Interactions on record — worth a quick check against your medications. Based on 3 of 4 ingredients. Check your meds →
Dietary supplement

Peak Digestion Ingredients & Drug Interactions

by Peak Pure & Natural

Peak Digestion 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 Peak Digestion 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

Peak Digestion is a dietary supplement by Peak Pure & Natural with 4 active ingredients. Its ingredients are commonly taken for inflammation and swelling, sinus and nasal congestion, digestion support.Based on those ingredients, 396 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Opti-Biome, Bromelain, Papaya Fruit Extract Concentrate. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Peak Digestion by Peak Pure & Natural

Ask about any prescription or over-the-counter medication and we check it for interactions with Peak Digestion by Peak Pure & Natural — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Peak Digestion by Peak Pure & Natural

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 Jul 11, 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 3 of its 4 active ingredients.

Peak Digestion contains four ingredients: bromelain (a protein-digesting enzyme from pineapple), Glutalytic, Opti-Biome (Bacillus subtilis, a beneficial bacterial strain), and Papaya Fruit Extract Concentrate. The first three are the active components; the others are inactive ingredients like maltodextrin and vegetable capsule material that support the formula.

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 health and gut support.
  • We looked for evidence on: Constipation, Diarrhea, Dyspepsia, Flatulence, Irritable bowel syndrome (IBS), Antibiotic-associated diarrhea — and 4 related terms.
  • The strongest evidence on file: Bacillus Subtilis is rated "Possibly Effective" for Antibiotic-associated diarrhea (Natural Medicines).
  • Also on file: Bacillus Subtilis is rated "Insufficient Reliable Evidence To Rate" for Constipation, Diarrhea, Dyspepsia, Flatulence, and more.

The evidence supporting these ingredients is limited. Bromelain is listed for several uses — hay fever, burns, cancer, nerve damage from chemotherapy, poor circulation, and diabetes — but the data we hold shows insufficient reliable evidence to rate it for any of them.

Bacillus subtilis (Opti-Biome) is rated possibly effective for antibiotic-associated diarrhea; for its other uses (athletic performance, liver disease, constipation, eczema, diabetes) the evidence is insufficient. Papaya Fruit Extract shows insufficient reliable evidence for all the uses listed — aging skin, hair loss, gallbladder cancer, colorectal cancer, and diabetes.

If you're taking this product for a specific condition, talk with your pharmacist about what the research actually supports.

The evidence, ingredient by ingredient Bromelain Bacillus Subtilis Papaya

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 3 of the 3 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 3 of 3.
  • General safety write-ups exist for 3 of 3.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Bromelain is generally well tolerated in the short term, though long-term safety data is sparse. The most common side effects are diarrhea, flatulence, stomach upset, and headache.

Rarely, IgE-mediated allergic reactions may occur, and inhaling bromelain dust (occupational exposure) can cause sensitization and asthma. Bacillus subtilis is generally well tolerated in healthy adults, but product quality and safety vary by strain; one case of headache was reported in a trial, and diarrhea is rare.

Papaya is well tolerated in food amounts; ripe fruit and leaf extract are generally safe, though nausea and vomiting have been reported with the leaf extract. Serious allergic reactions and hypersensitivity reactions (more common in people with latex allergy) are rare.

During pregnancy, bromelain should be avoided due to insufficient safety data, and safety while breastfeeding is unknown — avoid it. For Bacillus subtilis and papaya, there is not enough safety data; talk with your doctor before use in pregnancy or breastfeeding, and avoid unripe papaya during pregnancy.

Side effects, ingredient by ingredient Bromelain Bacillus Subtilis Papaya

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 3 matched ingredients can interact with medications — Papaya, Bromelain, Bacillus Subtilis.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications.
  • For scale: 396 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 Peak Digestion, double-check if you're on blood thinners or antiplatelet drugs (Moderate interaction with bromelain), diabetes medications (Moderate with papaya), amiodarone or other heart rhythm drugs (Moderate with papaya), warfarin (Moderate with papaya), levothyroxine or other thyroid medications (Moderate with papaya), or antibiotics including tetracyclines (Moderate and Minor respectively with bromelain and Bacillus subtilis).

Check your own medication Run your meds through the checker above

The bottom line

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

Peak Digestion is most relevant if you're looking for digestive support and have no concerns about medication interactions. If you take blood thinners, diabetes drugs, heart medications like amiodarone, thyroid medication, antibiotics, or tetracycline antibiotics, you'll need to check your exact medications with the tool below before starting.

Pregnant or breastfeeding? Talk with your pharmacist first.

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

Assessment coverage: 3 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated May 21, 2025.

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 Peak Digestion, straight from the product label.

Brand Peak Pure & Natural
Net contents 30 Capsule(s)
Market status On market
Date entered into DSLD May 21, 2025
DSLD ID 333609
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegetarian, Adult (18 - 50 Years), Gluten 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 Peak Digestion by Peak Pure & Natural, 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)
Servings per container
30
IngredientAmount% DV
Bromelain275 mg--
Glutalytic175 mg--
Opti-Biome0 NP--
Papaya Fruit Extract Concentrate125 mg--

Other ingredients: Maltodextrin, Vegetable Capsule, Nu-Flow

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: Adults take one (1) capsule with water before or after meals as needed for digestion as a dietary supplement or as directed by a healthcare practitioner.

Precautions

Warnings: Keep out of reach of children.

Do not exceed recommended dose. Do not use if clear neck seal is broken or missing.

If you are nursing, pregnant, taking medication or have a medical condition, consult your physician before taking this product.

Storage

Store at room temperature, in a dry place.

FDA Disclaimer Statement

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

Formula

OPTI-Biome Bacillus subtilis Probiotic & Digestive Enzymes Support Gut Health

FDA Statement of Identity

Dietary Supplement

Brand IP Statement(s)

OPTI-Biome is a registered trademark of BIO-CAT, Inc. Nu-Flow is a registered trademark of Ribus, Inc. Glutalytic is a registered trademark of Deerland Enzymes, Inc.

Formulation

Clean Label

V

Non GMO GF

Seals/Symbols

Manufactured in U.S.A With Quality Ingredients From Around The World

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

See for yourself

Peak Digestion by Peak Pure & Natural label

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

Peak Digestion 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 Peak Digestion by Peak Pure & Natural

These are the 4 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule 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.

Bromelain

Interacts with
141 drugs
275 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

Glutalytic

175 mg per serving

Opti-Biome

Interacts with
182 drugs
0 NP per serving Form: Bacillus subtilis MB40

Bacillus subtilis is a spore-forming probiotic bacterium found in soil and some fermented foods, and it is used mainly to support gut health and diges...

Opti-Biome monograph & interactions

Papaya Fruit Extract Concentrate

Interacts with
92 drugs
125 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 Fruit Extract Concentrate monograph & interactions

Other (inactive) ingredients: Maltodextrin, Vegetable Capsule, Nu-Flow. These complete the product’s ingredient list but are not active constituents.

Interaction report

Peak Digestion by Peak Pure & Natural Drug Interactions

Want to check YOUR meds against Peak Digestion?

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
396Drugs
393 Moderate 3 Minor

Ingredients driving the most interactions

Opti-Biome 182
Bromelain 141
Papaya Fruit Extract Concentrate 92

Individual Drug Interactions

The ingredients in Peak Digestion interact with 396 drugs. Click any drug to see the details.

3 of the 4 ingredients in Peak Digestion interact with drugs. Each result below shows which ingredient is responsible. Opti-Biome Bromelain Papaya Fruit Extract Concentrate

Each ingredient & the kinds of drugs it affects

For each ingredient in Peak Digestion 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.

Opti-Biome1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Bacillus subtilis with antibiotic drugs might decrease the effectiveness of B. subtilis.
Since B. subtilis preparations usually contain live and active organisms, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and B. subtilis preparations by at least 2 hours.

Likelihood Probable Evidence D
Opti-Biome 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

Papaya Fruit Extract Concentrate4 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
Papaya Fruit Extract Concentrate full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Peak Digestion, from the product label.

Peak Pure & Natural

See all Peak Pure & Natural products
Name
Peak Pure & Natural
Street Address
P.O. Box 24638
City
West Palm Beach
State
FL
ZipCode
33416
Phone Number
1-866-773-6899
Web Address
www.PeakNatural.com
Pharmacist Counseling Corner

Peak Digestion by Peak Pure & Natural: Common Questions

Does Peak Digestion by Peak Pure & Natural interact with any medications?
Yes. Based on its ingredients, Peak Digestion has a known interaction with 396 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Peak Digestion contains 4 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.
What does bromelain do in this product?
Bromelain is an enzyme from pineapple that breaks down proteins. It's included to support digestion, though the research on how well it works for the conditions it's marketed for — like hay fever, burns, or diabetes — shows insufficient reliable evidence.
What is Opti-Biome, and why is it in here?
Opti-Biome is a strain of Bacillus subtilis, a beneficial bacteria. It's included as a probiotic to support gut health. One use — antibiotic-associated diarrhea — is rated possibly effective in our data, but for other claims the evidence is insufficient.
Can I take this if I'm on antibiotics?
Not at the same time. Antibiotics kill live bacteria, so they'll destroy the Bacillus subtilis in this product. Talk with your pharmacist about separating doses — usually a few hours apart helps.
What side effects might I notice?
Most common are digestive: diarrhea, gas, stomach upset, and headache. Allergic reactions are rare but possible, especially if you're sensitive to pineapple or papaya or have a latex allergy.
Is this safe during pregnancy or breastfeeding?
No. Bromelain should be avoided in pregnancy due to insufficient safety data, and safety while breastfeeding is unknown. For the papaya and Bacillus subtilis, there isn't enough data either — talk with your doctor before use.
Will this help my diabetes?
The data we hold shows insufficient reliable evidence that papaya or bromelain work for diabetes. If that's why you're considering it, talk with your pharmacist about whether there's better-supported options.

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

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

Peak Digestion label
Go deeper

The Full Monographs Behind Peak Digestion’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

Bacillus Subtilis

Interacts with 182 drugs

Bacillus subtilis is a spore-forming probiotic bacterium found in soil and some fermented foods, and it is used mainly to support gut health and digestion. Early research is promising for ce...

Read the full Bacillus Subtilis 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 →
Sources

Sources & How We Checked

Peak Digestion'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 43 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 →

Bacillus Subtilis 10 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Lampropoulos PK, Gkentzi D, Tzifas S, Dimitriou G. Neonatal sepsis due to Bacillus subtilis. Cureus 2021;13(9):e17692. PubMed
  3. La Jeon Y, Yang JJ, Kim MJ, et al. Combined Bacillus licheniformis and Bacillus subtilis infection in a patient with oesophageal perforation. J Med Microbiol 2012;61(Pt 12):1766-1769. PubMed
  4. Wallet F, Crunelle V, Roussel-Delvallez M, Fruchart A, Saunier P, Courcol RJ. Bacillus subtilis as a cause of cholangitis in polycystic kidney and liver disease. Am J Gastroenterol 1996;91(7):1477-8.
  5. Velasco E, Martins CA, Tabak D, Bouzas LF. "Bacillus subtilis" infection in a patient submitted to a bone marrow transplantation. Rev Paul Med 1992;110(3):116-7.
  6. Kato A, Yoshifuji A, Komori K, et al. A case of Bacillus subtilis var. natto bacteremia caused by ingestion of natto during COVID-19 treatment in a maintenance hemodialysis patient with multiple myeloma. J Infect Chemother 2022;28(8):1212-1215. PubMed
  7. Freedman KE, Hill JL, Wei Y, et al. Examining the gastrointestinal and immunomodulatory effects of the novel probiotic Bacillus subtilis DE111. Int J Mol Sci 2021;22(5):2453. PubMed
  8. Lefevre M, Racedo SM, Denayrolles M, et al. Safety assessment of Bacillus subtilis CU1 for use as a probiotic in humans. Regul Toxicol Pharmacol 2017;83:54-65. PubMed
  9. Hanifi A, Culpepper T, Mai V, et al. Evaluation of Bacillus subtilis R0179 on gastrointestinal viability and general wellness: a randomised, double-blind, placebo-controlled trial in healthy adults. Benef Microbes 2015;6(1):19-27. PubMed
  10. Tokano M, Tarumoto N, Imai K, et al. A case of bacterial meningitis caused by Bacillus subtilis var. natto. Intern Med. 2022. Epub ahead of print.

See these in context on the Bacillus Subtilis 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 →

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.

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