Interactions on record — worth a quick check against your medications. Based on 6 of 18 ingredients. Check your meds →
Dietary supplement

Premium Digestive Enzymes Ingredients & Drug Interactions

by HerbTonics

Premium Digestive Enzymes label
See full label image
Capsule Category: Non-nutrient/non-botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Premium Digestive Enzymes 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

Premium Digestive Enzymes is a dietary supplement by HerbTonics with 18 active ingredients. Its ingredients are commonly taken for digestive support for protein digestion, wound cleaning (debridement of dead tissue), sore throat and inflammation.Based on those ingredients, 141 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Bromelain, Papain. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Premium Digestive Enzymes by HerbTonics

Ask about any prescription or over-the-counter medication and we check it for interactions with Premium Digestive Enzymes by HerbTonics — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Premium Digestive Enzymes by HerbTonics

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 Sep 3, 2026

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 0 of its 18 active ingredients.

This product has 18 ingredients, most of them digestive enzymes designed to break down food. The main ones are papain (from papaya, breaks down protein), bromelain (from pineapple, also breaks down protein), lactase (breaks down milk sugar), lipase (breaks down fat), and proteases (break down protein).

You'll also find amylase and glucoamylase (break down carbohydrates), cellulase and hemicellulase (break down plant fiber), and several others that help with digestion. The capsules themselves are made from vegetable material.

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

This product doesn't appear to be marketed for a specific use, so we graded its ingredients' overall clinical evidence instead.

Strong

Strong clinical evidence supports its ingredients for:

Why this rating?
  • The label markets general wellness (“Healthy digestion support”), not a specific health condition, so there is no single claim to grade against clinical-evidence data.
  • Since the label doesn't commit to one use, we graded the ingredients' overall clinical evidence instead.
  • On file: Lactose intolerance — rated "Effective" (Lactase) (Natural Medicines).

The evidence for most of these enzymes isn't well established in the data we hold. Lactase is rated effective for lactose intolerance — it genuinely helps people digest milk sugar.

For everything else in the blend — papain, bromelain, lipase, and the rest — there's either insufficient reliable evidence or no evidence on file. That doesn't mean they don't work; it means studies haven't yet proven their benefit for digestive support in a way that meets scientific standards.

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

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.

Papain is generally well tolerated when used short-term at normal doses, though some people have allergic reactions (itchy eyes, runny nose, sneezing, stomach cramps, diarrhea). High doses may cause serious problems like severe inflammation of the stomach or even tearing of the esophagus.

Bromelain is also generally well tolerated orally but can cause diarrhea, gas, stomach upset, or headache in some people. Lactase and lipase appear well tolerated at normal doses, though lipase has limited safety data overall.

The proteases (protease 1 and 2) may cause digestive upset or allergic reactions in some people. Several ingredients — aspergillopepsin, cellulase, peptidase, xylanase, hemicellulase, amylase, glucoamylase, invertase, pectinase, alpha galactosidase, and beta glucanase — have no safety data on file for us to review.

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

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?
  • 2 of the 6 matched ingredients can interact with medications — Papain, Bromelain.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs.
  • For scale: 141 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

If you take warfarin (Coumadin) or any other blood thinner or blood-clot preventer — such as aspirin, clopidogrel (Plavix), or apixaban (Eliquat) — check with your doctor or pharmacist before starting this product. Both papain and bromelain may increase your bleeding risk.

Also, if you take tetracycline antibiotics (like doxycycline), bromelain may increase their levels; mention this product to your healthcare provider.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with strong clinical evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.

This blend is built around common digestive enzymes, and lactase is proven effective for lactose intolerance. If you take warfarin or another blood thinner or blood-clot preventer, you need to check with your doctor or pharmacist before starting this product — papain and bromelain both raise bleeding risk.

If you're pregnant, breastfeeding, or have a serious digestive condition, talk it over with your healthcare provider first. For most others with occasional digestive discomfort, it's generally well tolerated at normal doses.

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

Assessment coverage: 7 of 18 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 22, 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 Premium Digestive Enzymes, straight from the product label.

Brand HerbTonics
Barcode (UPC) X001UIRQB3
Net contents 120 Vegetarian Capsule(s)
Market status On market
Date entered into DSLD Jan 22, 2022
DSLD ID 258994
Product type Non-nutrient/non-botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) 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 Premium Digestive Enzymes by HerbTonics, 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 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
60
UPC/BARCODE
X001UIRQB3
IngredientAmount% DV
Papain0 NP--
Bromelain0 NP--
Lactase0 NP--
Lipase0 NP--
Aspergillopepsin0 NP--
Cellulase0 NP--
Phytase0 NP--
Peptidase0 NP--
Xylanase0 NP--
Hemicellulase0 NP--
Amylase0 NP--
Glucoamylase0 NP--
Invertase0 NP--
Pectinase0 NP--
Protease 10 NP--
Protease 20 NP--
Alpha Galactosidase0 NP--
Beta Glucanase0 NP--

Other ingredients: Vegetable Capsules

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.
General Statements

Herbtonically made!

Win a free bottle

Formulation

Formulated for healthy digestion

100% Natural

Gluten free GMO free Dairy free

Premium digestive support

Zero fillers, binders, preservatives, gluten, milk, soy, eggs, gelatin, peanuts, fish, shellfish, artificial ingredients.

Suggested/Recommended/Usage/Directions

Suggested use: Adults take two (2) capsules once daily or as directed by a health care professional. For maximum effect, take daily for at least 30 days.

Precautions

Caution: Do not exceed recommended dose.

Pregnant or nursing mothers, children under 18, and individuals with a known medical condition should consult a physician before using this or any dietary supplement.

Pregnant or nursing mothers, children under 18, and individuals with a known medical condition should consult a physician before using this or any dietary supplement.

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.

Seals/Symbols

Made with Non-GMO Ingredients Lab Verified Good Manufacturing Practice GMP Certified Made in USA

Formula

With prebiotics and probiotics

FDA Statement of Identity

Dietary supplement

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

See for yourself

Premium Digestive Enzymes by HerbTonics label

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

Premium Digestive Enzymes 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 Premium Digestive Enzymes by HerbTonics

These are the 18 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Capsule(s) Dosage formCapsule Servings per container60 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.

Papain

Interacts with
2 drugs
0 NP 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
0 NP 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

Lactase

No known
interactions
0 NP per serving

Lactase is a digestive enzyme supplement that helps people who lack enough natural lactase break down lactose, the sugar in milk and dairy. It can red...

Lactase monograph & interactions

Lipase

No known
interactions
0 NP 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

Aspergillopepsin

0 NP per serving

Cellulase

0 NP per serving

Phytase

No known
interactions
0 NP per serving

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

Phytase monograph & interactions

Peptidase

0 NP per serving

Xylanase

0 NP per serving

Hemicellulase

0 NP per serving

Amylase

0 NP per serving

Glucoamylase

0 NP per serving

Invertase

0 NP per serving

Pectinase

0 NP per serving

Protease 1

No known
interactions
0 NP per serving

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

Protease 1 monograph & interactions

Protease 2

No known
interactions
0 NP per serving

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

Protease 2 monograph & interactions

Alpha Galactosidase

0 NP per serving

Beta Glucanase

0 NP per serving

Other (inactive) ingredients: Vegetable Capsules. These complete the product’s ingredient list but are not active constituents.

Interaction report

Premium Digestive Enzymes by HerbTonics Drug Interactions

Want to check YOUR meds against Premium Digestive Enzymes?

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
141Drugs
122 Moderate 19 Minor

Ingredients driving the most interactions

Bromelain 141
Papain 2

Individual Drug Interactions

The ingredients in Premium Digestive Enzymes interact with 141 drugs. Click any drug to see the details.

2 of the 18 ingredients in Premium Digestive Enzymes interact with drugs. Each result below shows which ingredient is responsible. Bromelain Papain

Each ingredient & the kinds of drugs it affects

For each ingredient in Premium Digestive Enzymes 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.

Bromelain2 drug types · 141 drugs

Anticoagulant/Antiplatelet Drugs

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

Likelihood Possible Evidence D
Tetracycline Antibiotics

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

Likelihood Possible Evidence B
Bromelain full monograph & interactions

Papain1 drug type · 2 drugs

Warfarin (Coumadin)

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

Likelihood Possible Evidence D
Papain full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Premium Digestive Enzymes, from the product label.

HerbTonics

See all HerbTonics products
Name
Herbtonics Inc
City
Twinsburg
State
Ohio
ZipCode
44087
Phone Number
330-486-0637
Pharmacist Counseling Corner

Premium Digestive Enzymes by HerbTonics: Common Questions

Does Premium Digestive Enzymes by HerbTonics interact with any medications?
Yes. Based on its ingredients, Premium Digestive Enzymes has a known interaction with 141 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Premium Digestive Enzymes contains 18 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 really help with digestion?
Lactase, one of the enzymes here, is proven to help digest milk sugar if you're lactose intolerant. For the other enzymes in the blend — papain, bromelain, lipase, and the rest — the evidence isn't yet clear enough to say they work. That doesn't mean they don't; it just means we don't have solid proof yet.
Can I take this if I'm on warfarin?
No — not without talking to your doctor first. Papain and bromelain in this product may increase warfarin's effects and raise your bleeding risk. One patient on warfarin developed dangerously high levels after taking a papain supplement. Your doctor or pharmacist needs to know you're considering this.
Will this cause side effects?
Most people tolerate it well at normal doses. Some experience mild digestion discomfort like gas, diarrhea, or stomach upset. Allergic reactions (itchy eyes, sneezing, rash, stomach cramps) can happen in people sensitive to these enzymes, though they're not common. High doses of papain can be unsafe and may damage the stomach or esophagus.
Is it safe during pregnancy?
Papain should be avoided — it's rated possibly unsafe. Bromelain should also be avoided. Lactase is rated likely safe, but for the other ingredients, safety data during pregnancy is missing or limited. Talk with your doctor or pharmacist before taking this product if you're pregnant.
What's papain, and why is it in here?
Papain is an enzyme from papaya that breaks down protein. It's included to help digest food, but it can interact with blood thinners and may trigger allergies in sensitive people. If you have a papaya allergy, this ingredient is a concern.

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

Not sure if Premium Digestive Enzymes 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.

Premium Digestive Enzymes label
Go deeper

The Full Monographs Behind Premium Digestive Enzymes’s Ingredients

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

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

Lactase

Lactase is a digestive enzyme supplement that helps people who lack enough natural lactase break down lactose, the sugar in milk and dairy. It can reduce gas, bloating, cramping, and diarrhe...

Read the full Lactase monograph → Herb & supplement monograph

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

Phytase

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

Read the full Phytase monograph → 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

Premium Digestive Enzymes'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 42 references behind this product’s interaction data

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

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

See these in context on the Papain monograph →

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

See these in context on the Bromelain monograph →

Lactase 1 reference
  1. Laukkanen A, Ruoppi P, Remes S, Koistinen T, Mäkinen-Kiljunen S. Lactase-induced occupational protein contact dermatitis and allergic rhinoconjunctivitis. Contact Dermatitis. 2007;57(2):89-93. PubMed

See these in context on the Lactase monograph →

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 →

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

See these in context on the Phytase monograph →

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

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

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

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

© 2021 Therapeutic Research Center, LLC

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