Interactions on record — worth a quick check against your medications. Based on 7 of 13 ingredients. Check your meds →
Dietary supplement

Ultra-Zyme Ingredients & Drug Interactions

by Natures Plus

Ultra-Zyme label
See full label image
Tablet Or Pill Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 23, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Ultra-Zyme 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-Zyme is a dietary supplement by Natures Plus with 13 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, 332 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Acidophilus, Bromelain, 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-Zyme by Natures Plus

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

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Ultra-Zyme by Natures Plus

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 24, 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 10 of its 13 active ingredients.
  • “Pancreatin 4x” is listed as a grouped ingredient — the label gives one combined amount (325 mg) without saying how much of each component you get.

Ultra-Zyme contains 13 active ingredients—a mix of digestive enzymes and a probiotic. Papain and bromelain are plant-derived protein-digesting enzymes; pepsin and protease are protein-digestive enzymes; amylase, cellulase, hemicellulase, and lipase break down carbohydrates, fiber, and fats respectively.

Lactase helps digest lactose in dairy. Pancreatin 4x is a standardized blend of pancreatic enzymes.

Betaine HCl is a stomach-acid compound, and acidophilus is a probiotic (beneficial bacteria). The tablet also contains inactive ingredients including di-calcium phosphate, stearic acid, microcrystalline cellulose, and several herbal flavoring agents like parsley, peppermint, fennel, ginger, and rosemary.

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 (“nutritional support for healthy digestion”), 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).
  • On file: Antibiotic-associated diarrhea — rated "Possibly Effective" (Lactobacillus Acidophilus) (Natural Medicines).
  • On file: Bacterial vaginosis — rated "Possibly Effective" (Lactobacillus Acidophilus) (Natural Medicines).
  • On file: Helicobacter pylori — rated "Possibly Effective" (Lactobacillus Acidophilus) (Natural Medicines).
  • On file: Irritable bowel syndrome (IBS) — rated "Possibly Effective" (Lactobacillus Acidophilus) (Natural Medicines).

Evidence for these ingredients is sparse. Lactase is effective for lactose intolerance.

Acidophilus is possibly effective for irritable bowel syndrome, Helicobacter pylori infection, antibiotic-associated diarrhea, and bacterial vaginosis, though it may be ineffective for atopic disease. For the other enzymes and compounds in Ultra-Zyme—including papain, bromelain, betaine HCl, pepsin, lipase, and protease—the evidence we hold does not establish effectiveness for the conditions they're claimed to help.

The evidence, ingredient by ingredient Papain Bromelain Lactase Betaine Hydrochloride Proteolytic Enzymes (proteases) Lipase Lactobacillus Acidophilus

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 7 of the 7 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 7 of 7.
  • General safety write-ups exist for 7 of 7.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most ingredients are generally well tolerated at appropriate doses when taken short-term. Papain may irritate the digestive tract and cause allergic reactions; papain is possibly unsafe in pregnancy and safety data during breastfeeding are insufficient.

Bromelain is generally well tolerated short-term, but should be avoided in pregnancy and lactation due to lack of safety data. Betaine HCl may irritate the stomach and should not be used by people with ulcers, gastritis, or acid reflux; it should be avoided in pregnancy and lactation.

Acidophilus is generally well tolerated in healthy adults and children and is possibly safe in pregnancy, though data during lactation are limited. Pepsin and protease may cause digestive upset or allergic reactions and should be avoided in pregnancy unless prescribed.

Lactase is likely safe in pregnancy and generally well tolerated, though caution is advised. Lipase is generally well tolerated but should be used only under medical guidance for serious digestive conditions, and safety data in pregnancy and lactation are limited.

Side effects, ingredient by ingredient Papain Bromelain Lactase Betaine Hydrochloride Proteolytic Enzymes (proteases) Lipase Lactobacillus Acidophilus

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 7 matched ingredients can interact with medications — Papain, Betaine Hydrochloride, Lactobacillus Acidophilus, Bromelain.
  • 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.

If you take warfarin or other blood thinners (anticoagulants) or antiplatelet drugs, check with your doctor or pharmacist first—papain and bromelain may increase bleeding risk. Tell your healthcare provider if you're on antibiotic drugs; taking them at the same time as acidophilus may reduce the probiotic's effectiveness, so timing matters.

If you use H2-blockers, antacids, or proton pump inhibitors (PPIs) to manage stomach acid, betaine HCl in this product may work against them.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glancePartially disclosed formula with strong clinical evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.

Ultra-Zyme is a digestive enzyme supplement most suitable for people seeking enzyme support for general digestion, particularly those with lactose intolerance (lactase is effective for that). If you take warfarin or other blood thinners, antibiotic drugs, or medications to suppress stomach acid, you'll want to clear this with your doctor or pharmacist first—the interactions are real.

If you're pregnant or breastfeeding, check with your healthcare provider before starting, as safety data for several ingredients are missing or advise against use.

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

Assessment coverage: 8 of 13 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 23, 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-Zyme, straight from the product label.

Brand Natures Plus
Barcode (UPC) 097467044531
Net contents 180 Tablet(s)
Market status On market
Date entered into DSLD Jun 23, 2021
DSLD ID 249002
Product type Other Combinations
Supplement form Tablet Or Pill
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-Zyme by Natures Plus, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
2 Tablet(s)
Maximum serving Sizes:
2 Tablet(s)
Servings per container
90
UPC/BARCODE
097467044531
IngredientAmount% DV
Amylase0 NP--
Papain65 mg--
Bromelain100 mg--
Lactase5 mg--
Cellulase20 mg--
Betaine HCl5 mg--
Glutamic Acid200 mg--
Hemicellulase5 mg--
Pepsin65 mg--
Ox Bile120 mg--
Lipase, Pancreatic0 NP--
Pancreatin 4x325 mg--
Protease0 NP--
Acidophilus150 mg--

Other ingredients: Di-Calcium Phosphate, Stearic Acid, Microcrystalline Cellulose, Hydroxypropyl Methylcellulose, Magnesium Stearate, Silica, Parsley, Peppermint, Fennel, Ginger, Rosemary, Pharmaceutical Glaze

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.
Formulation

Nutritional support for healthy digestion and overall well-being.

Free from artificial colors and preservatives. Free from the common allergens yeast, wheat, soy and milk.

Designed as a natural digestive aid.

Maximum strength

The ultimate digestive aid Hypo-allergenic

Gluten free

Formula

Pancreatin, ox bile and papain are specially coated to provide release of these enzymes in the intestines. Cellulase, hemi-cellulase and lactase are specially coated to provide release of 50% of these enzymes in the stomach and 50% in the intestines.

Suggested/Recommended/Usage/Directions

Directions: As a dietary supplement, take two tablets once daily.

Storage

Warning: Keep tightly closed in a cool, dry place and out of reach of children.

Precautions

Warning: Keep tightly closed in a cool, dry place and out of reach of children. Not to be used by children under 12 unless recommended by a physician.

If symptoms of digestive discomfort persist, discontinue use and consult a physician.

FDA Statement of Identity

Digestive Enzyme Supplement

Brand IP Statement(s)

Copyright Natural Organics

FDA Disclaimer Statement

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

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

See for yourself

Ultra-Zyme by Natures Plus label

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

Ultra-Zyme 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-Zyme by Natures Plus

These are the 13 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Tablet(s) Dosage formTablet Or Pill 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
65 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
100 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

Lactase

No known
interactions
5 mg 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

Cellulase

20 mg per serving

Betaine HCl

Interacts with
36 drugs
5 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

Glutamic Acid

200 mg per serving

Hemicellulase

5 mg per serving

Pepsin

No known
interactions
65 mg per serving

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

Pepsin monograph & interactions

Ox Bile

120 mg per serving

Pancreatin 4x

325 mg per serving

Acidophilus

Interacts with
182 drugs
150 mg per serving Form: Bifidus, Bulgaricus, Lactobacillus acidophilus

Lactobacillus acidophilus is a 'friendly' bacterium used as a probiotic to support gut and vaginal health. It is generally well tolerated in healthy p...

Acidophilus monograph & interactions

Other (inactive) ingredients: Di-Calcium Phosphate, Stearic Acid, Microcrystalline Cellulose, Hydroxypropyl Methylcellulose, Magnesium Stearate, Silica, Parsley, Peppermint, Fennel, Ginger, Rosemary, Pharmaceutical Glaze. These complete the product’s ingredient list but are not active constituents.

Interaction report

Ultra-Zyme by Natures Plus Drug Interactions

Want to check YOUR meds against Ultra-Zyme?

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

Ingredients driving the most interactions

Acidophilus 182
Bromelain 141
Betaine HCl 36
Papain 2

Individual Drug Interactions

The ingredients in Ultra-Zyme interact with 332 drugs. Click any drug to see the details.

4 of the 13 ingredients in Ultra-Zyme interact with drugs. Each result below shows which ingredient is responsible. Acidophilus Bromelain Betaine HCl Papain

Each ingredient & the kinds of drugs it affects

For each ingredient in Ultra-Zyme 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.

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
Acidophilus full monograph & interactions

Bromelain2 drug types · 141 drugs

Anticoagulant/Antiplatelet Drugs

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

Likelihood Possible Evidence D
Tetracycline Antibiotics

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

Likelihood Possible Evidence B
Bromelain full monograph & interactions

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
The maker

Brand information

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

Natures Plus

See all Natures Plus products
Name
Natural Organics Laboratories, Inc. makers of Nature's Plus
Street Address
9500 New Horizons Blvd
City
Amityville
State
New York
ZipCode
11701
Web Address
www.naturesplus.com
Pharmacist Counseling Corner

Ultra-Zyme by Natures Plus: Common Questions

Does Ultra-Zyme by Natures Plus interact with any medications?
Yes. Based on its ingredients, Ultra-Zyme 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?
Ultra-Zyme contains 13 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.
Will Ultra-Zyme help with my digestive problems?
The evidence we hold establishes effectiveness only for lactase in the case of lactose intolerance. For the other enzymes in this blend—papain, bromelain, pepsin, and the others—we don't have reliable evidence of effectiveness. Talk to your doctor or pharmacist about whether a digestive enzyme supplement makes sense for your specific situation.
Is it safe to take Ultra-Zyme if I'm pregnant?
Several ingredients advise against it: papain is possibly unsafe, bromelain should be avoided, and betaine HCl should be avoided. Lactase is likely safe, and acidophilus is possibly safe, but the overall profile warrants checking with your doctor or pharmacist before you start.
Can I take this with my antibiotics?
Yes, but timing matters. Acidophilus in Ultra-Zyme contains live organisms that antibiotics can kill, which would reduce its benefit. Ask your pharmacist or doctor whether you should take them several hours apart.
I'm on omeprazole (Prilosec) for acid reflux. Is Ultra-Zyme okay?
Probably not without checking first. Betaine HCl in Ultra-Zyme increases stomach acid, which directly opposes what your omeprazole (a proton pump inhibitor) is trying to do. Talk to your doctor or pharmacist—they may recommend against this combination or spacing the doses.
What are the main side effects I might notice?
Most people tolerate it well. Possible side effects include diarrhea, flatulence, upset stomach, or headache from the bromelain; allergic reactions (itching, rash, or respiratory symptoms) from papain, bromelain, pepsin, or protease in sensitive people; and mild digestive discomfort (bloating, cramps) from acidophilus. High doses of papain may cause serious stomach damage.
Does this product have fillers?
Yes. Beyond the 13 active ingredients, Ultra-Zyme contains inactive ingredients including di-calcium phosphate, stearic acid, microcrystalline cellulose, and others used as binders and capsule materials.

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

Not sure if Ultra-Zyme 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.

Ultra-Zyme label
Go deeper

The Full Monographs Behind Ultra-Zyme’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

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

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 →
Sources

Sources & How We Checked

Ultra-Zyme'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 52 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 →

Betaine Hydrochloride 2 references
  1. Yago MR, Frymoyer A, Benet LZ, Smelick GS, Frassetto LA, Ding X, Dean B, Salphati L, Budha N, Jin JY, Dresser MJ, Ware JA. The use of betaine HCl to enhance dasatinib absorption in healthy volunteers with rabeprazole-induced hypochlorhydria. AAPS J. 2014 PubMed
  2. Yago MR, Frymoyer AR, Smelick GS, Frassetto LA, Budha NR, Dresser MJ, Ware JA, Benet LZ. Gastric reacidification with betaine HCl in healthy volunteers with rabeprazole-induced hypochlorhydria. Mol Pharm. 2013 Nov 4;10(11):4032-7. PubMed

See these in context on the Betaine Hydrochloride 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
  5. 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
  6. 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.
  7. Kumar S, Kumar R, Rohilla L, Jacob N, Yadav J, Sachdeva N. A high potency multi-strain probiotic improves glycemic control in children with new-onset type 1 diabetes mellitus: A randomized, double-blind, and placebo-controlled pilot study. Pediatr Diabete
  8. Shahriari A, Karimi E, Shahriari M, Aslani N, Khooshideh M, Arab A. The effect of probiotic supplementation on the risk of gestational diabetes mellitus among high-risk pregnant women: A parallel double-blind, randomized, placebo-controlled clinical trial PubMed
  9. Xiao SD, Zhang DZ, Lu H, et al. Multicenter, randomized, controlled trial of heat-killed Lactobacillus acidophilus LB in patients with chronic diarrhea. Adv Ther. 2003;20(5):253-60.
  10. Rossi F, Amadoro C, Gasperi M, Colavita G. Lactobacilli infection case reports in the last three years and safety implications. Nutrients. 2022;14(6):1178. PubMed
  11. Ozer M, Goksu SY, Shahverdiani A, Mustafa M. Lactobacillus acidophilus-induced endocarditis and associated splenic abscess. Case Rep Infect Dis 2020;2020:1382709.
  12. Sadrin S, Sennoune S, Gout B, et al. A 2-strain mixture of Lactobacillus acidophilus in the treatment of irritable bowel syndrome: A placebo-controlled randomized clinical trial. Dig Liver Dis 2020;52(5):534-540. PubMed
  13. Stoffer JN, Slingsby TJ, Giuliari GP. Lactobacillus acidophilus endophthalmitis after intravitreal bevacizumab injection requiring intraocular lens explantation. Can J Ophthalmol 2022;57(1):e21-e22. PubMed
  14. Cukovic-Cavka S, Likic R, Francetic I, Rustemovic N, Opacic M, Vucelic B. Lactobacillus acidophilus as a cause of liver abscess in a NOD2/CARD15-positive patient with Crohn's disease. Digestion 2006;73(2-3):107-10.
  15. Hui J, Ren Y, Wang Y, Han Q. Lactobacillus acidophilus endophthalmitis postcataract operation: A case report with a literature review. Ocul Immunol Inflamm 2023.

See these in context on the Lactobacillus Acidophilus 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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