Bromelain is a digestive enzyme found in the stem and fruit of the pineapple plant (Ananas comosus). It is best known as a digestive aid and for its anti-inflammatory effects in traumatic injuries and after surgery. Bromelain has also been used successfully to treat a number of disorders, including heart disease, arthritis, upper respiratory tract infection, and Peyronie's disease (a condition that affects the genitourinary tract and can cause sexual dysfunction in men). Bromelain has also been used successfully to heal wounds caused by burns and to increase the actions of certain antibiotics. Please refer to the interactions section for more information.

• Reduces pain, bruising, and swelling from trauma (for example, sports injuries) or surgery and speeds the healing process
• Relieves the symptoms of gastrointestinal upset, aids in the healing of gastric ulcers, and is used as a digestive enzyme for pancreatic insufficiency
• Relieves the symptoms of angina, and because it inhibits clot formation and breaks down build-up of plaque in arteries, it is useful for thrombosis, thrombophlebitis, varicose veins, and atherosclerosis.
• Reduces joint inflammation in rheumatoid arthritis, osteoarthritis, sciatica, bursitis, tendonitis, and scleroderma
• Increases the actions of antibiotics 
• Suppresses cough and decreases bronchial secretions, resulting in increased lung function in patients with upper respiratory tract infections. It is also effective in patients with sinusitis.
• Can prevent the thickening of the fibrous connective tissue in the penis associated with Peyronie's disease
• Used for healing burns

Bromelain is one of the simple digestive enzymes extracted from tropical fruit, in this case pineapple.

Bromelain is available in tablet (500 mg) or capsule form for oral use.

For use as a digestive aid, 500 mg with meals is the recommended dosage. For other uses, the following dosages are recommended.

• Traumatic injuries—500 mg four times a day on an empty stomach
• Cardiovascular disease—500 to 750 mg three times a day on an empty stomach
• Joint inflammation—500 to 2,000 mg a day in two doses

For all other uses, consult your health care provider. You should take bromelain for only 8 to 10 days, but it may be tolerated for longer periods.

Bromelain may cause nausea, vomiting, diarrhea, and excessive menstrual bleeding, but no serious side effects have been reported in humans; however, allergic reactions, including skin reactions and asthma, may occur if you are allergic to pineapples. Experiments in animals have not shown bromelain to cause cancer or birth defects, but there have not been any studies concerning use of bromelain in pregnancy. Check with your health care provider if you have a blood-clotting disorder, liver or kidney disease, or hypertension.

In a clinical study, the combination of bromelain and amoxicillin increased the levels of this antibiotic in the blood. Studies with bromelain and tetracycline have yielded mixed results regarding whether bromelain increases the body's ability to absorb this antibiotic. More studies are needed to confirm these results. You should consult with your healthcare provider before using bromelain if you are currently taking these antibiotics.

Bradbrook JD. The effect of bromelain on the absorption of orally administered tetracycline. Br J Clin Pharmacol. 1978;6(6):552-554.

Bromelain. Alternative Medicine Review. August 1998;3:302–305.

Desser L, Rehberger A, Kokron E, Paukovits W. Cytokine synthesis in human peripheral blood mononuclear cells after oral administration of polyenzyme preparations. Oncology. 1993;50:403–407.

Haas EM. Staying Healthy with Nutrition: The Complete Guide to Diet and Nutritional Medicine. Berkeley, Calif: Celestial Arts; 1992:257–258.

Harborne J, Baxter H, eds. Phytochemical Dictionary: A Handbook of Bioactive Compounds from Plants. London, England: Taylor & Francis; 1993:376.

Masson M. Bromelain in blunt injuries of the locomotor system. A study of observed applications in general practice. Fortschr Med. 1995;113:303–306.

Murray MT. Encyclopedia of Nutritional Supplements: The Essential Guide for Improving Your Health Naturally. Rocklin, Calif: Prima Publishing; 1996:429.

Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine. 2nd ed. Rocklin, Calif: Prima Publishing; 1998:208,297–298,568,807,829–830.

Reynolds JEF, ed. Martindale: The Extra Pharmacopoeia. 31st ed. London, England: Royal Pharmaceutical Society; 1996:1681.

Sanders HJ. Therapy of chlamydia infections with tetracyclines. Int J Exp Clin Chemother. 1990;3(2):101-106.

Taussig SJ, Batkin S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J Ethnopharmacol. 1998;22:191–203.

Tinozzi S, Venegoni A. Efffect of bromelain on serum and tissue levels of amoxycillin. Drugs Exptl. Clin. Res. 1978; 4(1):39-44.

Uhlig G, Seifert J. The effect of proteolytic enzymes (traumanase) on posttraumatic edema. Fortschr Med. 1981;99:554–556.

Walker JA, Cerny FJ, Cotter JR, Burton HW. Attentuation of contraction-induced skeletal muscle injury by bromelain. Med Sci Sports Exerc. 1992;24:20–25.

Werbach MR. Nutritional Influences on Illness: A Sourcebook of Clinical Research. New Canaan, Conn: Keats Publishing; 1987:64–65,268–269,386.