Bromelain
Ananas comosus, Pineapple
Efficacy
-
Indications with possible efficacy:
None - Indications with possible, but poorly documented efficacy:
Post-operative/post-traumatic inflammation (especially of the nasal and paranasal sinuses) - Indications with no proof of efficacy:
Allergic rhinitis
Anti-inflammatory action
Burn debridement - topical use
Digestive aid
Enhancement of fat excretion in weight loss diet
Inhibition of platelet aggregation
Osteoarthritis
Smooth muscle relaxation
Stimulation of muscle contraction
Security
- Risk of Drug Interactions: Low
- Adverse Effects: Not Frequent
Description
Part of the plant used: enzymes extracted from pineapple
The pineapple plant, which is 60 to 120 cm tall, produces a very characteristic fruit, which is in fact a very complex flowerhead that wraps around the stem. Thus, the pineapple is the only cultivated fruit that has its main stem going completely through it. The plant is indigenous to South America and was spread around the world by Europeans settlers. It has been used in traditional tropical medicine for quite some time. It is now mostly cultivated for its fruit, which is used to make juice, candy and syrup.
Pineapple fruits are rich in citric acid (up to 8% in some varieties). The entire plant, fruit and juice are used commercially as a source of bromelain, a proteolytic enzyme. In the food industry, bromelain is used as a meat tenderizer. The plant's medicinal properties are attributed to bromelain, which has a 40% absorption rate when taken orally. Bromelain has been used for burn debridement, to reduce skin and mucosal irritation and inflammation. Some have claimed that bromelain could prevent ulcers and promote fat elimination in some "miracle" diets, but these effects have never been proven. In certain animals, topical application of enzymes obtained from the pineapple have promoted wound healing. In addition, bromelain increases the elimination of coagulation factors (fibrin and fibrinogen). It also appears to reduce inflammatory processes.
Direction of use
- Post-operative/post-traumatic inflammation :
Usual doses:
80 to 1500 mg daily, in 2 to 3 divided doses, for 10 days. Treatment may be prolonged over 10 days if necessary.
There is insufficient reliable information to conclude that bromelain is effective in any other indication.
Precautions
- Side effects
Bromelain is not associated with any severe toxicity. When taken orally, bromelain may cause gastro-intestinal disturbances and diarrhea. There are reports of allergic reactions to this product. - Contraindications
There may be a cross-allergenicity between wheat flour, honeybee venom, olive tree pollen and bromelain. - Interactions
Apparently, zinc, an oxidizing agent, inhibits bromelain activity while magnesium, a reducing agent, increases its activity. In addition, bromelain may increase the effects of anticoagulants. Concomitant tetracycline or amoxicillin therapy (antibiotic) might increase their levels. - Pregnancy and breastfeeding
Since there is no safety data available concerning its use during pregnancy and breast-feeding, pregnant and lactating women should not use bromelain. There are reports that ingestion of large quantities of pineapple juice may induce uterine contractions.
Clinical notes
- Choose a supplement that is reported to contain at least 2000 MCU (milk coagulation unit) per gram.
Warning
In 2004, Canada adopted new regulations that control the manufacturing, packaging, labeling and importing of natural health products. The new regulations also include an adverse reaction reporting system. Products that conform to the regulation's criteria are identified with a natural product number (NPN) and can be legally sold in Canada. This number indicates that the product meets specific criteria for safety and purity, not that it is effective for any indication.
Medicinal plant contents vary naturally from plant to plant - just as fruits from the same package may vary in taste and texture. There is no standard to measure the active content of each plant. Thus, efficacy of natural products should be expected to vary from brand to brand as well as from bottle to bottle of the same brand.
For more information about the Natural Health Products Regulations, or to check if a product has been assessed, visit the Health Canada website at www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php.
References
- Blumethal M et al. The Complete German Commission E monographs, 1998
- Natural Medicines Comprehensive Database, Therapeutic Research Faculty, 2010
- Facts and Comparisons, The review of Natural Products, 2000
- Passeportsanté.net. Broméline. www.passeportsante.net
- Taylor J. CE: Phytomedicinals: Uses, precautions, and drug interactions. Drug Topics 2003;1:79
- Herbal Companion to AHFS DI, American Society of Health-System Pharmacists, 2001
- Natural Therapeutics Pocket Guide, 2000-2001
- The Review of Natural Products, 6th Edition, 2010
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The patient information leaflets are provided by Vigilance Santé Inc. This content is for information purposes only and does not in any manner whatsoever replace the opinion or advice of your health care professional. Always consult a health care professional before making a decision about your medication or treatment.