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Bromelain

Bromelain, a pineapple-derived protease, shows modest anti-inflammatory and analgesic effects in small trials of osteoarthritis and post-surgical swelling, but the evidence base is fragmented, mostly low quality, and dominated by combination products. Promising rather than proven.

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What the science says

  • Reduces knee osteoarthritis pain Limited evidence

    A 16-week randomized comparative trial found bromelain improved total WOMAC score in knee osteoarthritis to a degree comparable with diclofenac, with fewer gastrointestinal complaints. A 2023 systematic review and meta-analysis of bromelain across indications found generally favorable but imprecise pain outcomes, with most included trials small and at moderate-to-high risk of bias, and many testing bromelain only as part of an enzyme combination (trypsin/rutoside).

  • Reduces post-surgical swelling, bruising and trismus Limited evidence

    Small dental and orthopedic trials report less oedema and jaw-opening restriction after third-molar surgery with perioperative bromelain, but effect sizes vary widely and blinding is often inadequate. The 2023 meta-analysis rated the overall certainty as low.

  • Treats sinusitis Limited evidence

    Bromelain has been used in Europe for acute rhinosinusitis, largely on the basis of older German trials of a multi-enzyme product; systematic reviews of herbal treatments for rhinosinusitis judged the evidence insufficient to recommend it. No adequately powered modern RCT supports the indication.

  • "Systemic enzyme therapy" for chronic inflammation or cancer Limited evidence

    Claims that orally ingested bromelain dissolves fibrin, clears circulating immune complexes or slows tumors rest on cell and animal work. Oral absorption of intact enzyme is limited and no clinical trial supports these uses.

Dosage & safety

Studied doseTrials used 500-1,000 mg/day of bromelain, usually divided into 2-3 doses, standardized in GDU (gelatin digesting units) or FIP units — commonly 2,000-2,400 GDU/g. Take between meals if you want a systemic anti-inflammatory effect and with meals if you want digestive proteolysis. Osteoarthritis trials ran 4-16 weeks.
SafetyUsually well tolerated; the most common effects are nausea, diarrhea and menstrual changes. Bromelain has mild antiplatelet and fibrinolytic activity and may increase bleeding risk with warfarin, DOACs, aspirin or NSAIDs, and before surgery (stop 2 weeks prior). Allergic reactions including anaphylaxis occur in people sensitized to pineapple, latex, celery, papain, wheat or grass pollen. It can increase absorption of some antibiotics (amoxicillin, tetracycline), raising their serum levels. Avoid in pregnancy — data are inadequate.

How to take it

TimingBetween meals if you want the anti-inflammatory effect; with meals if you want it to help digest protein.
With food?On an empty stomach for systemic use — food consumes the enzyme on the meal instead.
Worth knowingCompare GDU or FIP activity rather than milligrams; 500 mg of a weak preparation is not the same product as 500 mg at 2,400 GDU/g.

Interactions

With medications

  • warfarin, DOACs, aspirin and NSAIDs

    Bromelain has mild antiplatelet and fibrinolytic activity that adds to bleeding risk. do not combine without medical supervision, and stop 2 weeks before surgery

  • amoxicillin and tetracyclines

    Bromelain increases their absorption and can raise serum levels. tell your prescriber if you take it alongside an antibiotic course

With other supplements

  • fish oil, ginkgo, garlic and vitamin E

    Additive antiplatelet effect. avoid stacking, particularly before a procedure

Well-established interactions only — this is not a complete list. Always tell your doctor and pharmacist what you take.

Frequently asked questions

Does bromelain help with arthritis pain?

The evidence is limited: a 16-week trial found bromelain improved knee osteoarthritis scores comparably to diclofenac, but most bromelain trials are small, at risk of bias, and often test enzyme combinations.

Does bromelain reduce swelling after surgery?

Small dental and orthopaedic trials report less swelling and jaw stiffness with bromelain after wisdom tooth surgery, but results vary and a 2023 meta-analysis rated certainty as low. Bromelain for post-surgical swelling is promising rather than proven.

Should bromelain be taken with or without food?

Take bromelain between meals for an anti-inflammatory effect, or with meals to help digest protein. Trials used 500-1,000 mg/day in 2-3 doses; compare products by GDU activity rather than milligrams.

Is bromelain safe with blood thinners?

Bromelain has mild antiplatelet and fibrinolytic activity, so do not combine it with warfarin, DOACs, aspirin or NSAIDs without supervision, and stop 2 weeks before surgery. Avoid bromelain if you are allergic to pineapple, latex or papain.

Scientific references

Where to buy

Double Wood Supplements, Quercetin with Bromelain, 120 Capsules

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