Interactions on record — worth a quick check against your medications. Based on 6 of 7 ingredients. Check your meds →
Dietary supplement

Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor Ingredients & Drug Interactions

by Woodstock Vitamins

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

Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor is a dietary supplement by Woodstock Vitamins with 7 active ingredients. Its ingredients are commonly taken for inflammation and swelling, sinus and nasal congestion, digestion support.Based on those ingredients, 1,035 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Beet root Fiber, Bromelain, Papaya. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor by Woodstock Vitamins

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

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 3 of its 7 active ingredients.
  • “Plant Enzyme Blend” is a proprietary blend — the label gives one combined amount (10 mg) without saying how much of each component you get.

This product contains seven active ingredients: three plant enzymes (amylase, protease, and lipase) that are meant to help your body break down food, plus bromelain (a protein-digesting enzyme from pineapple), papain and papaya (which also contain protein-digesting compounds), and beet root fiber. The enzyme blend works together to support digestion.

Inactive ingredients like fructose, sorbitol, and natural flavor make it chewable.

Does it work?

Moderate 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
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: digestive support and nutrient absorption.
  • We looked for evidence on: Dyspepsia, Exercise-induced muscle damage, Exercise-induced muscle soreness, Inflammatory bowel disease (IBD), Intestinal parasite infection, Postoperative pain — and 4 related terms.
  • The strongest evidence on file: Beet is rated "Possibly Effective" for Exercise-induced muscle soreness (Natural Medicines).
  • Also on file: Papain is rated "Insufficient Reliable Evidence To Rate" for Exercise-induced muscle soreness, Intestinal parasite infection, Wound healing.
  • Also on file: Lipase is rated "Insufficient Reliable Evidence To Rate" for Inflammatory bowel disease (IBD), Dyspepsia.

The evidence for these ingredients is limited. Bromelain has insufficient reliable evidence for hay fever, burns, cancer, neuropathy from chemotherapy, and blood vessel health.

Papaya likewise shows insufficient evidence for aging skin, hair loss, cancers, and diabetes. Lipase shows insufficient evidence for inflammatory bowel disease and indigestion.

Beet root fiber is possibly effective for athletic performance and exercise-related muscle soreness, but is possibly ineffective for chronic lung disease. The plant enzymes protease and papain also lack established effectiveness ratings in our data.

The evidence, ingredient by ingredient Bromelain Papaya Papain Proteolytic Enzymes (proteases) Lipase Beet

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 6 of the 6 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 6 of 6.
  • General safety write-ups exist for 6 of 6.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Bromelain is generally well tolerated short-term, but long-term safety data is limited. Common side effects from bromelain include diarrhea, gas, stomach upset, and headache.

Allergic reactions are rare but possible, especially if you're sensitive to pineapple or have a latex allergy. Protease and lipase are also generally well tolerated, though protease can rarely cause allergic reactions from airborne exposure.

Papaya and papain are generally safe as food but may cause nausea, vomiting, or allergic reactions in sensitive people. Beet root fiber commonly causes red or black stools, which is harmless.

The safety data advises against bromelain during pregnancy and breastfeeding. For protease, lipase, papaya, and papain, there isn't enough data during pregnancy or breastfeeding — talk with your doctor or pharmacist for personalized advice.

Side effects, ingredient by ingredient Bromelain Papaya Papain Proteolytic Enzymes (proteases) Lipase Beet

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

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

Why this rating?
  • 4 of the 6 matched ingredients can interact with medications — Papain, Beet, Papaya, Bromelain.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications.
  • For scale: 1,036 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.

Most important: blood thinners and antiplatelet drugs like warfarin and aspirin (moderate risk of increased bleeding). Also check diabetes medications, amiodarone, levothyroxine, and any drugs your liver processes through CYP3A4 or CYP1A2.

Tetracycline antibiotics have a theoretical minor risk of higher levels. If you're on any prescription medications, run them through the checker on this page.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This product is mainly for digestive support with enzymes. If you take blood thinners, diabetes medications, amiodarone, levothyroxine, or drugs processed through your liver's CYP3A4 pathway, check with your pharmacist before starting.

Pregnant or breastfeeding? Talk to your doctor first, especially about bromelain.

Otherwise, it's generally well tolerated for most adults.

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

Assessment coverage: 6 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 11, 2022.

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

At a glance

General information

Key facts about Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor, straight from the product label.

Brand Woodstock Vitamins
Barcode (UPC) 719985701580
Net contents 240 Vegan Tablet(s)
Market status On market
Date entered into DSLD Apr 11, 2022
DSLD ID 263200
Product type Other Combinations
Supplement form Tablet Or Pill
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegan, Vegetarian, Adult (18 - 50 Years), Gluten Free, Dairy 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 Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor by Woodstock Vitamins, 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
120
UPC/BARCODE
719985701580
IngredientAmount% DV
Calories5 Calorie(s)--
Total Carbohydrates1 Gram(s)1%
Amylase0 NP--
Bromelain10 mg--
Protease0 NP--
Added Sugars1 Gram(s)2%
Lipase0 NP--
Total Sugars1 Gram(s)--
Papaya10 mg--
Beet root Fiber0 NP--
Papain200 mg--
Plant Enzyme Blend10 mg--

Other ingredients: Fructose, Sorbitol, Stearic Acid, Calcium Stearate, Natural Tropical Fruit Flavor, Citric Acid, 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

Suggested Use: Chew two tablets with a meal.

Formulation

Convenient chewable enzymes for digestion support Healthy digestion allows our bodies to receive nutrients from food. Enzymes support the breakdown of food, making nutrients more bioavailable to our bodies.

This product contains plant enzymes, making it a versatile supplement for both vegetarians and non-vegetarians alike.

Our Natural Papaya plus Plant Enzymes supplement supports the body's natural ability to utilize fats, carbohydrates and proteins from food.

Contains no artificial colors, flavors or preservatives; no wheat, gluten, milk, eggs, peanuts, tree nuts, soy, crustacean shellfish or fish.

We guarantee our supplements for potency and purity

Supports digestion

GF Gluten free

Formula

This product contains plant enzymes, making it a versatile supplement for both vegetarians and non-vegetarians alike.

Storage

Store in a cool, dry place.

Precautions

To report a serious adverse event, call 1-888-710-0006

Keep out of reach of children.

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.

FDA Statement of Identity

Dietary Supplement

See for yourself

Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor by Woodstock Vitamins label

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

What’s inside

The Ingredients in Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor by Woodstock Vitamins

These are the 7 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Tablet(s) Dosage formTablet Or Pill Servings per container120 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
10 mg per serving Form: Pineapple

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

Papaya

Interacts with
92 drugs
10 mg per serving

Papaya is a tropical fruit that is nutritious and generally safe to eat as food, and it contains an enzyme called papain used as a digestive aid and m...

Papaya monograph & interactions

Papain

Interacts with
2 drugs
200 mg per serving Form: 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

Plant Enzyme Blend

10 mg per serving

Other (inactive) ingredients: Fructose, Sorbitol, Stearic Acid, Calcium Stearate, Natural Tropical Fruit Flavor, Citric Acid, Silica. These complete the product’s ingredient list but are not active constituents.

Interaction report

Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor by Woodstock Vitamins Drug Interactions

Want to check YOUR meds against Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor?

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
1,035Drugs
814 Moderate 221 Minor

Ingredients driving the most interactions

Bromelain 141
Papaya 92
Papain 2

Each ingredient & the kinds of drugs it affects

For each ingredient in Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor 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.

Beet root Fiber3 drug types · 861 drugs

Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, beet might increase the levels of CYP3A4 substrates.
In vitro research suggests that betanin, the major pigment in beet, competitively inhibits CYP3A4 in a dose-dependent manner similarly to strong CYP3A4 inhibitor ketoconazole.

Likelihood Possible Evidence D
Antihypertensive Drugs

Beet and beetroot contain nitrates, which can cause vasodilation, potentially leading to lower blood pressure. However, a study published in the European Journal of Clinical Nutrition using concentrated beetroot juice found no significant impact on blood pressure or heart rate in different age groups. Other small clinical studies suggest that while beet consumption might transiently lower blood pressure due to vessel dilation, there's no consistent evidence of a lasting effect. Overall, the theoretical risk of reduced blood pressure due to beet's nitrate content exists, but studies generally indicate a low and temporary impact rather than a sustained decrease.

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

Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research suggests that beet induces CYP1A2 enzymes.

Likelihood Possible 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

Papaya4 drug types · 92 drugs

Amiodarone (Cordarone)

Theoretically, papaya extract may increase the levels and clinical effects of amiodarone.
Animal research in rats shows that a single oral dose of papaya extract, as well as multiple doses of papaya extract daily over 14 days, prior to a single dose of amiodarone delays the time to maximum amiodarone concentration. However, only the 14-day papaya extract regimen increases systemic amiodarone exposure by 60% to 70%. This interaction has not been reported in humans.

Likelihood Probable Evidence D
Antidiabetes Drugs

Concomitant use of antidiabetic drugs with fermented papaya can produce additive effects. It is unclear if other forms of papaya have the same effect.
A small low-quality clinical study in patients with type 2 diabetes who are taking glibenclamide shows that taking a fermented papaya preparation 3 grams daily for 2 months decreases fasting and postprandial blood glucose levels when compared to baseline. Additionally, of the 25 patients in the study, 9 required a reduction in glibenclamide dose.

Likelihood Probable Evidence B
Levothyroxine (Synthroid, Others)

Theoretically, consuming large quantities of papaya fruit can reduce the clinical effects of levothyroxine.
In one case-report, a 37-year-old male with a history of thyroidectomy who was stabilized on levothyroxine for 5 years presented with hypothyroidism after consuming 5-6 papaya fruits daily for 14 days during vacation. In a controlled re-challenge test involving 5-6 papayas daily, the patient remained euthyroid for 7 days, but developed mild hypothyroidism after 14 days. Both times, thyroid levels normalized 40-45 days after discontinuing papaya.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, concomitant use of warfarin with papain-containing papaya extract 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

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 Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor, from the product label.

Woodstock Vitamins

See all Woodstock Vitamins products
Name
Village Vitality LLC
City
Woodstock
State
NY
ZipCode
12498
Web Address
woodstockvitamins.com
Pharmacist Counseling Corner

Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor by Woodstock Vitamins: Common Questions

Does Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor by Woodstock Vitamins interact with any medications?
Yes. Based on its ingredients, Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor has a known interaction with 1,035 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor contains 7 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 if I'm on warfarin or another blood thinner?
No — not without talking to your pharmacist or doctor first. Both the papain and bromelain in this product may increase bleeding risk. There's even a case report of someone on warfarin whose blood-thinning effect got dangerously high after taking papain. Your doctor may need to adjust your dose or skip this product.
What are the common side effects?
Mostly digestive ones: diarrhea, gas, stomach upset, and occasionally headache from the bromelain. You might also see red or black stools from the beet root fiber — that's normal and harmless. Allergic reactions are rare but possible if you're sensitive to papaya, pineapple, or latex.
Is this safe during pregnancy or while breastfeeding?
The bromelain in this product is best avoided during pregnancy and breastfeeding because there isn't enough safety data. For the other ingredients — papaya, papain, protease, and lipase — there also isn't enough information to know either way. Talk with your doctor or pharmacist to see if it's right for you.
Will this help my digestion?
The three main digestive enzymes here — amylase, protease, and lipase — lack established effectiveness ratings in our data. Bromelain and papain also don't have strong evidence for digestive support. If you're looking for proven digestive help, ask your pharmacist about your options.
Can I take this with my diabetes medication?
Check with your pharmacist first. Papaya, especially fermented forms, may lower blood sugar on its own, so taking it with diabetes drugs could cause your blood sugar to drop too much. Your doctor may need to monitor your levels.
What's in here besides the active enzymes?
The inactive ingredients are fructose, sorbitol, stearic acid, calcium stearate, natural tropical fruit flavor, citric acid, and silica. These are fillers, binders, and flavor — they don't have active effects but help make the tablet chewable and palatable.

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

Not sure if Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor 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.

Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor label
Go deeper

The Full Monographs Behind Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor’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

Papaya

Interacts with 92 drugs

Papaya is a tropical fruit that is nutritious and generally safe to eat as food, and it contains an enzyme called papain used as a digestive aid and meat tenderizer. Papaya leaf extract is b...

Read the full Papaya 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

Proteolytic Enzymes (proteases)

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

Read the full Proteolytic Enzymes (proteases) monograph →
Herb & supplement monograph

Lipase

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

Read the full Lipase monograph →
Herb & supplement monograph

Beet

Interacts with 861 drugs

Beet, especially beetroot juice, is a nitrate-rich food that may modestly lower blood pressure and slightly improve exercise performance in some people. It is generally safe as a food, but s...

Read the full Beet monograph →
Sources

Sources & How We Checked

Chewable Natural Papaya plus Plant Enzymes Tropical Fruit Flavor'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 62 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 →

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 →

Papaya 14 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. 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.
  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. Blanco C, Diaz-Perales A, Collada C, et al. Class I chitinases as potential panallergens involved in the latex-fruit syndrome. J Allergy Clin Immunol 1999;103(3 Pt 1):507-13. PubMed
  6. Diaz-Perales A, Collada C, Blanco C, et al. Cross-reactions in the latex-fruit syndrome: A relevant role of chitinases but not of complex asparagine-linked glycans. J Allergy Clin Immunol 1999;104:681-7. PubMed
  7. Castillo, R., Delgado, J., Quiralte, J., Blanco, C., and Carrillo, T. Food hypersensitivity among adult patients: epidemiological and clinical aspects. Allergol.Immunopathol.(Madr.) 1996;24(3):93-97.
  8. Oderinde, O., Noronha, C., Oremosu, A., Kusemiju, T., and Okanlawon, O. A. Abortifacient properties of aqueous extract of Carica papaya (Linn) seeds on female Sprague-Dawley rats. Niger.Postgrad.Med J 2002;9(2):95-98. DOI
  9. Danese, C., Esposito, D., D'Alfonso, V., Cirene, M., Ambrosino, M., and Colotto, M. Plasma glucose level decreases as collateral effect of fermented papaya preparation use. Clin Ter. 2006;157(3):195-198.
  10. Iliev, D. and Elsner, P. Generalized drug reaction due to papaya juice in throat lozenges. Dermatology 1997;194(4):364-366. PubMed
  11. Andersen HA, Bernatz PE, Grindlay JH. Perforation of the esophagus after use of a digestant agent: report of case and experimental study. Ann Otol Rhinol Laryngol 1959;68:890-6. PubMed
  12. Deiana L, Marini S, Mariotti S. Ingestion of large amounts of papaya fruit and impaired effectiveness of levothyroxine therapy. Endocr Pract 2012;18(1):98-100. PubMed
  13. Rodrigues M, Alves G, Francisco J, Fortuna A, Falcão A. Herb-drug pharmacokinetic interaction between Carica papaya extract and amiodarone in rats. J Pharm Pharm Sci 2014;17(3):302-15. PubMed
  14. Rajapakse S, de Silva NL, Weeratunga P, Rodrigo C, Sigera C, Fernando SD. Carica papaya extract in dengue: a systematic review and meta-analysis. BMC Complement Altern Med. 2019;19(1):265. PubMed

See these in context on the Papaya monograph →

Beet 14 references
  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
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  3. Siervo M, Lara J, Ogbonmwan I, Mathers JC. Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis. J Nutr 2013;143:818-26. PubMed
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Papain 11 references
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  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
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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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