Safety Profile
Overall safety rating: Generally Safe
Bromelain Side Effects & Safety
Evidence:Moderate
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Potential Side Effects
- Mild gastrointestinal discomfort (diarrhea, nausea) in some users
- Allergic reactions possible in individuals with pineapple allergy
- Increased heart rate at very high doses (rare)
- May increase bleeding tendency — discontinue 2 weeks before surgery
Drug & Supplement Interactions
- Anticoagulants (warfarin, aspirin, heparin) — bromelain has fibrinolytic activity and may increase bleeding risk
- Antibiotics (amoxicillin, tetracyclines) — bromelain may increase antibiotic absorption and tissue levels
- Sedatives — bromelain may potentiate sedative effects (theoretical)
Maximum Dose
Do not exceed: Up to 2,400 GDU/day (960mg) has been used in clinical trials without significant adverse effects
References
- ReviewBrien S, Lewith G, Walker A, et al. (2004). Bromelain as a treatment for osteoarthritis: a review of clinical studies. Evidence-Based Complementary and Alternative Medicine. DOI PubMed
- RCTBraun JM, Schneider B, Beuth HJ (2005). Therapeutic use, efficiency and safety of the proteolytic pineapple enzyme Bromelain-POS in children with acute sinusitis in Germany. In Vivo. PubMed
- RCTAkhtar NM, Naseer R, Farooqi AZ, et al. (2004). Oral enzyme combination versus diclofenac in the treatment of osteoarthritis of the knee. Clinical Rheumatology. DOI PubMed
- Günay UB, Tanin MK, Demiröz A (2026). Efficacy and Safety of Bromelain-Based Enzymatic Debridement for Chronic Wounds: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.. Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society. DOI PubMed
- De Freitas LR, Udoma-Udofa OC, Reginato PH, Mitsui HC, et al. (2025). Bromelain-Based Enzymatic Debridement Versus Standard of Care in Deep Burn Injuries: A Systematic Review and Meta-Analysis.. Journal of burn care & research : official publication of the American Burn Association. DOI PubMed
- Meta-analysisLeelakanok N, Petchsomrit A, Janurai T, Saechan C, et al. (2023). Efficacy and safety of bromelain: A systematic review and meta-analysis.. Nutrition and health. DOI PubMed
- Avadanei-Luca S, Moraru DC, Bulgaru-Iliescu AI, Tatar R, et al. (2026). Histopathological Changes Following Bromelain-Based Enzymatic Debridement (NexoBrid®): A Comprehensive Systematic Review of Preclinical and Clinical Evidence.. Medical sciences (Basel, Switzerland). DOI PubMed