Interactions on record — worth a quick check against your medications. Based on 6 of 12 ingredients. Check your meds →
Dietary supplement

Vibra-Gest Ingredients & Drug Interactions

by NaturesPlus

Vibra-Gest label
See full label image
Capsule 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 Vibra-Gest 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

Vibra-Gest is a dietary supplement by NaturesPlus with 12 active ingredients. Its ingredients are commonly taken for inflammation and swelling, sinus and nasal congestion, digestion support.Based on those ingredients, 306 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Bifidobacterium longum, Lactobacillus acidophilus, Bromelain. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Vibra-Gest by NaturesPlus

Ask about any prescription or over-the-counter medication and we check it for interactions with Vibra-Gest by NaturesPlus — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Vibra-Gest by NaturesPlus

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

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 12 of its 12 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Vibra-Gest is a 12-ingredient digestive support formula combining plant-based enzymes and beneficial bacteria. The active ingredients are bromelain (from pineapple), papain (from papaya), protease, amylase, lipase, cellulase, lactase, and three probiotic strains: bifidobacterium longum, lactobacillus acidophilus, and lactobacillus bulgaricus.

Each works to help break down different components of food — proteins, carbohydrates, fats, and fiber — and the live probiotics aim to support your gut flora. The remaining ingredients are cellulose, microcrystalline cellulose, magnesium stearate, silica, and purified water.

Does it work?

Strong evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed

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

Strong

Strong clinical evidence supports its ingredients for:

Why this rating?
  • The label markets general wellness (“healthy digestive function”), 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).

The evidence for these ingredients is mixed. Lactase is effective for lactose intolerance.

Lactobacillus acidophilus is possibly effective for irritable bowel syndrome (IBS), helicobacter pylori infection, antibiotic-associated diarrhea, and bacterial vaginosis. For the other ingredients and conditions — bromelain for allergic rhinitis, burns, or diabetes; papain for exercise-induced muscle soreness; and the other probiotics for various digestive or immune concerns — the evidence in our data is insufficient to establish real benefit.

If you're taking this for a specific reason, it's worth discussing with your doctor whether the data supports its use for your situation.

The evidence, ingredient by ingredient Bromelain Lactase Bifidobacterium Longum Lipase Papain 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 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.

Bromelain is generally well tolerated short-term, though long-term safety data are limited. It may cause diarrhea, flatulence, stomach upset, or headache.

Allergic reactions are possible, especially if you're sensitive to pineapple. Papain is also generally tolerated when used short-term, but high doses may cause severe stomach irritation or other GI problems; allergic reactions can occur.

The probiotics are generally well tolerated in healthy people, though rare cases of infection from the live organisms have occurred in people who are critically ill or immune-compromised. Lactase is generally well tolerated, though rare contact dermatitis or allergic reactions have been reported in occupational settings.

Lipase has not been thoroughly evaluated for safety, and no adverse effects have been reported in adults at supplement doses.

Side effects, ingredient by ingredient Bromelain Lactase Bifidobacterium Longum Lipase Papain 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 6 matched ingredients can interact with medications — Papain, Lactobacillus Acidophilus, Bromelain, Bifidobacterium Longum.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs.
  • For scale: 306 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 starting if you take warfarin or other blood thinners — papain and protease may increase their effects and bleeding risk. If you take blood-thinning medications like aspirin, ibuprofen, or naproxen, bromelain may raise bleeding risk.

If you're on antibiotics, take this product several hours away from your antibiotic dose, since the live probiotics may be killed if taken together. If you take tetracycline antibiotics, bromelain may theoretically increase their levels.

Check your own medication Run your meds through the checker above

The bottom line

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

Vibra-Gest is a digestive enzyme and probiotic blend that may help some people — particularly those with lactose intolerance or certain GI conditions like IBS — but the evidence for many of its uses is not yet established. The main concern is interactions with blood thinners like warfarin, and spacing it away from antibiotics if you're taking them.

If you take any prescription medications, especially blood thinners, antibiotics, or tetracycline antibiotics, check with your doctor or pharmacist before starting this product.

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

Assessment coverage: 7 of 12 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 24, 2023.

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 Vibra-Gest, straight from the product label.

Brand NaturesPlus
Barcode (UPC) 097467044586
Net contents 180 Capsule(s)
Market status On market
Date entered into DSLD Oct 24, 2023
DSLD ID 298612
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegetarian, Adult (18 - 50 Years), Gluten Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Vibra-Gest by NaturesPlus, 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
180
UPC/BARCODE
097467044586
IngredientAmount% DV
Bromelain10.5 mg--
Lactobacillus bulgaricus50 mg--
Amylase50 mg--
Lactase50 mg--
Cellulase30 mg--
Bifidobacterium longum20 mg--
Lipase50 mg--
Papain30 mg--
Oxidase10 mg--
Phosphatase5 mg--
Lactobacillus acidophilus100 mg--
Protease20 mg--

Other ingredients: Cellulose, Microcrystalline Cellulose, Magnesium Stearate, Silica, Water, Purified

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.
Formula

Plant-derived enzymes and 3 probiotics promoting healthy digestive function. Includes 9 powerful enzymes for maximum activity: Amylase, Lactase, Lipase, Papain, Cellulase, Protease, Bromelain, Oxidase and Phosphatase.

Plant-derived enzymes

Formulation

Free from artificial colors and artificial preservatives.

Vegetarian

Gluten free

Vegetarian digestive support

Vegetarian digestive support

Storage

Keep tightly closed. Refrigerate after opening.

Precautions

Keep out of reach of children.

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.

Brand IP Statement(s)

Copyright Natural Organics

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Directions: Take one capsule with a meal. Designed as a natural digestive aid.

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

See for yourself

Vibra-Gest by NaturesPlus label

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

Vibra-Gest 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 Vibra-Gest by NaturesPlus

These are the 12 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container180 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
10.5 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

Lactobacillus bulgaricus

50 mg per serving

Amylase

50 mg per serving Form: Aspergillus oryzae

Lactase

No known
interactions
50 mg per serving Form: Aspergillus oryzae

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

30 mg per serving Form: Trichoderma longibrachiatum

Bifidobacterium longum

Interacts with
182 drugs
20 mg per serving

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...

Bifidobacterium longum monograph & interactions

Lipase

No known
interactions
50 mg per serving Form: Rhizopus oryzae

Lipase is a digestive enzyme that helps your body break down dietary fats. It is well established as part of prescription pancreatic enzyme therapy fo...

Lipase monograph & interactions

Papain

Interacts with
2 drugs
30 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

Oxidase

10 mg per serving Form: Aspergillus niger

Phosphatase

5 mg per serving Form: Aspergillus niger

Lactobacillus acidophilus

Interacts with
182 drugs
100 mg per serving Form: Carrot, Powder

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

Lactobacillus acidophilus monograph & interactions

Protease

Interacts with
2 drugs
20 mg per serving Form: Aspergillus niger

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...

Protease monograph & interactions

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

Interaction report

Vibra-Gest by NaturesPlus Drug Interactions

Want to check YOUR meds against Vibra-Gest?

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
306Drugs
303 Moderate 3 Minor

Ingredients driving the most interactions

Bifidobacterium longum 182
Lactobacillus acidophilus 182
Bromelain 141
Papain 2

Individual Drug Interactions

The ingredients in Vibra-Gest interact with 306 drugs. Click any drug to see the details.

4 of the 12 ingredients in Vibra-Gest interact with drugs. Each result below shows which ingredient is responsible. Bifidobacterium longum Lactobacillus acidophilus Bromelain Papain

Each ingredient & the kinds of drugs it affects

For each ingredient in Vibra-Gest 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.

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 longum full monograph & interactions

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
Lactobacillus 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

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 Vibra-Gest, from the product label.

NaturesPlus

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

Vibra-Gest by NaturesPlus: Common Questions

Does Vibra-Gest by NaturesPlus interact with any medications?
Yes. Based on its ingredients, Vibra-Gest has a known interaction with 306 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Vibra-Gest contains 12 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 Vibra-Gest while pregnant or breastfeeding?
Bromelain and papain: the safety data advises against bromelain in pregnancy, and papain is possibly unsafe in pregnancy due to safety concerns — both are best avoided. For breastfeeding, there isn't enough data on either, so ask your doctor or pharmacist. Lactobacillus acidophilus is possibly safe in pregnancy and during breastfeeding, but data are limited. Lactase is likely safe in both, though you should check with your doctor first. For the other ingredients (bifidobacterium longum, lipase, and others), safety data are limited or not available — discuss with your healthcare provider before use.
What are the most common side effects?
Bromelain and papain may cause diarrhea, flatulence, and stomach upset. The probiotics may cause bloating, flatulence, or abdominal discomfort, though these are uncommon. Allergic reactions to bromelain or papain are possible in sensitive individuals. If you have any concerns about side effects, mention them to your doctor or pharmacist.
Is this product safe for people with serious illnesses or weak immune systems?
Caution is needed. The live probiotics in this product have been associated with rare but serious infections in critically ill patients and those who are immune-compromised. If you fall into either category, talk with your doctor before using it.
How far apart should I take this from antibiotics?
The probiotics (lactobacillus acidophilus and bifidobacterium longum) contain live organisms that antibiotics can kill, making the probiotics less effective. Space your antibiotic and this supplement several hours apart — your doctor or pharmacist can advise you on the best timing for your specific antibiotic.
Does Vibra-Gest really help with digestion?
The evidence varies by ingredient. Lactase definitely helps digest lactose if you're lactose intolerant. Lactobacillus acidophilus is possibly effective for IBS and some other GI issues. For the digestive enzymes (bromelain, papain, amylase, lipase) and the other probiotics, the evidence in our data is insufficient to confirm they improve digestion in healthy people.

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

Not sure if Vibra-Gest is safe with your meds?

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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.

Vibra-Gest label
Go deeper

The Full Monographs Behind Vibra-Gest’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

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

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

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

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

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

Vibra-Gest'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 68 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 →

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 →

Bifidobacterium Longum 21 references
  1. Ha GY, Yang CH, Kim H, Chong Y. Case of sepsis caused by Bifidobacterium longum. J Clin Microbiol 1999;37:1227-8.
  2. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  3. Xiao JZ, Takahashi S, Odamaki T, et al. Antibiotic susceptibility of bifidobacterial strains distributed in the Japanese market. Biosci Biotechnol Biochem. 2010;74(2):336-42. PubMed
  4. Rautava S, Kainonen E, Salminen S, Isolauri E. Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant. J Allergy Clin Immunol. 2012;130(6):1355-60. PubMed
  5. 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.
  6. Pellonperä O, Vahlberg T, Mokkala K, et al. Weight gain and body composition during pregnancy: a randomised pilot trial with probiotics and/or fish oil. Br J Nutr. 2020 Nov 4:1-11. PubMed
  7. Pellonperä O, Mokkala K, Houttu N, et al. Efficacy of fish oil and/or probiotic intervention on the incidence of gestational diabetes mellitus in an at-risk group of overweight and obese women: A randomized, placebo-controlled, double-blind clinical trial PubMed
  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. Esaiassen E, Hjerde E, Cavanagh JP, Simonsen GS, Klingenberg C; Norwegian Study Group on Invasive Bifidobacterial Infections. Bifidobacterium bacteremia: Clinical characteristics and a genomic approach to assess pathogenicity. J Clin Microbiol. 2017;55(7) PubMed
  10. Enomoto T, Sowa M, Nishimori K, et al. Effects of bifidobacterial supplementation to pregnant women and infants in the prevention of allergy development in infants and on fecal microbiota. Allergol Int 2014;63(4):575-85. PubMed
  11. US Food and Drug Administration (FDA). Dear Healthcare Provider Letter: Warning Regarding Use of Probiotics in Preterm Infants. September 2023. Available at: https://www.fda.gov/media/172606/download?attachment. Accessed November 1, 2023.
  12. Pillai A, Tan J, Paquette V, Panczuk J. Does probiotic bacteremia in premature infants impact clinically relevant outcomes? A case report and updated review of literature. Clin Nutr ESPEN. 2020;39:255-259. PubMed
  13. Sabaté JM, Iglicki F. Effect of Bifidobacterium longum 35624 on disease severity and quality of life in patients with irritable bowel syndrome. World J Gastroenterol 2022;28(7):732-744.
  14. Malaguarnera M, Greco F, Barone G, Gargante MP, Malaguarnera M, Toscano MA. Bifidobacterium longum with fructo-oligosaccharide (FOS) treatment in minimal hepatic encephalopathy: a randomized, double-blind, placebo-controlled study. Dig Dis Sci 2007;52(11) PubMed
  15. Zbinden A, Zbinden R, Berger C, Arlettaz R. Case series of Bifidobacterium longum bacteremia in three preterm infants on probiotic therapy. Neonatology 2015;107(1):56-9.
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Lipase 1 reference
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See these in context on the Lipase monograph →

Papain 11 references
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Lactobacillus Acidophilus 15 references
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See these in context on the Lactobacillus Acidophilus monograph →

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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.

© 2021 Therapeutic Research Center, LLC

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