May potentially increase the risk of bleeding or potentiate the effects of warfarin therapy.

– Am J Health Syst Pharm 2000 Jul 1;57(13):1221-7; quiz 1228-30 — Potential interactions between alternative therapies and warfarin. — Heck AM, DeWitt BA, Lukes AL.

Caution is advised if administering bromelain to individuals with hypertension, since one report indicated individuals with pre-existing hypertension might experience tachycardia following high doses of bromelain.

– Gutfreund A, Taussig S, Morris A. Effect of oral bromelain on blood pressure and heart rate of hypertensive patients. Hawaii Med J 1978;37:143-146.

The allergenic potential of proteolytic enzymes should not be underestimated. They can cause IgE-mediated respiratory allergies of both the immediate type and the late-phase of immediate type. Bromelain, due to its use as a meat tenderizer and to clarify beer, is considered a potential ingestive allergen.


– Gailhofer G, Wilders-Truschnig M, Smolle J, Ludvan M. Asthma caused by bromelain: an occupational allergy. Clin Allergy 1988;18:445-450.

Avoid if allergic to pineapple. Can increase the effect of blood-thinning drugs. Large doses can cause upset stomach and cramps.

Bromelain may interact with antibiotics.
– Br J Clin Pharmacol 1978 Dec;6(6):552-4 — The effect of bromelain on the absorption of orally administered tetracycline. — Bradbrook ID, Morrison PJ, Rogers HJ.