea, heartburn, and abdominal pain. Bromelain may also cause headache. Allergic reactions are rare but possible, especially with glucosamine. If you develop swelling, difficulty breathing, or a rash, stop and seek medical attention.
Will this help my arthritis pain?
Glucosamine is likely effective for osteoarthritis, and both chondroitin sulfate and Indian frankincense resin extract are possibly effective for it. Individual results vary, and the evidence is not the same for all types of arthritis or joint pain. Talk with your doctor about whether it makes sense for your specific situation.
Is it safe to take while pregnant or breastfeeding?
The safety data for bromelain, chondroitin, glucosamine, and Indian frankincense in pregnancy is not enough to know either way—the facts advise caution or avoidance in pregnancy. Breastfeeding safety is also unclear for most of these ingredients. Talk with your doctor or pharmacist about your individual situation before taking this product during pregnancy or while nursing.
Can I take this if I'm on antibiotics?
If you take tetracycline antibiotics (like doxycycline), bromelain might theoretically increase their levels, though a human study found no actual difference. Manganese in this product might reduce how well your body absorbs tetracycline or quinolone antibiotics (like ciprofloxacin). Ask your pharmacist or doctor before combining them.

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.

Joint Flex label
Go deeper

The Full Monographs Behind Joint Flex’s Ingredients

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

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

Chondroitin Sulfate

Interacts with 2 drugs

Chondroitin sulfate is a naturally occurring building block of cartilage that is widely taken, often with glucosamine, for osteoarthritis joint pain. The evidence is mixed—some people report...

Read the full Chondroitin Sulfate monograph → Herb & supplement monograph

Glucosamine

Interacts with 170 drugs

Glucosamine is a natural compound found in cartilage and joint fluid, and it is one of the most popular supplements for osteoarthritis, especially of the knee. The evidence is mixed, with so...

Read the full Glucosamine monograph → Herb & supplement monograph

Manganese

Interacts with 83 drugs

Manganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get enough from a normal diet. Supplements m...

Read the full Manganese monograph → Herb & supplement monograph

Boswellia Serrata

Interacts with 952 drugs

Boswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoarthritis symptoms, but the overall evidenc...

Read the full Boswellia Serrata monograph →
Sources

Sources & How We Checked

Joint Flex'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 136 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.

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
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See these in context on the Bromelain monograph →

Chondroitin Sulfate 22 references
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  10. Oliviero, U., Sorrentino, G. P., De Paola, P., Tranfaglia, E., D'Alessandro, A., Carifi, S., Porfido, F. A., Cerio, R., Grasso, A. M., Policicchio, D., and . Effects of the treatment with matrix on elderly people with chronic articular degeneration. Drug
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  18. Provenza JR, Shinjo SK, Silva JM, Peron CR, Rocha FA. Combined glucosamine and chondroitin sulfate, once or three times daily, provides clinically relevant analgesia in knee osteoarthritis. Clin Rheumatol 2015;34:1455-62. PubMed
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  20. Greenlee H, Crew KD, Shao T, Kranwinkel G, Kalinsky K, Maurer M, Brafman L, Insel B, Tsai WY, Hershman DL. Phase II study of glucosamine with chondroitin on aromatase inhibitor-associated joint symptoms in women with breast cancer. Support Care Cancer 201 PubMed
  21. Chu EC, Huang KHK, Cheung G, Ng G, Lin A. Delayed Skin Allergy to Glucosamine Chondroitin Supplement. Cureus 2023;15(3):e36310. PubMed
  22. Lila AM, Alekseeva LI, Baranov AA, et al. Chondroitin sulfate and glucosamine combination in patients with knee and hip osteoarthritis: A long-term observational study in Russia. World J Orthop 2023;14(6):443-457. PubMed

See these in context on the Chondroitin Sulfate monograph →

Glucosamine 58 references
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See these in context on the Glucosamine monograph →

Manganese 21 references
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Boswellia Serrata 16 references
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