Interactions on record — worth a quick check against your medications. Based on 7 of 11 ingredients. Check your meds →
Dietary supplement

Keto Paleo MacroGest Ingredients & Drug Interactions

by Natural Factors

Keto Paleo MacroGest label
See full label image
Capsule 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 Keto Paleo MacroGest 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

Keto Paleo MacroGest is a dietary supplement by Natural Factors with 11 active ingredients. Its ingredients are commonly taken for inflammation and swelling, sinus and nasal congestion, digestion support.Based on those ingredients, 227 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Amla powder, Bromelain, Serrapeptase. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Keto Paleo MacroGest by Natural Factors

Ask about any prescription or over-the-counter medication and we check it for interactions with Keto Paleo MacroGest by Natural Factors — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Keto Paleo MacroGest by Natural Factors

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

Partial disclosure
Ingredient Transparency · database check
Partial

Most active ingredients list an amount, but at least one is hidden in a blend or missing.

Why this rating?
  • The label discloses an exact amount for 8 of its 11 active ingredients.
  • “Pancreatin 8X” is listed as a grouped ingredient — the label gives one combined amount (110 mg) without saying how much of each component you get.

Keto Paleo MacroGest contains 11 active ingredients: three digestive enzymes (bromelain from pineapple, papain from papaya, and a blend called pancreatin 8X), three pancreatic enzymes (amylase, protease, and lipase), a fungal protease, a fungal amylase, rutin extract, amla powder (Indian gooseberry), and serrapeptase. These are designed to support digestion and nutrient breakdown.

The product also contains inactive ingredients—a delayed-release vegetarian capsule, microcrystalline cellulose (a binder), and magnesium stearate (a lubricant).

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: support digestion of protein and fat foods.
  • We looked for evidence on: Dyspepsia, Exercise-induced muscle soreness, Postoperative pain, Postoperative swelling, Indigestion, 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: Lipase is rated "Insufficient Reliable Evidence To Rate" for Dyspepsia.
  • Also on file: Rutin is rated "Insufficient Reliable Evidence To Rate" for Postoperative swelling.

The evidence for most ingredients in this product is not yet well established. Bromelain, papain, protease, lipase, serrapeptase, and rutin all show insufficient reliable evidence to rate them for their intended purposes—whether that's aiding digestion, reducing inflammation, or supporting bone or joint health.

Amla powder does have some promising research: it's rated possibly effective for gastroesophageal reflux disease (acid reflux) and dyslipidemia (abnormal blood fat levels). The data we hold doesn't establish clear effectiveness for the other conditions these ingredients are sometimes used for.

The evidence, ingredient by ingredient Bromelain Papain Lipase Proteolytic Enzymes (proteases) Rutin Indian Gooseberry Serrapeptase

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.

Bromelain, papain, and serrapeptase are generally well tolerated in the short term, but long-term safety data are limited. The most common side effects are digestive: diarrhea, flatulence, stomach upset, nausea, and abdominal pain.

Allergic reactions—including hives, itching, or in rare cases respiratory symptoms if dust is inhaled—can occur in people sensitive to these enzymes. Papain at high doses has rarely caused severe stomach inflammation or even tears in the esophagus.

Rutin may cause headache, flushing, or rashes in some people. During pregnancy, bromelain and serrapeptase are not recommended—safety data are insufficient.

Papain in concentrated or unripe form is best avoided in pregnancy. For rutin, the safety data show it's likely safe in food, but supplement doses in pregnancy haven't been well studied, so talk it over with your doctor.

Breastfeeding safety is unknown or poorly studied for all of these ingredients; if you're nursing, check with your healthcare provider before taking this product.

Side effects, ingredient by ingredient Bromelain Papain Lipase Proteolytic Enzymes (proteases) Rutin Indian Gooseberry Serrapeptase

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?
  • 5 of the 7 matched ingredients can interact with medications — Papain, Rutin, Indian Gooseberry, Bromelain, Serrapeptase.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications.
  • For scale: 227 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 you take this product, double-check with your doctor or pharmacist if you're on any of these: blood thinners like warfarin (Coumadin), anticoagulants, or antiplatelet drugs (Moderate severity)—bromelain, papain, amla powder, and serrapeptase all raise bleeding risk. Aspirin and clopidogrel (Plavix) carry the same concern.

Diabetes medications (Moderate severity)—rutin and amla powder may lower blood sugar further. Tetracycline antibiotics (Minor severity)—bromelain may affect how your body absorbs them.

No interactions are documented for the pancreatic amylase or fungal amylase in this product.

Check your own medication Run your meds through the checker above

The bottom line

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

Keto Paleo MacroGest is a multi-enzyme digestive supplement, but the evidence that it works for its intended purpose is limited for most of its ingredients. If you take a blood thinner, aspirin, or diabetes medication—or if you're pregnant or breastfeeding—you should talk with your doctor or pharmacist before starting this product, because several ingredients may increase bleeding risk or affect blood sugar.

Because you're the one taking it, the decision is between you and your own healthcare provider.

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

Assessment coverage: 9 of 11 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated May 22, 2020.

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 Keto Paleo MacroGest, straight from the product label.

Brand Natural Factors
Barcode (UPC) 068958017600
Net contents 60 Delayed Release Capsule(s)
Market status On market
Date entered into DSLD May 22, 2020
DSLD ID 220117
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar 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 Keto Paleo MacroGest by Natural Factors, 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)
UPC/BARCODE
068958017600
IngredientAmount% DV
Bromelain11.45 mg--
Papain7.2 mg--
Amylase, Pancreatic0 NP--
Protease, Pancreatic0 NP--
Lipase, Pancreatic0 NP--
Triacylglycerol Lipase0.72 mg--
Protease, Fungal31.5 mg--
Pancreatin 8X110 mg--
Rutin extract20 mg--
Amla powder13 mg--
Alpha-Amylase, Fungal8.4 mg--
Serrapeptase3.44 mg--

Other ingredients: delayed release vegetarian Capsule, Microcrystalline Cellulose, 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.
Seals/Symbols

isura Non-GMO - Mass Spec Documentation Lab tested

Purity & Potency Guaranteed

Suggested/Recommended/Usage/Directions

Suggested Usage: 1 capsule with a meal or as directed by a health professional.

Precautions

Cautions: As with any supplement, consult your health professional before use if you are pregnant, breastfeeding, or trying to conceive, or if you are taking medication, have a medical condition, or anticipate a surgery.

Keep out of the reach of children.

Sealed for your protection. Do not use if seal is broken.

Formula

Keto Paleo MacroGest is a full spectrum enzyme formula designed to support the complete digestion of protein-rich and high-fat foods such as dairy, eggs, and meat.

Ideal for Keto and Paleo based diets, this premium supplement eases digestive discomfort, such as occasional gas and bloating.

Full-spectrum enzyme formula

Formulation

Contains no artificial colors, preservatives, or sweeteners; no dairy, starch, sugar, wheat, gluten, yeast, soy, corn, egg, fish, shellfish, salt, tree nuts, or GMOs.

Intensive Strength

Helps digest protein-rich & high-fat foods

8 times more concentrated than USP standard.

Manufactured by Natural Factors to ensure safety and potency in accordance with Good Manufacturing Practices (GMP) of the FDA and Health Canada.

Storage

For freshness, store in a cool, dry place.

FDA Disclaimer Statement

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

General Statements

Product of Canada Recyclable container and label.

USP (united States Pharmacopeia). FCC (Food Chemical Codex), HUT (Hemoglobin Unit on the Tyrosine Basis), PU (Papain Unit). DU (Dextrinizing Unit), SPU (Specialty Peptidase Unit), LU (lipase Unit).

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

Keto Paleo MacroGest by Natural Factors label

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

Keto Paleo MacroGest 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 Keto Paleo MacroGest by Natural Factors

These are the 11 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule 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
11.45 mg per serving Form: Ananas comosus

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

Papain

Interacts with
2 drugs
7.2 mg per serving Form: Carica papaya

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

Triacylglycerol Lipase

No known
interactions
0.72 mg per serving Form: Rhizopus oryzae

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...

Triacylglycerol Lipase monograph & interactions

Pancreatin 8X

110 mg per serving Form: Sus scrofa

Rutin extract

Interacts with
86 drugs
20 mg per serving Form: Sophora japonica

Rutin is a plant flavonoid (often taken from buckwheat or citrus) that people use mainly for blood vessel and circulation problems like varicose veins...

Rutin extract monograph & interactions

Amla powder

Interacts with
208 drugs
13 mg per serving

Indian gooseberry (amla) is a vitamin C-rich fruit used in Ayurvedic medicine for many purposes, from antioxidant support to cholesterol and digestion...

Amla powder monograph & interactions

Alpha-Amylase, Fungal

8.4 mg per serving Form: Aspergillus oryzae

Serrapeptase

Interacts with
122 drugs
3.44 mg per serving Form: Serratia marcescens E15

Serrapeptase is an enzyme marketed to reduce inflammation, swelling, pain, and mucus, but the human evidence is limited and mostly low quality. If you...

Serrapeptase monograph & interactions

Other (inactive) ingredients: Delayed release vegetarian Capsule, Microcrystalline Cellulose, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.

Interaction report

Keto Paleo MacroGest by Natural Factors Drug Interactions

Want to check YOUR meds against Keto Paleo MacroGest?

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
227Drugs
208 Moderate 19 Minor

Ingredients driving the most interactions

Amla powder 208
Bromelain 141
Serrapeptase 122
Rutin extract 86
Papain 2

Individual Drug Interactions

The ingredients in Keto Paleo MacroGest interact with 227 drugs. Click any drug to see the details.

5 of the 11 ingredients in Keto Paleo MacroGest interact with drugs. Each result below shows which ingredient is responsible. Amla powder Bromelain Serrapeptase Rutin extract Papain

Each ingredient & the kinds of drugs it affects

For each ingredient in Keto Paleo MacroGest 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.

Amla powder4 drug types · 208 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, Indian gooseberry may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking Indian gooseberry 500 mg along with clopidogrel 75 mg or ecosprin 75 mg, as a single dose or for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with clopidogrel 75 mg or ecosprin 75 mg alone. Until more is known, use caution when taking Indian gooseberry in combination with anticoagulant/antiplatelet drugs.

Likelihood Possible Evidence B
Antidiabetes Drugs

Taking Indian gooseberry with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that taking Indian gooseberry fruit or fruit extract alone or in conjunction with antidiabetes medications can lower blood glucose levels. Dose adjustments to diabetes medications might be necessary.

Likelihood Possible Evidence B
Aspirin

Theoretically, Indian gooseberry may increase the risk of bleeding if used with aspirin; however, research is conflicting.
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking a single dose of Indian gooseberry 500 mg along with ecosprin 75 mg, or taking a combination of Indian gooseberry 500 mg twice daily plus ecosprin 75 mg once daily for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with ecosprin 75 mg alone.

Likelihood Possible Evidence B
Clopidogrel (Plavix)

Theoretically, Indian gooseberry may increase the risk of bleeding if used with clopidogrel; however, research is conflicting.
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking a single dose of Indian gooseberry 500 mg along with clopidogrel 75 mg, or taking a combination of Indian gooseberry 500 mg twice daily plus clopidogrel 75 mg once daily for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with clopidogrel 75 mg alone.

Likelihood Possible Evidence B
Amla 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

Serrapeptase1 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, taking serrapeptase with drugs that have antiplatelet or anticoagulant effects might increase the risk of bruising and bleeding.
In vitro research shows that serrapeptase has fibrinolytic activity.

Likelihood Possible Evidence D
Serrapeptase full monograph & interactions

Rutin extract1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, taking rutin with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research suggests that rutin has hypoglycemic effects.

Likelihood Possible Evidence D
Rutin extract 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 Keto Paleo MacroGest, from the product label.

Natural Factors

See all Natural Factors products
Name
Natural Factors Canada
Pharmacist Counseling Corner

Keto Paleo MacroGest by Natural Factors: Common Questions

Does Keto Paleo MacroGest by Natural Factors interact with any medications?
Yes. Based on its ingredients, Keto Paleo MacroGest has a known interaction with 227 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Keto Paleo MacroGest contains 11 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.
Can I take this while I'm pregnant?
Not safely without talking to your doctor first. Bromelain and serrapeptase should be avoided in pregnancy—the safety data aren't there. Papain in concentrated form is best avoided too. Rutin hasn't been well studied at supplement doses during pregnancy. Check with your doctor or pharmacist for personalized advice.
What's papain, and why is it in a digestive supplement?
Papain is an enzyme from papaya fruit that breaks down protein, similar to how your stomach does. It's included to help with digestion, though the evidence for how well it works isn't yet clear.
Will this help my acid reflux?
The only ingredient with research supporting it for acid reflux is amla powder, which is rated possibly effective. The other enzymes in this product haven't shown clear evidence for reflux relief.
What are the most common side effects?
Digestive upset—diarrhea, gas, stomach discomfort, nausea—is most common, especially when you first start. Some people also report headache, flushing, or rashes. Allergic reactions are rare but possible if you're sensitive to these enzymes.
Can I take this long-term?
The safety data for long-term use are limited for most of these ingredients. They're generally well tolerated short-term, but if you want to take this regularly, talk it over with your doctor or pharmacist.
Is this safe while breastfeeding?
The safety data during breastfeeding are insufficient or unknown for every ingredient in this product. Before you take it, check with your healthcare provider to see what's right for you.

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

Not sure if Keto Paleo MacroGest 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.

Keto Paleo MacroGest label
Go deeper

The Full Monographs Behind Keto Paleo MacroGest’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

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

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

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

Rutin

Interacts with 86 drugs

Rutin is a plant flavonoid (often taken from buckwheat or citrus) that people use mainly for blood vessel and circulation problems like varicose veins and hemorrhoids. The evidence is limite...

Read the full Rutin monograph → Herb & supplement monograph

Indian Gooseberry

Interacts with 208 drugs

Indian gooseberry (amla) is a vitamin C-rich fruit used in Ayurvedic medicine for many purposes, from antioxidant support to cholesterol and digestion. Early research is promising for some u...

Read the full Indian Gooseberry monograph → Herb & supplement monograph

Serrapeptase

Interacts with 122 drugs

Serrapeptase is an enzyme marketed to reduce inflammation, swelling, pain, and mucus, but the human evidence is limited and mostly low quality. If you want to try it, choose an enteric-coate...

Read the full Serrapeptase monograph →
Sources

Sources & How We Checked

Keto Paleo MacroGest'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 44 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
  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 →

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 →

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

See these in context on the Lipase monograph →

Rutin 2 references
  1. Mehta DK (Ex Ed). British National Formulary, Number 37. British Medical Association and Royal Pharmaceutical Society of Great Britain: London, England, March 1999.
  2. Sun C, Wang L, Sun J, Wang Z, Tang Z. Hypoglycemic and hypolipidemic effects of rutin on hyperglycemic rats. J Tradit Chin Med. 2020;40(4):640-645.

See these in context on the Rutin monograph →

Indian Gooseberry 6 references
  1. Sabu, M. C. and Kuttan, R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property. J Ethnopharmacol. 2002;81(2):155-160. PubMed
  2. Fatima N, Pingali U, Muralidhar N. Study of pharmacodynamic interaction of Phyllanthus emblica extract with clopidogrel and ecosprin in patients with type II diabetes mellitus. Phytomedicine. 2014;21(5):579-85. PubMed
  3. Shanmugarajan D, Girish C, Harivenkatesh N, Chanaveerappa B, Prasanna Lakshmi NC. Antihypertensive and pleiotropic effects of Phyllanthus emblica extract as an add-on therapy in patients with essential hypertension-A randomized double-blind placebo-contro
  4. Akhtar MS, Ramzan A, Ali A, Ahmad M. Effect of amla fruit (Emblica officinalis Gaertn.) on blood glucose and lipid profile of normal subjects and type 2 diabetic patients. Int J Food Sci Nutr. 2011;62(6):609-16.
  5. Usharani P, Fatima N, Muralidhar N. Effects of Phyllanthus emblica extract on endothelial dysfunction and biomarkers of oxidative stress in patients with type 2 diabetes mellitus: a randomized, double-blind, controlled study. Diabetes Metab Syndr Obes. 20 PubMed
  6. Majeed M, Mundkur L, Paulose S, Nagabhushanam K. Novel Emblica officinalis extract containing ß-glucogallin vs. metformin: a randomized, open-label, comparative efficacy study in newly diagnosed type 2 diabetes mellitus patients with dyslipidemia. Food Fu

See these in context on the Indian Gooseberry monograph →

Serrapeptase 2 references
  1. Tachibana M, Mizukoshi O, Harada Y, et al. A multi-centre, double-blind study of serrapeptase versus placebo in post-antrotomy buccal swelling. Pharmatherapeutica 1984;3:526-30..
  2. Mazzone A, Catalani M, Costanzo M, et al. Evaluation of Serratia peptidase in acute or chronic inflammation of otorhinolaryngology pathology: a multicentre, double-blind, randomized trial versus placebo. J Int Med Res 1990;18:379-88.. PubMed

See these in context on the Serrapeptase 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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