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

Multi Enzyme Formula Ingredients & Drug Interactions

by tnvitamins

Tablet Or Pill Category: Other Combinations
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Multi Enzyme Formula is a dietary supplement by tnvitamins with 11 active ingredients. Its ingredients are commonly taken for low stomach acid (hypochlorhydria), bloating and gas, indigestion.Based on those ingredients, 1,038 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Peppermint, Probiotic Blend, Bromelain. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Multi Enzyme Formula by tnvitamins

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

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 10 of its 12 active ingredients.
  • “Peppermint” is listed as a grouped ingredient — the label gives one combined amount (30 mg) without saying how much of each component you get.
  • “Probiotic Blend” is a proprietary blend — the label gives one combined amount (110 mcg) without saying how much of each component you get.
  • “Pancreatin” is listed as a grouped ingredient — the label gives one combined amount (90 mg) without saying how much of each component you get.

This 12-ingredient enzyme formula combines digestive enzymes, probiotics, and botanical extracts. The active ingredients include betaine hydrochloride (which increases stomach acid), pancreatic enzymes (pancreatin, protease, lipase, amylase), plant-based proteases (papain from papaya, bromelain from pineapple), the stomach enzyme pepsin, cellulase, beneficial bacteria (Lactobacillus acidophilus and L. rhamnosus), and peppermint leaf extract.

The formula also contains inactive ingredients—standard tablet binders and fillers like cellulose, dicalcium phosphate, and magnesium stearate.

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 with enzymes and probiotics.
  • We looked for evidence on: Abdominal pain, Antibiotic-associated diarrhea, Diarrhea, Dyspepsia, Exercise-induced muscle soreness, Food allergies — and 4 related terms.
  • The strongest evidence on file: Peppermint is rated "Likely Effective" for Irritable bowel syndrome (IBS) (Natural Medicines).
  • Also on file: Peppermint is rated "Possibly Effective" for Dyspepsia.
  • Also on file: Lactobacillus Acidophilus is rated "Possibly Effective" for Antibiotic-associated diarrhea, Irritable bowel syndrome (IBS).

The evidence supporting this formula's ingredients is mixed and limited. Peppermint leaf extract is likely effective for irritable bowel syndrome and possibly effective for indigestion and nausea—that's its strongest showing.

Lactobacillus acidophilus is possibly effective for irritable bowel syndrome, antibiotic-associated diarrhea, and Helicobacter pylori infection. Most of the other ingredients—betaine hydrochloride, papain, bromelain, pepsin, lipase, and the other probiotics—have insufficient evidence to rate their effectiveness for the conditions they're marketed to treat.

In short, only peppermint and L. acidophilus have some research backing; the rest lack solid proof.

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.

This formula is generally well tolerated by most people, but individual ingredients carry cautions. Betaine hydrochloride can irritate the stomach and is unsafe for anyone with ulcers, gastritis, or true acid reflux—it may cause heartburn.

Papain and bromelain may trigger allergic reactions in sensitive people, including digestive upset or respiratory symptoms if you're exposed to airborne particles. Pepsin and protease similarly can cause digestive upset or rarely allergic reactions.

Lactobacillus acidophilus is safe in healthy adults but can occasionally cause bloating, gas, or abdominal discomfort. Peppermint oil is generally well tolerated but can cause heartburn, abdominal pain, and rarely allergic reactions including anaphylaxis in very sensitive individuals.

During pregnancy, betaine hydrochloride and bromelain are best avoided; concentrated peppermint supplements should also be avoided unless your doctor approves. For breastfeeding, there isn't enough data on most ingredients, so check with your healthcare provider first.

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, Betaine Hydrochloride, Peppermint, Lactobacillus Acidophilus, Bromelain.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs.
  • For scale: 1,039 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Multi Enzyme Formula, check your exact medications against these drug types: blood thinners and antiplatelet drugs (warfarin, aspirin, clopidogrel—Moderate risk of bleeding), medications metabolized by CYP3A4, CYP2C9, or CYP2C19 enzymes (felodipine and many others—Moderate risk of higher levels), cyclosporine (Moderate), antibiotics especially tetracyclines (Minor risk of reduced antibiotic effect) and all antibiotics (Minor risk of probiotic loss of effectiveness), and acid-reducing drugs like H2-blockers and PPIs (Minor risk of reduced effectiveness). Use the search tool on this page with your medication names to be sure.

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 enzyme and probiotic formula is aimed at digestive support, with the strongest evidence for peppermint (IBS, indigestion) and Lactobacillus acidophilus (IBS, antibiotic-associated diarrhea). If you take any medications—especially blood thinners, acid-reducing drugs, cyclosporine, antibiotics, or drugs metabolized by the liver—run them through the interaction checker before starting, since this formula affects over 1,000 medications.

Avoid it if you have ulcers or acid reflux, and talk with your pharmacist if you're pregnant, breastfeeding, or have serious digestive conditions.

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

Assessment coverage: 8 of 12 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 23, 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 Multi Enzyme Formula, straight from the product label.

Brand tnvitamins
Barcode (UPC) 095234265905
Net contents 60 Tablet(s)
Market status On market
Date entered into DSLD Apr 23, 2020
DSLD ID 217353
Product type Other Combinations
Supplement form Tablet Or Pill
Dietary claims / uses All Other
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 Multi Enzyme Formula by tnvitamins, 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 Tablet(s)
Maximum serving Sizes:
2 Tablet(s)
Servings per container
30
UPC/BARCODE
095234265905
IngredientAmount% DV
Betaine Hydrochloride200 mg--
Amylase100 mg--
Papain60 mg--
Bromelain60 mg--
Lipase25 mg--
Cellulase30 mg--
Peppermint30 mg--
Lactobacillus rhamnosus0 NP--
Lactobacillus acidophilus0 NP--
Probiotic Blend110 mcg--
Pepsin10 mg--
Peppermint leaf 4:1 extract7.5 mg--
Protease50 mg--
Pancreatin90 mg--
Pancreatin 4:1 extract22.5 mg--

Other ingredients: Dicalcium Phosphate, Cellulose, Stearic Acid, Croscarmellose, Vegetable Magnesium Stearate, Silica, Cellulose Coating

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.
Formula

10 Effective enzymes plus probiotic blend

FDA Statement of Identity

Dietary Supplement

Precautions

Contains: Milk ingredients.

Caution: Pregnant or lactating women should consult a doctor before use.

If you are under medical supervision, please consult a doctor before use. Discontinue use and consult a doctor if any adverse reactions occur.

Keep out of reach of children.

Suggested/Recommended/Usage/Directions

Directions: For adults, take two (2) or more tablets before or after meals, or as directed by a health care professional.

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.

General Statements

To reorder www.tnvitamins.com 1-800-645-4446

See for yourself

Multi Enzyme Formula by tnvitamins label

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

What’s inside

The Ingredients in Multi Enzyme Formula by tnvitamins

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

Serving size2 Tablet(s) Dosage formTablet Or Pill Servings per container30 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.

Betaine Hydrochloride

Interacts with
36 drugs
200 mg per serving

Betaine hydrochloride is a supplement used to temporarily increase stomach acid in people who may have low acid levels. Evidence for its benefits is l...

Betaine Hydrochloride monograph & interactions

Amylase

100 mg per serving

Papain

Interacts with
2 drugs
60 mg per serving

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

Papain monograph & interactions

Bromelain

Interacts with
141 drugs
60 mg per serving

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

Bromelain monograph & interactions

Lipase

No known
interactions
25 mg per serving

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

Lipase monograph & interactions

Cellulase

30 mg per serving

Peppermint

Interacts with
796 drugs
30 mg per serving

Peppermint is a popular herb with the best evidence supporting enteric-coated peppermint oil for easing IBS symptoms. It is generally well tolerated f...

Peppermint monograph & interactions

Probiotic Blend

Interacts with
182 drugs
110 mcg 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

Pepsin

No known
interactions
10 mg per serving

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

Pepsin monograph & interactions

Protease

No known
interactions
50 mg per serving Form: Papaya

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

Protease monograph & interactions

Pancreatin

90 mg per serving
  • › Pancreatin 4:1 extract

Other (inactive) ingredients: Dicalcium Phosphate, Cellulose, Stearic Acid, Croscarmellose, Vegetable Magnesium Stearate, Silica, Cellulose Coating. These complete the product’s ingredient list but are not active constituents.

Interaction report

Multi Enzyme Formula by tnvitamins 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
1,038Drugs
959 Moderate 79 Minor

Ingredients driving the most interactions

Bromelain 141
Papain 2

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.

Peppermint5 drug types · 796 drugs

Cyclosporine (Neoral, Sandimmune)

Theoretically, peppermint oil might increase the levels and adverse effects of cyclosporine.
In animal research, peppermint oil inhibits cyclosporine metabolism and increases cyclosporine levels. Inhibition of cytochrome P450 3A4 (CYP3A4) may be partially responsible for this interaction. An interaction between peppermint oil and cyclosporine has not been reported in humans.

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

Theoretically, peppermint might increase the levels of CYP2C19 substrates.
In vitro research shows that peppermint oil inhibits CYP2C19. So far, this interaction has not been reported in humans.

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

Theoretically, peppermint might increase the levels of CYP2C9 substrates.
In vitro research shows that peppermint oil inhibits CYP2C9. So far, this interaction has not been reported in humans.

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

Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Clinical research in healthy volunteers shows that a single dose of peppermint oil 600 mg inhibits CYP3A4 enzymes and increases the AUC of felodipine, a CYP3A4 substrate. However, in vitro research suggests that peppermint oil only inhibits CYP3A4 at very high concentrations.

Likelihood Possible Evidence B
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, peppermint might increase the levels of CYP1A2 substrates.
In vitro and animal research shows that peppermint oil and peppermint leaf inhibit CYP1A2. However, in clinical research, peppermint tea did not significantly affect the metabolism of caffeine, a CYP1A2 substrate. It is possible that the 6-day duration of treatment may have been too short to identify a difference.

Likelihood Possible Evidence B

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

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

Betaine Hydrochloride3 drug types · 36 drugs

Antacids

Betaine hydrochloride increases stomach acidity and could decrease the effects of antacids.
In human research, betaine hydrochloride increases stomach acidity. Antacids are taken to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with antacids might decrease the effects of the antacids.

Likelihood Possible Evidence D
H2-Blockers

Betaine hydrochloride increases stomach acidity and could decrease the effects of H2-blockers.
In human research, betaine hydrochloride increases stomach acidity. H2-blockers are used to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with H2-blockers might decrease the effects of H2-blockers.

Likelihood Possible Evidence D
Proton Pump Inhibitors (Ppis)

Betaine hydrochloride increases stomach acidity and could decrease the effects of PPIs.
In human research, betaine hydrochloride increases stomach acidity. PPIs are used to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with PPIs might decrease the effects of PPIs

Likelihood Possible Evidence D

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
The maker

Brand information

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

tnvitamins

See all tnvitamins products
Name
Total Nutrition, Inc.
City
Farmingdale
State
NY
ZipCode
11735
Phone Number
1-800-645-4446
Web Address
www.tnvitamins.com
Pharmacist Counseling Corner

Multi Enzyme Formula by tnvitamins: Common Questions

Does Multi Enzyme Formula by tnvitamins interact with any medications?
Yes. Based on its ingredients, Multi Enzyme Formula has a known interaction with 1,038 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 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.
Does this enzyme formula really help with digestion?
The evidence is strongest for peppermint, which is possibly effective for indigestion. Lactobacillus acidophilus has some support for digestive conditions like IBS and diarrhea. The other enzymes—papain, bromelain, pepsin, lipase, and protease—don't have enough research to prove they work for digestion in supplement form, even though they're naturally found in your stomach and food.
Can I take this if I'm on antibiotics?
You'll need to be careful. Antibiotics can kill the beneficial bacteria (probiotics) in this formula, making them less effective. Also, bromelain may slightly raise tetracycline antibiotic levels. Separate the timing of your antibiotic and this formula by a few hours, and run both through the interaction checker with your pharmacist to be safe.
Is this safe if I have acid reflux?
No, you should avoid it. Betaine hydrochloride, one of the active ingredients, increases stomach acid and is not safe for people with acid reflux, gastritis, or ulcers—it may cause heartburn or irritate existing damage.
What's in the peppermint part of this formula?
The formula contains peppermint leaf 4:1 extract, a concentrated form. Peppermint in food or tea is generally safe, but this concentrated supplement can interact with medications metabolized by your liver and may cause heartburn, abdominal pain, or allergic reactions in sensitive people.
Can I take this while pregnant or breastfeeding?
Betaine hydrochloride and bromelain are best avoided in pregnancy due to safety concerns. For the other ingredients, there isn't enough data, so talk with your doctor or pharmacist before use—they can give you personalized advice based on your situation.
What are the probiotics in this for?
The formula contains Lactobacillus acidophilus and L. rhamnosus, beneficial bacteria meant to support gut health. L. acidophilus has some evidence for irritable bowel syndrome, diarrhea, and other digestive issues, though it's safest taken a few hours away from antibiotics.

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

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

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

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

Betaine Hydrochloride

Interacts with 36 drugs

Betaine hydrochloride is a supplement used to temporarily increase stomach acid in people who may have low acid levels. Evidence for its benefits is limited and mostly based on tradition rat...

Read the full Betaine Hydrochloride 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

Peppermint

Interacts with 796 drugs

Peppermint is a popular herb with the best evidence supporting enteric-coated peppermint oil for easing IBS symptoms. It is generally well tolerated for most adults, but it can cause heartbu...

Read the full Peppermint monograph →
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

Proteolytic Enzymes (proteases)

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

Read the full Proteolytic Enzymes (proteases) monograph →
Sources

Sources & How We Checked

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 92 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.

Betaine Hydrochloride 2 references
  1. Yago MR, Frymoyer A, Benet LZ, Smelick GS, Frassetto LA, Ding X, Dean B, Salphati L, Budha N, Jin JY, Dresser MJ, Ware JA. The use of betaine HCl to enhance dasatinib absorption in healthy volunteers with rabeprazole-induced hypochlorhydria. AAPS J. 2014 PubMed
  2. Yago MR, Frymoyer AR, Smelick GS, Frassetto LA, Budha NR, Dresser MJ, Ware JA, Benet LZ. Gastric reacidification with betaine HCl in healthy volunteers with rabeprazole-induced hypochlorhydria. Mol Pharm. 2013 Nov 4;10(11):4032-7. PubMed

See these in context on the Betaine Hydrochloride 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 →

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
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Lipase 1 reference
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See these in context on the Lipase monograph →

Peppermint 41 references
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Lactobacillus Acidophilus 15 references
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Proteolytic Enzymes (proteases) 3 references
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See these in context on the Proteolytic Enzymes (proteases) 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.

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