Interactions on record — worth a quick check against your medications. Based on 11 of 22 ingredients. Check your meds →
Dietary supplement

Probiotics + Enzymes Ingredients & Drug Interactions

by Nature's Truth

Capsule Category: Non-nutrient/non-botanical
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Probiotics + Enzymes is a dietary supplement by Nature's Truth with 22 active ingredients. Its ingredients are commonly taken for inflammation and swelling, sinus and nasal congestion, digestion support.Based on those ingredients, 332 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Lactobacillus acidophilus, Bifidobacterium longum, Bifidobacterium bifidum. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Probiotics + Enzymes by Nature's Truth

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 5 of its 22 active ingredients.
  • “Pancreatin” is listed as a grouped ingredient — the label gives one combined amount (226 mg) without saying how much of each component you get.
  • “Probiotic-14 Blend” is a proprietary blend — the label gives one combined amount (120 mcg) without saying how much of each component you get.

Nature's Truth Probiotics + Enzymes contains 22 active ingredients: multiple digestive enzymes (amylase, bromelain, protease, lipase, cellulase, papain, and pancreatin) that break down food, plus 13 different probiotic strains — live beneficial bacteria and one beneficial yeast (Streptococcus thermophilus) — along with betaine hydrochloride and ox bile extract to support digestion and nutrient absorption. The inactive ingredients are gelatin, rice powder, magnesium stearate, and silica.

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: supports gastrointestinal health and digestion.
  • We looked for evidence on: Abdominal pain, Antibiotic-associated diarrhea, Aspirin-associated gastric damage, Colic, Clostridioides difficile infection, Constipation — and 4 related terms.
  • The strongest evidence on file: Lactobacillus Acidophilus is rated "Possibly Effective" for Antibiotic-associated diarrhea (Natural Medicines).
  • Also on file: Lipase is rated "Insufficient Reliable Evidence To Rate" for Dyspepsia.
  • Also on file: Betaine Hydrochloride is rated "Insufficient Reliable Evidence To Rate" for Diarrhea, Dyspepsia.

The product contains several ingredients for which evidence is limited or mixed. Lactobacillus acidophilus is possibly effective for irritable bowel syndrome (IBS), Helicobacter pylori infection, antibiotic-related diarrhea, and bacterial vaginosis.

Bifidobacterium bifidum is possibly effective for IBS and respiratory tract infections. For most of the enzymes — bromelain, papain, lipase, and betaine hydrochloride — the evidence we hold rates them as insufficient to establish effectiveness for the conditions they're promoted for.

The safety and effectiveness profiles of most of the other probiotic strains in this blend are not yet well established in the data we hold.

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 11 of the 11 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 11 of 11.
  • General safety write-ups exist for 11 of 11.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

The probiotics in this product are generally well tolerated in healthy adults, though some people report mild digestive upset including bloating, flatulence, and abdominal discomfort — usually uncommon and temporary. Bromelain and papain may cause digestive symptoms (diarrhea, gas, upset stomach) or, rarely, allergic reactions; they're not safe for people with ulcers or gastritis.

Betaine hydrochloride can irritate the stomach and is unsafe for those with existing ulcers, gastritis, or true acid reflux. There's a rare concern that probiotics containing live organisms could theoretically cause infection in critically ill or severely immunocompromised patients, though this is uncommon in healthy people with intact immune systems.

Pregnancy: Bromelain is not recommended — not enough safety data. Betaine hydrochloride should be avoided.

Papain (concentrated form and unripe papaya products) is best avoided. Lipase, protease, and most probiotic strains have limited pregnancy safety data; check with your doctor.

Bifidobacterium longum is rated possibly safe. Breastfeeding: Bromelain, betaine hydrochloride, and papain should be avoided due to insufficient safety data.

Lipase, protease, and most probiotics have limited breastfeeding data; ask your healthcare provider first.

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

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

Why this rating?
  • 8 of the 11 matched ingredients can interact with medications — Papain, Betaine Hydrochloride, Lactobacillus Acidophilus, Bromelain, Bifidobacterium Breve, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs.
  • For scale: 332 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 this product, double-check with your pharmacist if you take blood thinners (anticoagulants or antiplatelet drugs) — bromelain and papain may increase bleeding risk. If you're on warfarin specifically, papain is a documented concern.

Separate this product and any antibiotic by several hours, since the probiotics it contains may be killed by the antibiotic. If you take acid-reflux or stomach medications (H2-blockers, antacids, or PPIs), the betaine hydrochloride in this product may reduce their effectiveness.

If you take tetracycline antibiotics, bromelain theoretically might increase their levels, though study results are mixed.

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 may help with digestive health and IBS symptoms in some people, and the probiotics are generally well tolerated by healthy adults. If you take blood thinners (warfarin, aspirin, or other anticoagulants), stomach-acid medication (PPIs, H2-blockers, or antacids), or antibiotics, check with your pharmacist before starting — several ingredients interact with these drugs.

Pregnant or breastfeeding? Talk to your doctor or pharmacist first, especially because of bromelain and betaine hydrochloride.

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

Assessment coverage: 11 of 22 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 22, 2024.

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 Probiotics + Enzymes, straight from the product label.

Brand Nature's Truth
Net contents 60 Quick Release Capsule(s)
Market status On market
Date entered into DSLD Feb 22, 2024
DSLD ID 306797
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
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 Probiotics + Enzymes by Nature's Truth, 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 Quick Release Capsule(s)
Maximum serving Sizes:
2 Quick Release Capsule(s)
Servings per container
30
IngredientAmount% DV
Amylase0 NP--
Bromelain40 mg--
Protease0 NP--
Lipase0 NP--
Cellulase50 mg--
Lactobacillus acidophilus0 NP--
Lactobacillus salivarius0 NP--
Lactobacillus plantarum0 NP--
Bifidobacterium longum0 NP--
Bifidobacterium bifidum0 NP--
Lactobacillus paracasei0 NP--
Lactobacillus bulgaricus0 NP--
Lactobacillus casei0 NP--
Bifidobacterium animalis lactis0 NP--
Betaine Hydrochloride400 mg--
Papain40 mg--
Streptococcus thermophilus0 NP--
Lactobacillus brevis0 NP--
Lactobacillus gasseri0 NP--
Lactobacillus rhamnosus0 NP--
Bifidobacterium breve0 NP--
Pancreatin226 mg--
Ox Bile Extract100 mg--
Probiotic-14 Blend120 mcg--

Other ingredients: Gelatin, Rice, Powder, Magnesium Stearate, 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.
General Statements

Vitamins

100% satisfaction guaranteed

Formulation

Digestive aid Stomach friendly Supports gastrointestinal health

Gluten free Non GMO

Support Stomach friendly formula is designed to help your body's ability to digest protein, carbs & fat for optimal support.

No gluten, wheat, soy, artificial color, artificial flavor, artificial sweetener, preservatives.

Formula

Targeted enzymes

Maintain Each serving features a complex blend of 14 probiotics to support overall gastrointestinal function and targeted enzymes to help support healthy digestion. Balance With popular enzymes such as papain, pancreatin, amylase & more to promote digestive wellness and balance.

We've combined the finest digestive nutrients to create our Nature's Truth Probiotic + Enzymes formula. Probiotics are good bacteria that are naturally found in the human digestive tract, while enzymes are naturally created by our bodies to break down nutrients and aid in digestion. Our one of a kind formula provides you with a synergistic blend of 14 probiotics and key enzymes designed to support healthy gastrointestinal function.

FDA Statement of Identity

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.

Suggested/Recommended/Usage/Directions

Directions: For adults, take two (2) quick release capsules before or after meals.

Precautions

Warning: If you are pregnant, nursing, taking any medications or have any medical condition, consult your doctor before use.

If any adverse reactions occur, immediately stop using this product and consult your doctor. If seal under cap is damaged or missing, do not use.

Keep out of reach of children.

Storage

Store unopened container in a cool, dry place. Refrigerate after opening.

Brand IP Statement(s)

Copyright 2021 Nature's Truth

Seals/Symbols

Our non-GMO pledge Visit our website

See for yourself

Probiotics + Enzymes by Nature's Truth label

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

What’s inside

The Ingredients in Probiotics + Enzymes by Nature's Truth

These are the 22 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Quick Release 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
40 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

Cellulase

50 mg per serving

Betaine Hydrochloride

Interacts with
36 drugs
400 mg per serving

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

Betaine Hydrochloride monograph & interactions

Papain

Interacts with
2 drugs
40 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

Pancreatin

226 mg per serving

Ox Bile Extract

100 mg per serving Form: Cholic Acid

Probiotic-14 Blend

120 mcg per serving

Other (inactive) ingredients: Gelatin, Rice, Powder, Magnesium Stearate, Silica. These complete the product’s ingredient list but are not active constituents.

Interaction report

Probiotics + Enzymes by Nature's Truth Drug Interactions

Want to check YOUR meds against Probiotics + 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
332Drugs
303 Moderate 29 Minor

Each ingredient & the kinds of drugs it affects

For each ingredient in Probiotics + 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.

Lactobacillus acidophilus1 drug type · 182 drugs

Antibiotic Drugs

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

Likelihood Probable Evidence D

Bifidobacterium longum1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Bifidobacterium longum with antibiotic drugs might decrease the effectiveness of B. longum.
Since B. longum 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. longum preparations by at least 2 hours.

Likelihood Probable Evidence D

Bifidobacterium bifidum1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Bifidobacterium. bifidum with antibiotic drugs might decrease the effectiveness of B. bifidum.
Since B. bifidum 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. bifidum preparations by at least 2 hours.

Likelihood Probable Evidence D

Lactobacillus gasseri1 drug type · 182 drugs

Antibiotic Drugs

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

Likelihood Probable Evidence D

Bifidobacterium breve1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Bifidobacterium breve with antibiotic drugs might decrease the effectiveness of B. breve.
Since B. breve 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. breve preparations by at least 2 hours.

Likelihood Probable Evidence D

Bromelain2 drug types · 141 drugs

Anticoagulant/Antiplatelet Drugs

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

Likelihood Possible Evidence D
Tetracycline Antibiotics

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

Likelihood Possible Evidence B

Betaine Hydrochloride3 drug types · 36 drugs

Antacids

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

Likelihood Possible Evidence D
H2-Blockers

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

Likelihood Possible Evidence D
Proton Pump Inhibitors (Ppis)

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

Likelihood Possible Evidence D

Papain1 drug type · 2 drugs

Warfarin (Coumadin)

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

Likelihood Possible Evidence D
The maker

Brand information

Manufacturer and brand details for Probiotics + Enzymes, from the product label.

Nature's Truth

See all Nature's Truth products
Name
Nature's Truth LLC
City
Ronkonkoma
State
NY
ZipCode
11779
Phone Number
1-844-544-1030
Web Address
NaturesTruth.com
Pharmacist Counseling Corner

Probiotics + Enzymes by Nature's Truth: Common Questions

Does Probiotics + Enzymes by Nature's Truth interact with any medications?
Yes. Based on its ingredients, Probiotics + Enzymes has a known interaction with 332 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Probiotics + Enzymes contains 22 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 antibiotics?
You can, but separate them — take your antibiotic at least 2 hours away from this product. The live probiotics in here may be killed by the antibiotic if taken at the same time, which reduces their benefit. Ask your pharmacist for the best timing for your specific antibiotic.
Does this product work for IBS?
Two of the probiotic strains in this — Lactobacillus acidophilus and Bifidobacterium bifidum — are possibly effective for IBS. The evidence isn't strong, and results vary from person to person, but some people do see benefit. Give it time and track your symptoms.
What do the enzymes do?
The enzymes (amylase breaks down carbs, protease breaks down protein, lipase breaks down fat) are meant to help your digestive system break down food more completely. They also include betaine hydrochloride and bile extract to boost stomach acid and fat digestion.
Are there any common side effects?
Most people tolerate this well, but some report mild digestive upset — bloating, gas, diarrhea, or stomach discomfort — especially when first starting. These usually settle down. If you have a history of ulcers or acid reflux, the betaine hydrochloride in this may irritate your stomach.
Is this safe to take while pregnant or breastfeeding?
Several ingredients in this product lack adequate safety data for pregnancy or breastfeeding. Bromelain and betaine hydrochloride are best avoided during both. Talk to your doctor or pharmacist about whether this is right for you before taking it.
What if I'm allergic to pineapple or papaya?
This product contains bromelain (from pineapple) and papain (from papaya), so there's a real risk of an allergic reaction if you're sensitive to those fruits. Allergic symptoms can include itching, swelling, rash, or digestive upset. Avoid this product and tell your pharmacist about your allergy.

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

Not sure if Probiotics + 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.

Probiotics + Enzymes label
Go deeper

The Full Monographs Behind Probiotics + Enzymes’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

Betaine Hydrochloride

Interacts with 36 drugs

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

Read the full Betaine Hydrochloride monograph →
Herb & supplement monograph

Papain

Interacts with 2 drugs

Papain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food and laboratory uses, strong human evidence...

Read the full Papain monograph →
Herb & supplement monograph

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

Lactobacillus Acidophilus

Interacts with 182 drugs

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

Read the full Lactobacillus Acidophilus monograph →
Herb & supplement monograph

Bifidobacterium Longum

Interacts with 182 drugs

Bifidobacterium longum is a 'friendly' bacterium found naturally in the human gut and used as a probiotic. It is generally well tolerated and is most studied for digestive issues, though evi...

Read the full Bifidobacterium Longum monograph →
Herb & supplement monograph

Bifidobacterium Bifidum

Interacts with 182 drugs

Bifidobacterium bifidum is a 'friendly' bacteria (probiotic) that naturally lives in the human gut and is taken to support digestion and gut balance. Some evidence suggests probiotics may he...

Read the full Bifidobacterium Bifidum monograph →
Herb & supplement monograph

Streptococcus Thermophilus

Streptococcus thermophilus is a friendly bacterium used as a probiotic, often combined with other strains in yogurt and supplements. It is generally well tolerated in healthy people and may...

Read the full Streptococcus Thermophilus monograph →
Herb & supplement monograph

Lactobacillus Gasseri

Interacts with 182 drugs

Lactobacillus gasseri is a 'friendly' probiotic bacterium found naturally in the human gut, mouth, and vaginal tract, and in some fermented foods. Early research suggests it may help with di...

Read the full Lactobacillus Gasseri monograph →
Herb & supplement monograph

Bifidobacterium Breve

Interacts with 182 drugs

Bifidobacterium breve is a 'friendly' gut bacterium taken as a probiotic, most often to support digestion and balance the gut microbiome. Some studies suggest possible benefits for certain d...

Read the full Bifidobacterium Breve monograph →
Sources

Sources & How We Checked

Probiotics + 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 121 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 →

Lactobacillus Acidophilus 15 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Begtrup LM, de Muckadell OB, Kjeldsen J, Christensen RD, Jarbøl DE. Long-term treatment with probiotics in primary care patients with irritable bowel syndrome--a randomised, double-blind, placebo controlled trial. Scand J Gastroenterol 2013;48(10):1127-35 PubMed
  3. Chatterjee S, Kar P, Das T, Ray S, Gangulyt S, Rajendiran C, Mitra M. Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12 for prevention of antibiotic-associated
  4. Shavakhi A, Tabesh E, Yaghoutkar A, Hashemi H, Tabesh F, Khodadoostan M,Minakari M, Shavakhi S, Gholamrezaei A. The effects of multistrain probiotic compound on bismuth-containing quadruple therapy for Helicobacter pylori infection: a randomized placebo-c
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Bifidobacterium Longum 21 references
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Bifidobacterium Bifidum 7 references
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  4. Karamali M, Dadkhah F, Sadrkhanlou M, et al. Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Metab 2016;42(4):234-41. PubMed
  5. Badehnoosh B, Karamali M, Zarrati M, et al. The effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. J Matern Fetal Neonatal Med. 2018 May;31(9):1128-1136.
  6. Pruccoli G, Silvestro E, Pace Napoleone C, Aidala E, Garazzino S, Scolfaro C. Are probiotics safe? Bifidobacterium bacteremia in a child with severe heart failure. Infez Med. 2019;27(2):175-178.
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See these in context on the Bifidobacterium Bifidum monograph →

Betaine Hydrochloride 2 references
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Papain 11 references
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Streptococcus Thermophilus 21 references
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Lactobacillus Gasseri 12 references
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Bifidobacterium Breve 9 references
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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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