Dietary Sources

Bromelain is found in the common pineapple plant, but not in high enough doses to act as medicine.

Available Forms

Bromelain is available in tablet or capsule form for use by mouth. A topical variety is sometimes used by health care providers to treat severe burns. Never try to treat a severe burn yourself. Always see a provider.

How to Take It

DO NOT give bromelain to a child. There are no studies to know if it's safe or not.

The German Commission E recommends 80 to 320 mg, 2 to 3 times per day. For specific conditions, higher doses may be prescribed.

Precautions

Supplements may have side effects or interact with medications. You should take them only under the supervision of a knowledgeable health care provider. Bromelain is generally recommended for no longer than 8 to 10 consecutive days.

Side effects from bromelain are generally mild and include:

• Nausea and vomiting
• Diarrhea
• Excessive menstrual bleeding

People who are allergic to pineapples, Latex, wheat, celery, papain, carrot, fennel, cypress pollen, or grass pollen may also be allergic to bromelain.

Pregnant women and people with bleeding disorders, high blood pressure, and liver or kidney disease should not take bromelain.

Bromelain may increase the risk of bleeding during and after surgery. You should stop taking bromelain at least 2 weeks before surgery.

Possible Interactions

If you are being treated with any of the following medications, you should not use bromelain without talking to your health care provider.

Bromelain may increase the amount of antibiotics absorbed by the body. In one clinical study, the combination of bromelain and amoxicillin raised levels of amoxicillin in the blood. Also, some studies suggest that bromelain may increase the body's absorption of tetracycline, another antibiotic. But results of other studies have been conflicting.

Bromelain may affect the blood's ability to clot. When taken with blood thinners, it could raise the risk of bleeding. Some blood-thinning drugs include:

• Warfarin (Coumadin)
• Clopidogrel (Plavix)
• Aspirin

Some experts believe bromelain may make sedative drugs stronger, including:

• Anti seizure medications, such as phenytoin (Dilantin) and valproic acid (Depakote)
• Barbiturates
• Benzodiazepines, such as alprazolam (Xanax) and diazepam (Valium)
• Drugs to treat insomnia, such as zolpidem (Ambien), zaleplon (Sonata), eszopiclone (Lunesta), and ramelteon (Rozerem)
• Tricyclic antidepressants, such as amitriptyline (Elavil)
• Alcohol

The same is true of herbs with a sedating effect, such as valerian, kava, and catnip.

Supporting Research

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