Bromelain

Ananas comosus · Pineapple Enzyme · Bromelains

Snapshot

Indications	Contraindications
Third molar surgery recovery¹ Recovery after wisdom tooth surgery^{2, 3} Chronic wound debridement⁴ Burn debridement⁵ Episiotomy pain and healing⁶ Skin flap healing after Mohs surgery⁷ Sinusitis symptoms^8–10	Warfarin or other blood thinners⁵ Tetracycline antibiotics⁵ Bromelain hypersensitivity¹¹

Bromelain is a group of protein-digesting enzymes from the stem and fruit of the pineapple plant¹². It is taken for its anti-inflammatory effect, which in cell studies reflects lower cytokine and prostaglandin signaling¹³. Oral use centers on swelling and pain after surgery, especially wisdom tooth extraction, and on wound healing^{1, 6}. Topical bromelain-based products are used to debride burns and chronic wounds⁵. Sinusitis, osteoarthritis, and exercise soreness are also common reasons for use¹².

Evidence is best for post-surgical use: a meta-analysis found less pain, edema, and trismus after lower third molar surgery, though the authors call for higher-quality trials¹. For oral sinusitis use, the research is insufficient to support a recommendation¹². Effects on inflammatory markers across trials are inconsistent¹⁴. Topical enzymatic debridement increased complete debridement in chronic wounds in a meta-analysis of randomized trials⁴. In a 2022 double-blind trial in eye floaters, a mixed fruit enzyme supplement containing bromelain cleared vitreous opacities in a dose-dependent manner, leaving bromelain's own contribution untested. Oral products come mainly as capsules and tablets; see Form comparison.

Bleeding concern with anticoagulants rests on preclinical antithrombotic data, and clinical relevance is undetermined⁵. Health Canada labels ask for a practitioner's advice before use with blood thinners, anti-inflammatory agents, or antibiotics¹¹.

Last updated October 16, 2026. Read how we make monographs.

In the full monograph

62 sources, 46 studies

When to useThe situations practitioners use it for, each with the reason and the study behind it.
SafetyWho should avoid it, who needs extra care, and the side effects reported in studies.
InteractionsThe medicines and supplements it interacts with, the effect of each, and what labeling says to watch.
Protocol notesThe doses used in studies, how and when they were taken, and how the forms on the market compare.
How it worksWhat it is and how it works in the body, in plain terms.
Published studiesThe studies behind each use, popular claims checked against them, and trials still under way.
Word of mouthWhat patients and practitioners report online, kept separate from the clinical evidence.
Clinical perspectiveA closing read of where the evidence is solid, where it is thin, and what has not been studied.

Snapshot

In the full monograph

Sources