Interactions on record — worth a quick check against your medications. Based on 7 of 8 ingredients. Check your meds →
Dietary supplement

Ultra Enzyme Ingredients & Drug Interactions

by New Sun

Ultra Enzyme 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 Ultra Enzyme 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

Ultra Enzyme is a dietary supplement by New Sun with 8 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, 259 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Bromelain, Papaya fruit powder, Betaine HCl. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Ultra Enzyme by New Sun

Ask about any prescription or over-the-counter medication and we check it for interactions with Ultra Enzyme by New Sun — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Ultra Enzyme by New Sun

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 7 of its 10 active ingredients.
  • “Pancreatin 11X” is listed as a grouped ingredient — the label gives one combined amount (134 mg) without saying how much of each component you get.

Ultra Enzyme contains ten active ingredients—all digestive enzymes and supporting compounds. Amylase, bromelain, protease, lipase, and cellulase break down carbohydrates, proteins, and fats so your body can absorb them.

Papain and acid protease help further with protein digestion. Betaine HCl boosts stomach acid to aid digestion, and ox bile extract helps your body process fats.

Pancreatin 11X is a blend of multiple enzymes extracted from pork pancreas. The inactive ingredients are cellulose, gelatin, magnesium stearate, and silica—these are just fillers and capsule materials.

Does it work?

Not established
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
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use.

Why this rating?
  • The label markets this product for: supports healthy digestion and nutrient breakdown.
  • We looked for evidence on: Dyspepsia, Exercise-induced muscle soreness, Pancreatic insufficiency, Postoperative pain, Postoperative swelling, Rhinosinusitis — and 4 related terms.
  • The closest evidence on file: Papain is rated "Insufficient Reliable Evidence To Rate" for Exercise-induced muscle soreness (Natural Medicines).
  • Also on file: Papain is rated "Insufficient Reliable Evidence To Rate" for Wound healing.
  • Also on file: Lipase is rated "Insufficient Reliable Evidence To Rate" for Dyspepsia.

The evidence for these individual enzymes is not established in the data we hold. Papain, bromelain, papaya fruit powder, lipase, and betaine HCl all carry ratings of insufficient reliable evidence for the conditions they're claimed to treat—whether that's cancer, hay fever, burns, thyroid function, or digestive complaints.

That doesn't mean they don't work; it means the clinical trials either don't exist, are too small, or are too mixed to draw a clear conclusion.

The evidence, ingredient by ingredient Papain Bromelain Betaine Hydrochloride Papaya Proteolytic Enzymes (proteases) Pancreatic Enzyme Products Lipase

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.

Most of these enzymes are generally well tolerated at normal doses, but a few things matter. Papain and bromelain can trigger allergic reactions in sensitive people—itching, rash, swelling, or breathing trouble.

High doses of papain are unsafe and have caused serious injury to the esophagus and stomach. Betaine HCl can irritate your stomach and should be avoided if you have ulcers, gastritis, or reflux.

If you're pregnant, the data advises against papain, bromelain, and betaine HCl; for protease, lipase, and acid protease, there isn't enough safety information to know either way, so talk with your doctor. The same caution applies in breastfeeding—the data is too thin to say it's safe.

Side effects, ingredient by ingredient Papain Bromelain Betaine Hydrochloride Papaya Proteolytic Enzymes (proteases) Pancreatic Enzyme Products Lipase

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

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

Why this rating?
  • 4 of the 6 matched ingredients can interact with medications — Papain, Betaine Hydrochloride, Papaya, Bromelain.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications.
  • For scale: 259 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.

Check before you take this if you're on warfarin or any blood thinner, antidiabetes medications, amiodarone, levothyroxine, any antiplatelet drug like aspirin, tetracycline antibiotics, H2-blockers, antacids, or proton pump inhibitors. These are the medication types with documented interactions.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glancePartially disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.

This product is designed to support digestion, but it's not appropriate for everyone. If you take warfarin, any blood thinner, diabetes medications, heart rhythm drugs, thyroid hormone, or acid-reducing medications, check with your pharmacist first.

If you're pregnant or breastfeeding, talk with your doctor before starting. People with a history of stomach ulcers or reflux should avoid it.

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

Assessment coverage: 7 of 10 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 22, 2021.

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 Ultra Enzyme, straight from the product label.

Brand New Sun
Barcode (UPC) 49-4
Net contents 90 Capsule(s)
Market status On market
Date entered into DSLD Apr 22, 2021
DSLD ID 244893
Product type Other Combinations
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 Ultra Enzyme by New Sun, 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
90
UPC/BARCODE
49-4
IngredientAmount% DV
Amylase0 NP--
Papain2 mg--
Bromelain40 mg--
Protease0 NP--
Lipase0 NP--
Cellulase0.1 mg--
Betaine HCl200 mg--
Papaya fruit powder45 mg--
Ox Bile extract100 mg--
Acid Protease10 mg--
Pancreatin 11X134 mg--

Other ingredients: Cellulose, Gelatin, 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.
Suggested/Recommended/Usage/Directions

Recommendation: Take 1 capsule with a meal.

Formula

New Sun Ultra Enzyme is a comprehensive blend of enzymes that supports healthy digestion. Formulated with bromelain, ox bile, pancreatin and papain, Ultra enzyme helps to optimize the breakdown of fats, carbohydrates and protein.

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.

Formulation

Not manufactured with wheat, gluten, soy, milk, egg, fish, shellfish or tree nut ingredients.

Natural color variation may occur in this product.

Supports healthy digestion

Precautions

Produced in a GMP facility that processes other ingredients containing these allergens.

Warning: For adults only.

Consult physician if pregnant/nursing, taking medication (especially blood thinners), or have a medical condition (including allergy to papaya, pineapple).

Consult physician if pregnant/nursing, taking medication (especially blood thinners), or have a medical condition (including allergy to papaya, pineapple).

Keep out of reach of children.

Do not eat fresh packets. Keep in bottle.

Contains sulfites.

FDA Statement of Identity

Dietary Supplement

Storage

Store in a cool, dry place after opening.

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

See for yourself

Ultra Enzyme by New Sun label

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

Ultra Enzyme 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 Ultra Enzyme by New Sun

These are the 8 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container90 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
2 mg per serving

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

Papain monograph & interactions

Bromelain

Interacts with
141 drugs
40 mg per serving Form: Pineapple

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

Bromelain monograph & interactions

Cellulase

0.1 mg per serving

Betaine HCl

Interacts with
36 drugs
200 mg per serving

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

Betaine HCl monograph & interactions

Papaya fruit powder

Interacts with
92 drugs
45 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 powder monograph & interactions

Ox Bile extract

100 mg per serving Form: Total Cholic Acids

Acid Protease

No known
interactions
10 mg per serving Form: Aspergillopepsin

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

Acid Protease monograph & interactions

Pancreatin 11X

Interacts with
1 drug
134 mg per serving

Pancreatic enzyme products supply the digestive enzymes (lipase, protease, and amylase) that some people cannot make enough of, helping them break dow...

Pancreatin 11X monograph & interactions

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

Interaction report

Ultra Enzyme by New Sun Drug Interactions

Want to check YOUR meds against Ultra Enzyme?

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
259Drugs
212 Moderate 47 Minor

Ingredients driving the most interactions

Bromelain 141
Papaya fruit powder 92
Betaine HCl 36
Papain 2
Pancreatin 11X 1

Individual Drug Interactions

The ingredients in Ultra Enzyme interact with 259 drugs. Click any drug to see the details.

5 of the 8 ingredients in Ultra Enzyme interact with drugs. Each result below shows which ingredient is responsible. Bromelain Papaya fruit powder Betaine HCl Papain Pancreatin 11X

Each ingredient & the kinds of drugs it affects

For each ingredient in Ultra Enzyme 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

Papaya fruit powder4 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 powder full monograph & interactions

Betaine HCl3 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
Betaine HCl 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

Pancreatin 11X1 drug type · 1 drug

Acarbose (Precose, Prandase)

Theoretically, pancreatic enzyme products may reduce the effects of acarbose.
The digestive enzymes present in pancreatic enzyme products may break down acarbose, reducing its effects.

Likelihood Possible Evidence D
Pancreatin 11X full monograph & interactions
The maker

Brand information

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

New Sun

See all New Sun products
Name
New Sun, Inc.
City
Hendersonville
State
NC
ZipCode
28792
Phone Number
(800) 544-0777
Web Address
mynewsun.com
Pharmacist Counseling Corner

Ultra Enzyme by New Sun: Common Questions

Does Ultra Enzyme by New Sun interact with any medications?
Yes. Based on its ingredients, Ultra Enzyme has a known interaction with 259 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Ultra Enzyme contains 8 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 Ultra Enzyme if I'm on aspirin or another blood thinner?
Not without checking with your pharmacist first. Bromelain in this product may increase bleeding risk, and papain and papaya fruit powder can intensify warfarin's effects. Different blood thinners behave differently, so your pharmacist needs to see your exact medication before you start.
Will this help my digestion?
The evidence for whether these enzymes improve digestion isn't established in the data we hold. That said, they're used as digestive aids, and most people tolerate them well at normal doses.
What are the side effects I might expect?
Most common are mild digestive upsets—diarrhea, gas, stomach upset, or headache. Allergic reactions are possible if you're sensitive to papain or bromelain; symptoms include itching, rash, or breathing trouble. High doses of papain or taking this on an empty stomach with betaine HCl might irritate your stomach.
Is it safe to take Ultra Enzyme while pregnant?
The data advises against papain, bromelain, and betaine HCl during pregnancy. For protease, lipase, and acid protease, there isn't enough safety information to know either way. Talk with your doctor before starting.
Can I take this if I'm on a thyroid medication like Synthroid?
You'll need to check with your pharmacist. The papaya fruit powder in this product may theoretically reduce levothyroxine's effects, especially at high intakes, so timing and dose matter.
What if I'm on diabetes medication?
Talk to your pharmacist or doctor first. The papaya fruit powder may add to the blood-sugar-lowering effect of antidiabetes drugs, which could lower your blood sugar too much.

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.

Ultra Enzyme label
Go deeper

The Full Monographs Behind Ultra Enzyme’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

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

Papaya

Interacts with 92 drugs

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

Read the full Papaya monograph → Herb & supplement monograph

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

Pancreatic Enzyme Products

Interacts with 1 drug

Pancreatic enzyme products supply the digestive enzymes (lipase, protease, and amylase) that some people cannot make enough of, helping them break down and absorb food. Prescription versions...

Read the full Pancreatic Enzyme Products 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 →
Sources

Sources & How We Checked

Ultra Enzyme'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 90 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 →

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
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Lipase 1 reference
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Betaine Hydrochloride 2 references
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