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Review

Bromelain

No authors listed
In: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012.
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Review

Bromelain

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Excerpt

Bromelain is a concentrated mixture of proteins and enzymes made from the stems and fruit of the pineapple plant (Ananas comosus) that has antiinflammatory and digestive properties, and is used topically to treat wounds and burns and orally for digestive problems and sinusitis. Bromelain is generally recognized as safe (GRAS) and has not been linked to serum aminotransferase elevations nor to instances of clinically apparent liver injury.

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References

    1. Zimmerman HJ. Unconventional drugs. Miscellaneous drugs and diagnostic chemicals. In, Zimmerman, HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia: Lippincott,1999: pp. 731-4.(Expert review of hepatotoxicity published in 1999; several herbal medications linked to liver injury are discussed, but bromelain is not mentioned).
    1. Seeff L, Stickel F, Navarro VJ. Hepatotoxicity of herbals and dietary supplements. In, Kaplowitz N, DeLeve LD, eds. Drug-induced liver disease. 3rd ed. Amsterdam: Elsevier, 2013, pp. 631-58.(Review of hepatotoxicity of herbals does not mention bromelain).
    1. Bromelain. PDR for Herbal Medicines. 4th ed. Montvale, New Jersey: Thomson Healthcare Inc. 2007; pp 945-8.(Compilation of short monographs on herbal medications and dietary supplements).
    1. Taub SJ. The use of bromelains in sinusitis: a double-blind clinical evaluation. Eye Ear Nose Throat Mon. 1967;46:361-2.(Among 59 adults with acute or chronic sinusitis treated with bromelain or placebo four times daily for 6 days concurrently with antibiotics and decongestants, an excellent response was reported in 69% on bromelain vs 23% on placebo, and although there were no differences in improvements in headache and pain, there were also no “toxic manifestations”). - PubMed
    1. Seltzer AP. Adjunctive use of bromelains in sinusitis: a controlled study. Eye Ear Nose Throat Mon. 1967;46:1281-8.(Among 49 patients with symptoms of sinusitis treated for 6 days, good to excellent responses occurred in 80% of patients on bromelain treatment vs 50% on placebo, although rates of improvements in headache and pain were not different in the two groups; “side effects were not encountered”). - PubMed

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