Interactions on record — worth a quick check against your medications. Based on 7 of 15 ingredients. Check your meds →
Dietary supplement

Multi-Enzyme Formula Ingredients & Drug Interactions

by GNC Preventive Nutrition

Multi-Enzyme Formula 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 Multi-Enzyme Formula 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

Multi-Enzyme Formula is a dietary supplement by GNC Preventive Nutrition with 15 active ingredients. Its ingredients are commonly taken for digestive health and balance, diarrhea (including antibiotic-related), vaginal yeast and bacterial infections.Based on those ingredients, 306 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Probiotic Blend, Bromelain, Papain. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Multi-Enzyme Formula by GNC Preventive Nutrition

Ask about any prescription or over-the-counter medication and we check it for interactions with Multi-Enzyme Formula by GNC Preventive Nutrition — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Multi-Enzyme Formula by GNC Preventive Nutrition

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 27, 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 11 of its 15 active ingredients.
  • “Probiotic Blend” is a proprietary blend — the label gives one combined amount (3 mg) without saying how much of each component you get.
  • “Multi-Enzyme Blend” is a proprietary blend — the label gives one combined amount (296 mg) without saying how much of each component you get.
  • “CereCalase Proprietary Blend” is a proprietary blend — the label gives one combined amount (10 mg) without saying how much of each component you get.

This formula contains 15 active ingredients, most of them digestive enzymes. Amylase, lipase, and glucoamylase break down carbohydrates and fats; bromelain (from pineapple) and papain (from papaya) are proteases that help break down protein.

Cellulase, hemicellulase, and beta-glucanase target fiber and plant cell material. Lactase helps people digest lactose, the sugar in dairy.

Phytase is another enzyme, and the formula also includes three protease variants and a blend of Lactobacillus acidophilus, a probiotic (beneficial bacteria). The inactive ingredients are vegetable cellulose capsule material, rice bran, cellulose, and silica.

Does it work?

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

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

Why this rating?
  • The label markets this product for: Digestive support and enzyme function.
  • We looked for evidence on: Dyspepsia, Lactose intolerance, Exercise-induced muscle soreness, Postoperative swelling, Allergic rhinitis (hay fever), Rhinosinusitis — and 3 related terms.
  • The strongest evidence on file: Lactase is rated "Effective" for Lactose intolerance (Natural Medicines).
  • Also on file: Papain is rated "Insufficient Reliable Evidence To Rate" for Exercise-induced muscle soreness.
  • Also on file: Lipase is rated "Insufficient Reliable Evidence To Rate" for Dyspepsia.

The evidence for most of these enzymes isn't well established. Lactase is effective for lactose intolerance — if you have trouble digesting dairy, it works.

Lactobacillus acidophilus is possibly effective for irritable bowel syndrome, antibiotic-associated diarrhea, Helicobacter pylori (a stomach bacterium), and bacterial vaginosis. For papain, bromelain, lipase, phytase, and the proteases, the data we hold rates effectiveness as insufficient to say whether they work for their claimed uses.

The evidence, ingredient by ingredient Lactobacillus Acidophilus Papain Bromelain Lipase Lactase Proteolytic Enzymes (proteases) Phytase

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.

These ingredients are generally well tolerated short-term at standard doses. Papain may irritate the digestive tract or trigger allergic reactions in sensitive people, and high doses can rarely cause severe gastritis or esophageal damage.

Bromelain commonly causes mild digestive upset — diarrhea, gas, nausea — and allergic reactions are possible. Lactobacillus acidophilus is generally safe in healthy adults; rare serious infections have been reported in people with weakened immunity or critical illness, and mild gas or bloating can occur.

The proteases are generally well tolerated but may cause digestive upset or allergic reactions in some people. For pregnancy: papain is possibly unsafe and best avoided; bromelain safety is not established so it should be avoided; Lactobacillus acidophilus is possibly safe.

Lipase, phytase, and the proteases have limited or no pregnancy data — talk with your doctor. For breastfeeding: papain, bromelain, phytase, and the proteases lack adequate safety data — ask your healthcare provider before use.

Lactobacillus acidophilus safety while breastfeeding is not documented in our data — check with your doctor. Lactase is possibly safe during breastfeeding.

Side effects, ingredient by ingredient Lactobacillus Acidophilus Papain Bromelain Lipase Lactase Proteolytic Enzymes (proteases) Phytase

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 3 of the 7 matched ingredients can interact with medications — Papain, Lactobacillus Acidophilus, Bromelain.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs.
  • For scale: 306 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) or antiplatelet drugs like aspirin, double-check with your doctor or pharmacist before starting — papain and bromelain may increase bleeding risk. Tetracycline antibiotics may have higher levels when combined with bromelain.

Most importantly, separate doses of this product from any antibiotic by a few hours, since antibiotics can reduce the probiotic's effectiveness.

Check your own medication Run your meds through the checker above

The bottom line

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

This is a multi-enzyme digestive aid best suited to people looking to support digestion, especially if they're deficient in digestive enzymes or have lactose intolerance. If you take warfarin or other blood thinners, antibiotics, or tetracycline antibiotics, check with your doctor or pharmacist before starting — the interactions here are real and may need dosing adjustments or timing changes.

Pregnant or breastfeeding? Talk it over with your healthcare provider first.

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

Assessment coverage: 9 of 15 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 25, 2011.

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 Multi-Enzyme Formula, straight from the product label.

Brand GNC Preventive Nutrition
Barcode (UPC) 048107079802
Net contents 180 Vegetarian Capsules
Market status On market
Date entered into DSLD Nov 25, 2011
DSLD ID 1841
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegetarian, 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 Multi-Enzyme Formula by GNC Preventive Nutrition, 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
048107079802
IngredientAmount% DV
Amylase7000 DU--
Papain280000 FCCPU--
Bromelain300000 FCCPU--
Lipase250 FIP--
Lactase500 ALU--
Cellulase100 CU--
Glucoamylase11 AGU--
Diastase125 DP--
Beta-Glucanase0 Not Present--
Phytase0 Not Present--
Hemicellulase0 Not Present--
Probiotic Blend3 mg--
Protease 4.515000 HUT--
Protease 315 SAPU--
Protease 62000 HUT--
Lactobacillus acidophilus0 NP--
Multi-Enzyme Blend296 mg--
CereCalase Proprietary Blend10 mg--

Other ingredients: Vegetable Cellulose Capsule, Rice Bran, Cellulose, Silica

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions

DIRECTIONS: As a dietary supplement, take one capsule with a full glass of water before your largest meal.

Precautions

KEEP OUT OF REACH OF CHILDREN.

CONTAINS: Milk and Wheat.

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.

Formula

Suitable for people on low-gluten diets.

General Statements

1 capsule dosage

DIGESTION

Enzymes help to ease digestion and release vital nutrients. Specific digestive enzymes are necessary for the breakdown of certain types of foods. If these enzymes are lacking, nutrients from these foods may pass through the digestive system without being digested. This multi-enzyme formula may help support digestive health*

Proven bioactivity with probiotic blend

Supports protein, carbohydrate and fat digestion*

General

CODE 731622 KLG

Brand IP Statement(s)

CereCalase(R) is a registered trademark of National Enzyme Company.

Formulation

No Sugar, No Starch, No Artificial Colors, No Artificial Flavors, Sodium Free, No Soy, Yeast Free.

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

Multi-Enzyme Formula by GNC Preventive Nutrition label

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

Multi-Enzyme Formula 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 Multi-Enzyme Formula by GNC Preventive Nutrition

These are the 15 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.

Probiotic Blend

Interacts with
182 drugs
3 mg per serving

Lactobacillus acidophilus is a 'friendly' bacterium used as a probiotic to support gut and vaginal health. It is generally well tolerated in healthy p...

Probiotic Blend monograph & interactions

Multi-Enzyme Blend

296 mg per serving

CereCalase Proprietary Blend

10 mg per serving
  • › Beta-Glucanase
  • › Phytase
  • › Hemicellulase

Other (inactive) ingredients: Vegetable Cellulose Capsule, Rice Bran, Cellulose, Silica. These complete the product’s ingredient list but are not active constituents.

Interaction report

Multi-Enzyme Formula by GNC Preventive Nutrition Drug Interactions

Want to check YOUR meds against Multi-Enzyme Formula?

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
306Drugs
303 Moderate 3 Minor

Ingredients driving the most interactions

Probiotic Blend 182
Bromelain 141
Papain 2

Individual Drug Interactions

The ingredients in Multi-Enzyme Formula interact with 306 drugs. Click any drug to see the details.

3 of the 15 ingredients in Multi-Enzyme Formula interact with drugs. Each result below shows which ingredient is responsible. Probiotic Blend Bromelain Papain

Each ingredient & the kinds of drugs it affects

For each ingredient in Multi-Enzyme Formula 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.

Probiotic Blend1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Lactobacillus acidophilus with antibiotic drugs might decrease the effectiveness of L. acidophilus.
L. acidophilus preparations usually contain live and active organisms. Therefore, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and L. acidophilus preparations by at least two hours.

Likelihood Probable Evidence D
Probiotic Blend full monograph & interactions

Bromelain2 drug types · 141 drugs

Anticoagulant/Antiplatelet Drugs

Bromelain may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
There is one case report of a patient experiencing minor bruising while taking bromelain with naproxen. Bromelain is thought to have antiplatelet activity. Whether this interaction is of concern with topical bromelain is unclear. Interference with coagulation of burn wounds has been reported in a patient receiving bromelain-based enzymatic debridement. However, observational research has found that topical bromelain debridement is not associated with increases or decreases in laboratory markers of coagulation when compared with surgical debridement.

Likelihood Possible Evidence D
Tetracycline Antibiotics

Theoretically, bromelain might increase levels of tetracycline antibiotics.
Laboratory research suggests that bromelain might increase the absorption of tetracycline antibiotics. However, a study in healthy adults reported no difference in tetracycline plasma levels when a 500 mg dose was taken with or without bromelain 80 mg.

Likelihood Possible Evidence B
Bromelain full monograph & interactions

Papain1 drug type · 2 drugs

Warfarin (Coumadin)

Theoretically, papain might increase the effects and side effects of warfarin.
In one case report, a patient previously stable on warfarin was found to have an international normalization ratio (INR) of 7.4, which was attributed to ingestion of a supplement containing papain from papaya extract.

Likelihood Possible Evidence D
Papain full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Multi-Enzyme Formula, from the product label.

GNC Preventive Nutrition

See all GNC Preventive Nutrition products
Phone Number
1-888-462-2548
Pharmacist Counseling Corner

Multi-Enzyme Formula by GNC Preventive Nutrition: Common Questions

Does Multi-Enzyme Formula by GNC Preventive Nutrition interact with any medications?
Yes. Based on its ingredients, Multi-Enzyme Formula has a known interaction with 306 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Multi-Enzyme Formula contains 15 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.
Will this help my digestion?
It's designed to supplement digestive enzymes, but the evidence for most of these ingredients is insufficient — we don't have solid data showing they work for digestion in general. Lactase is effective for lactose intolerance if that's your concern. If you suspect a real enzyme deficiency, talk with your doctor about testing first.
Is this safe to take every day?
The enzymes are generally well tolerated short-term, but we don't have much long-term safety data. Bromelain especially — the research is limited beyond a few weeks or months. Check with your doctor if you're planning regular long-term use, especially if you have a serious digestive condition.
Can I take this if I'm pregnant?
Not without checking with your doctor first. Papain is possibly unsafe in pregnancy and best avoided. Bromelain safety isn't established so it should be avoided too. The other ingredients have limited pregnancy data. Your healthcare provider can advise based on your situation.
What's Lactobacillus acidophilus for?
It's a beneficial bacteria (probiotic) that's possibly effective for irritable bowel syndrome, antibiotic-associated diarrhea, Helicobacter pylori infection, and bacterial vaginosis. It's generally safe in healthy adults, though it may cause mild bloating or gas in some people.
Can I take this with my antibiotics?
Yes, but separate them — take your antibiotic and then wait a few hours before the enzyme formula. Antibiotics kill the live probiotic organisms in this product, so timing matters. For tetracycline antibiotics specifically, bromelain may increase their blood levels, so mention this combination to your pharmacist.
What if I'm allergic to papaya or pineapple?
This formula contains papain (from papaya) and bromelain (from pineapple), so if you're sensitive to those fruits, you're at risk for allergic reactions — itchy eyes, runny nose, stomach cramps, or rashes. Let your doctor or pharmacist know about any fruit allergies before taking it.

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

Not sure if Multi-Enzyme Formula is safe with your meds?

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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.

Multi-Enzyme Formula label
Go deeper

The Full Monographs Behind Multi-Enzyme Formula’s Ingredients

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

Herb & supplement monograph

Lactobacillus Acidophilus

Interacts with 182 drugs

Lactobacillus acidophilus is a 'friendly' bacterium used as a probiotic to support gut and vaginal health. It is generally well tolerated in healthy people, and there is reasonable evidence...

Read the full Lactobacillus Acidophilus 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

Bromelain

Interacts with 141 drugs

Bromelain is a group of protein-digesting enzymes from pineapple that people take mainly for inflammation, swelling, and sinus problems. Some early studies are promising, but the overall evi...

Read the full Bromelain monograph → Herb & supplement monograph

Lipase

Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy for people who cannot make enough of their...

Read the full Lipase monograph → Herb & supplement monograph

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

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

Phytase

Phytase is an enzyme that breaks down phytic acid (phytate) found in grains, beans, nuts, and seeds, which can free up minerals like iron, zinc, and calcium for absorption. It is widely used...

Read the full Phytase monograph →
Sources

Sources & How We Checked

Multi-Enzyme Formula'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 57 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Papain 11 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf 1997;17:342-56.
  3. Shuttleworth D, Hill S, Marks R, Connelly DM. Relief of experimentally induced pruritus with a novel eutectic mixture of local anaesthetic agents. Br J Dermatol 1988;119:535-40.
  4. Mansfield LE, Ting S, Haverly RW, Yoo TJ. The incidence and clinical implications of hypersensitivity to papain in an allergic population, confirmed by blinded oral challenge. Ann Allergy 1985;55:541-3.
  5. Martin, T., Uhder, K., Kurek, R., Roeddiger, S., Schneider, L., Vogt, H. G., Heyd, R., and Zamboglou, N. Does prophylactic treatment with proteolytic enzymes reduce acute toxicity of adjuvant pelvic irradiation? Results of a double-blind randomized trial PubMed
  6. Walker-Renard, P. Update on the medicinal management of phytobezoars. Am J Gastroenterol. 1993;88(10):1663-1666.
  7. Tymoszuk D, Wiszniewska M, Walusiak-Skorupa J. Papain-induced occupational rhinoconjunctivitis and asthma - A case report. Med Pr 2016;67(1):109-12. PubMed
  8. Soto-Mera MT, López-Rico MR, Filgueira JF, et al. Occupational allergy to papain. Allergy 2000;55(10):983-4. PubMed
  9. Tarlo SM, Shaikh W, Bell B, et al. Papain-induced allergic reactions. Clin Allergy 1978;8(3):207-15. PubMed
  10. Baur X, König G, Bencze K, Fruhmann G. Clinical symptoms and results of skin test, RAST and bronchial provocation test in thirty-three papain workers: Evidence for strong immunogenic potency and clinically relevant proteolytic e?ects of airborne papain. C
  11. Novey HS, Keenan WJ, Fairshter RD, Wells ID, Wilson AF, Culver BD. Pulmonary disease in workers exposed to papain: clinico-physiological and immunological studies. Clin Allergy 1980;10(6):721-31. PubMed

See these in context on the Papain monograph →

Bromelain 19 references
  1. Nettis E, Napoli G, Ferrannini A, Tursi A. IgE-mediated allergy to bromelain. Allergy 2001;56:257-8. PubMed
  2. Taussig SJ, Batkin S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J Ethnopharmacol 1988;22:191-203.. PubMed
  3. Bradbrook ID, Morrison PJ, Rogers HJ. The effect of bromelain on the absorption of orally administered tetracycline. Br J Clin Pharmacol 1978;6:552-4. PubMed
  4. Bush TM, Rayburn KS, Holloway SW, et al. Adverse interactions between herbal and dietary substances and prescription medications: a clinical survey. Altern Ther Health Med 2007;13:30-5.
  5. Brien S, Lewith G, Walker AF, et al. Bromelain as an adjunctive treatment for moderate-to-severe osteoarthritis of the knee: a randomized placebo-controlled pilot study. QJM 2006;99:841-50. PubMed
  6. Mori S, Ojima Y, Hirose T, et al. The clinical effect of proteolytic enzyme containing bromelain and trypsin on urinary tract infection evaluated by double blind method. Acta Obstet Gynaecol Jpn 1972;19:147-53.
  7. Glaser D, Hilberg T. The influence of bromelain on platelet count and platelet activity in vitro. Platelets 2006;17:37-41. PubMed
  8. Heinicke R M, van der Wal L, Yokoyama M. Effect of bromelain (Ananase) on human platelet aggregation. Experientia 1972;28:844-5. PubMed
  9. Gailhofer, G., Wilders-Truschnig, M., Smolle, J., and Ludvan, M. Asthma caused by bromelain: an occupational allergy. Clin Allergy 1988;18(5):445-450. PubMed
  10. Mattei, O., Fabri, G., and Farina, G. [Occupational health experience regarding four cases of asthma due to bromelain (author's transl)]. Medicina del Lavoro 1979;70(5):404-409.
  11. Galleguillos, F. and Rodriguez, J. C. Asthma caused by bromelin inhalation. Clin Allergy 1978;8(1):21-24. PubMed
  12. Perez-Camo I, Quirce S, Duran MA, and et al. Latex allergy: evidence of cross-reactivity with papain and bromelain [abstract]. Allergy 1996;51(suppl 31):48.
  13. Martin GJ, Ehrenreich J, and Asbell N. Bromelain: pineapple proteases with anti-edema activity. Exp Med Surg 1962;20:227-247.
  14. Kasemsuk T, Saengpetch N, Sibmooh N, Unchern S. Improved WOMAC score following 16-week treatment with bromelain for knee osteoarthritis. Clin Rheumatol. 2016 Oct;35(10):2531-40. PubMed
  15. Kutlu Ö, DemirbaS A, Elmas ÖF, Güvenç U, Metin A. Fixed drug eruption: a new side effect of bromelain. Contact Dermatitis 2020. Online ahead of print. PubMed
  16. Shoham Y, Shapira E, Haik J, et al. Bromelain-based enzymatic debridement of chronic wounds: Results of a multicentre randomized controlled trial. Wound Repair Regen 2021;29(6):899-907. PubMed
  17. Pfister P, Garcia Wendel PD, Kim BS, et al. Coagulation side effects of enzymatic debridement in burned patients. Burns 2022. PubMed
  18. Hasham S, Riyat H, Fletcher A, O'Boyle CP, Alexander S. To bleed or not to bleed? Case series and discussion of haemorrhage risk with enzymatic debridement in burn injuries. Scars Burn Heal 2023;9:20595131231168333. PubMed
  19. Leelakanok N, Petchsomrit A, Janurai T, Saechan C, Sunsandee N. Efficacy and safety of bromelain: A systematic review and meta-analysis. Nutr Health 2023. PubMed

See these in context on the Bromelain monograph →

Lipase 1 reference
  1. Casper C, Hascoet JM, Ertl T, et al. Recombinant bile salt-stimulated lipase in preterm infant feeding: A randomized phase 3 study. PLoS One. 2016;11(5):e0156071. PubMed

See these in context on the Lipase monograph →

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 →

Phytase 7 references
  1. Lei XG, Weaver JD, Mullaney E, Ullah AH, Azain MJ. Phytase, a new life for an "old" enzyme. Annu Rev Anim Biosci. 2013;1:283-309. PubMed
  2. Smuts CM, Matsungo TM, Malan L, et al. Effect of small-quantity lipid-based nutrient supplements on growth, psychomotor development, iron status, and morbidity among 6- to 12-mo-old infants in South Africa: a randomized controlled trial. Am J Clin Nutr. 2 PubMed
  3. van Heemst RC, Sander I, Rooyackers J, et al. Hypersensitivity pneumonitis caused by occupational exposure to phytase. Eur Respir J. 2009;33(6):1507-9. PubMed
  4. Baur X, Melching-Kollmuss S, Koops F, Strassburger K, Zober A. IgE-mediated allergy to phytase -- a new animal feed additive. Allergy. 2002;57(10):943-5. PubMed
  5. Doekes G, Kamminga N, Helwegen L, Heederik D. Occupational IgE sensitisation to phytase, a phosphatase derived from Aspergillus niger. Occup Environ Med. 1999;56(7):454-9. PubMed
  6. Brnic M, Hurrell RF, Songré-Ouattara LT, et al. Effect of phytase on zinc absorption from a millet-based porridge fed to young Burkinabe children. Eur J Clin Nutr. 2017;71(1):137-141. PubMed
  7. Koshy JC, Sharabi SE, Feldman EM, Hollier LH Jr, Patrinely JR, Soparkar CN. Effect of dietary zinc and phytase supplementation on botulinum toxin treatments. J Drugs Dermatol. 2012;11(4):507-12.

See these in context on the Phytase monograph →

Lactobacillus Acidophilus 15 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Begtrup LM, de Muckadell OB, Kjeldsen J, Christensen RD, Jarbøl DE. Long-term treatment with probiotics in primary care patients with irritable bowel syndrome--a randomised, double-blind, placebo controlled trial. Scand J Gastroenterol 2013;48(10):1127-35 PubMed
  3. Chatterjee S, Kar P, Das T, Ray S, Gangulyt S, Rajendiran C, Mitra M. Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12 for prevention of antibiotic-associated
  4. Shavakhi A, Tabesh E, Yaghoutkar A, Hashemi H, Tabesh F, Khodadoostan M,Minakari M, Shavakhi S, Gholamrezaei A. The effects of multistrain probiotic compound on bismuth-containing quadruple therapy for Helicobacter pylori infection: a randomized placebo-c
  5. Karamali M, Dadkhah F, Sadrkhanlou M, et al. Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Metab 2016;42(4):234-41. PubMed
  6. Badehnoosh B, Karamali M, Zarrati M, et al. The effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. J Matern Fetal Neonatal Med. 2018 May;31(9):1128-1136.
  7. Kumar S, Kumar R, Rohilla L, Jacob N, Yadav J, Sachdeva N. A high potency multi-strain probiotic improves glycemic control in children with new-onset type 1 diabetes mellitus: A randomized, double-blind, and placebo-controlled pilot study. Pediatr Diabete
  8. Shahriari A, Karimi E, Shahriari M, Aslani N, Khooshideh M, Arab A. The effect of probiotic supplementation on the risk of gestational diabetes mellitus among high-risk pregnant women: A parallel double-blind, randomized, placebo-controlled clinical trial PubMed
  9. Xiao SD, Zhang DZ, Lu H, et al. Multicenter, randomized, controlled trial of heat-killed Lactobacillus acidophilus LB in patients with chronic diarrhea. Adv Ther. 2003;20(5):253-60.
  10. Rossi F, Amadoro C, Gasperi M, Colavita G. Lactobacilli infection case reports in the last three years and safety implications. Nutrients. 2022;14(6):1178. PubMed
  11. Ozer M, Goksu SY, Shahverdiani A, Mustafa M. Lactobacillus acidophilus-induced endocarditis and associated splenic abscess. Case Rep Infect Dis 2020;2020:1382709.
  12. Sadrin S, Sennoune S, Gout B, et al. A 2-strain mixture of Lactobacillus acidophilus in the treatment of irritable bowel syndrome: A placebo-controlled randomized clinical trial. Dig Liver Dis 2020;52(5):534-540. PubMed
  13. Stoffer JN, Slingsby TJ, Giuliari GP. Lactobacillus acidophilus endophthalmitis after intravitreal bevacizumab injection requiring intraocular lens explantation. Can J Ophthalmol 2022;57(1):e21-e22. PubMed
  14. Cukovic-Cavka S, Likic R, Francetic I, Rustemovic N, Opacic M, Vucelic B. Lactobacillus acidophilus as a cause of liver abscess in a NOD2/CARD15-positive patient with Crohn's disease. Digestion 2006;73(2-3):107-10.
  15. Hui J, Ren Y, Wang Y, Han Q. Lactobacillus acidophilus endophthalmitis postcataract operation: A case report with a literature review. Ocul Immunol Inflamm 2023.

See these in context on the Lactobacillus Acidophilus monograph →

Proteolytic Enzymes (proteases) 3 references
  1. Weeks JA, Harper RA, Simon RA, Burdick JD. Assessment of sensitization risk of a laundry pre-spotter containing protease. Cutan Ocul Toxicol. 2011;30(4):272-9. PubMed
  2. Marquès LI, Lara S, Abós T, Bartolomé B. Occupational rhinitis due to pepsin. J Investig Allergol Clin Immunol. 2006;16(2):136-7. DOI
  3. Cartier A, Malo JL, Pineau L, Dolovich J. Occupational asthma due to pepsin. J Allergy Clin Immunol. 1984;73(5 Pt 1):574-7. PubMed

See these in context on the Proteolytic Enzymes (proteases) monograph →

Parts of this content are provided by the Therapeutic Research Center, LLC.

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

© 2021 Therapeutic Research Center, LLC

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