--- title: "Bromelain: Research & Side Effects | BodyHackGuide" url: https://www.bodyhackguide.co/compound/bromelain description: "Bromelain: mechanism, clinical studies & side effects." lang: en --- Skip to content Compare notes on r/BodyHackGuide (https://reddit.com/r/bodyhackguide) Compare notes with other researchers. Join r/BodyHackGuide (https://reddit.com/r/bodyhackguide) # Bromelain Immune & Inflammation: https://www.bodyhackguide.co/wiki#cat-immune-&-inflammation Status Approved (prescription, topical) Evidence Small, mixed human trials, graded on the Anti-Inflammatory Supplements bench (https://www.bodyhackguide.co/stack/anti-inflammatory-supplements) Bromelain is a mixture of protein-digesting enzymes (cysteine proteases) extracted from the stem and fruit of the pineapple plant, Ananas comosus. Reviewed 28 October 2026 01 Overview ## What Bromelain is Oral bromelain is sold as a digestive aid (PMID: 12165279; PMID: 15936249), and the FDA affirmed bromelain as generally recognized as safe for use as a food enzyme in 1995 (21 CFR 184.1024). A topical concentrate of pineapple stem enzymes enriched in bromelain, NexoBrid (anacaulase-bcdb), is a prescription biologic for removing dead burned tissue (eschar) from deep burns: the European Union authorized it on 18 December 2012 and now lists it for all age groups, and the FDA approved it for adults on 28 December 2022 and added children on 15 August 2024 (EMA product page; Drugs@FDA). Oral bromelain trials are small and mixed: pooled analyses after wisdom tooth surgery found less pain at some time points (PMID: 30986376; PMID: 30573710), while a placebo-controlled knee osteoarthritis trial found no benefit (PMID: 17121765). ### How it works ### What bromelain is Bromelain is a crude pineapple extract that contains several closely related proteases (enzymes that cut proteins) along with other components (PMID: 11577981). The name usually refers to stem bromelain, a mixture of cysteine endopeptidases (thiol proteases) with other enzymes and several protease inhibitors (PMID: 23304525). A 2017 purification found at least eight active protease forms in pineapple stem extract, each with a mass of about 24 kDa, typical of the papain family of plant proteases (PMID: 28238440). Commercial chemical and supplement preparations contain mainly stem bromelain, while the protease activity of pineapple fruit comes mostly from a related enzyme, fruit bromelain (PMID: 15710346). The FDA's food regulation describes bromelain as an enzyme preparation from Ananas comosus and A. bracteatus whose characteristic activity is that of a peptide hydrolase (EC 3.4.22.32) (21 CFR 184.1024). The drug substance in NexoBrid, anacaulase-bcdb, is 80 to 95 percent protein, mainly stem bromelain, ananain, a jacalin-like lectin and protease inhibitors (NexoBrid FDA label). Read the full mechanism Show less ### Effects on immune cells: laboratory and animal studies Most of the immunology work comes from Laura Hale's laboratory at Duke University (PMID: 1281188; PMID: 12165279; PMID: 18482869). - Human cells in the laboratory: bromelain stripped several surface molecules, including CD44 and CD45RA, from human T cells and increased their activation through the CD2 receptor (PMID: 1281188). In whole blood, bromelain altered 14 of 59 white cell surface markers, but plasma, through the protease inhibitor alpha-2-macroglobulin, blocked most of this activity, so the authors judged effective concentrations more likely in the gut than in the bloodstream (PMID: 12165279). Bromelain cut migration of human neutrophils toward the chemical signal interleukin-8 by 40 percent (PMID: 18482869) and reduced release of inflammatory signals, including TNF and interferon-gamma, by colon biopsies from people with inflammatory bowel disease (PMID: 18160345). - Mice: bromelain reduced neutrophil migration into the inflamed abdominal cavity by 50 to 85 percent (PMID: 18482869). Oral bromelain reduced colitis in interleukin-10-deficient mice and needed to be enzymatically active to do so (PMID: 15936249), kept its protease activity through the gut when given with an antacid (PMID: 14996417), and with repeated doses produced antibodies against bromelain (PMID: 17161360). A 2001 review concluded that bromelain's effects in laboratory and animal studies depend only partly on its protease activity (PMID: 11577981). ### Effects on platelets and clotting - Human cells in the laboratory: bromelain reduced platelet aggregation in blood from 10 healthy men (PMID: 16308185) and prevented thrombin-induced aggregation of isolated human platelets (PMID: 10218125). - Rats: oral bromelain reduced clot formation in small blood vessels (PMID: 10218125). - People: the NexoBrid label cites published reports that oral bromelain reduced platelet aggregation and plasma fibrinogen and moderately prolonged clotting times (partial thromboplastin and prothrombin times) (NexoBrid FDA label). - Laboratory and animal data cited on the same label suggest that bromelain promotes the breakdown of clots (NexoBrid FDA label). ### Absorption by mouth In 19 healthy men, bromelain taken by mouth appeared intact in the blood, at least partly still active and bound to the plasma protease inhibitors alpha-2-macroglobulin and alpha-1-antichymotrypsin, with an estimated plasma half-life of 6 to 9 hours (PMID: 9252520). With repeated doses of 3 g a day in that study, plasma levels reached up to 5,000 pg/mL by 48 hours, and an average of 10.8 micrograms of bromelain was present in plasma over 3 to 51 hours (PMID: 9252520). ### Removing burn eschar The enzymes in NexoBrid dissolve burn eschar, and the components responsible have not been identified (NexoBrid FDA label). After application to burn wounds, bromelain reaches the blood with a median peak at 4 hours, exposure rises with the size of the treated area, most patients have no measurable level after 72 hours, and the mean terminal half-life is 12 hours (NexoBrid FDA label). In laboratory tests, bromelain inhibited the liver enzymes CYP2C8 and CYP2C9, and no clinical drug interaction studies have been done (NexoBrid FDA label). ### Studied for - Burn care - Wound debridement - Oral and maxillofacial surgery - Inflammation and immunology - Enzymology - Occupational allergy ### Benefits listed - Complete removal of burn eschar in 93 percent of adults with a topical bromelain-enriched enzyme gel (DETECT phase 3 trial) - Less surgical excision of deep burns (4 percent versus 72 percent with standard care in DETECT) - Less blood loss during eschar removal (14 versus 814 mL in DETECT) - Faster eschar removal in children (median 1 versus 6 days in the CIDS trial) Show 2 more Show less - Less pain 7 days after wisdom tooth surgery in pooled analyses of small oral trials - Less bruising around the eyes 7 days after rhinoplasty (46-patient placebo-controlled trial) 02 Research Free with email ## What the research shows ### Graded on a research bench Reference pages that put Bromelain next to the compounds people pair it with: roles, evidence, overlap and conflicts. No dosing. Research use only. - Anti-Inflammatory Supplements Small, mixed human trials human data on 5 of 6 compounds on the bench: https://www.bodyhackguide.co/stack/anti-inflammatory-supplements ### Unlock the research summary Enter your email to keep reading. It is free, and it opens these sections on every compound page in this browser. - A summary of the key research - Safety and side effects - A link to the PubMed results You also get the free peptide cheat sheet by email. Unsubscribe anytime. Have an account? Sign in (https://www.bodyhackguide.co/auth) 03 Safety ## Bromelain side effects and interactions ### Side effects #### Common - Itching with topical NexoBrid (15 percent versus 13 percent with standard care in adults) - Fever with topical NexoBrid (12 versus 9 percent in adults) - Mainly gastrointestinal side effects with oral bromelain, alone or combined with other compounds (11 participants across 7 trials in a 2023 review; PMID: 37202035) #### Serious events - Allergic reactions including anaphylaxis, reported with NexoBrid use after approval (NexoBrid FDA label) - Occupational asthma after inhaling bromelain powder (PMID: 3233722; PMID: 498486) - Possible bleeding risk: reduced platelet aggregation and fibrinogen reported after oral bromelain (NexoBrid FDA label warning) ### Who should not use it Contraindications Contraindications on the NexoBrid label (topical prescription product): - Known allergy to anacaulase-bcdb, bromelain or pineapple, or to any other component (NexoBrid FDA label). - Known allergy to papaya or papain, because of the risk of cross-sensitivity (NexoBrid FDA label). Read all the contraindications and cautions Show less Cautions in the literature: - Bleeding and clotting: the NexoBrid label advises avoiding the product in uncontrolled clotting disorders and using caution with anticoagulants, other drugs that affect clotting, low platelet counts or other bleeding risks, citing reports of reduced platelet aggregation and fibrinogen after oral bromelain (NexoBrid FDA label); laboratory studies found reduced platelet aggregation in human blood (PMID: 16308185; PMID: 10218125). - Pineapple and papain allergy: a child with known pineapple allergy had a mild allergic reaction to bromelain given for sinusitis (PMID: 15796206), and bromelain and papain cross-reacted in sensitized workers (PMID: 498486). - Inhaled powder: bromelain dust caused occupational asthma in laboratory and pharmaceutical workers (PMID: 3233722; PMID: 498486). - Pregnancy and breastfeeding: the NexoBrid label reports no human data on use in pregnancy and no data on presence in milk (NexoBrid FDA label). ### Interactions 3 pairings in our record: 1 with a caution and 2 to monitor. - Anticoagulants and other drugs that affect clotting Caution The NexoBrid label advises caution in patients on anticoagulants or other drugs that affect clotting, citing reports that oral bromelain reduced platelet aggregation and fibrinogen (NexoBrid FDA label); laboratory studies found reduced platelet aggregation in human blood (PMID: 16308185). - Drugs broken down by CYP2C8 or CYP2C9 Monitor Bromelain inhibited the liver enzymes CYP2C8 and CYP2C9 in laboratory tests, and no clinical drug interaction studies have been done (NexoBrid FDA label). - Antibiotics Monitor A 2001 review lists enhanced absorption of drugs, particularly antibiotics, among the effects claimed for oral bromelain (PMID: 11577981). This interaction data is compiled from published research and community reports. It may not be exhaustive. Always consult a healthcare professional before combining compounds. Need bloodwork before starting? Full hormone + metabolic panels from Anabolic Insights. Code CHONCH for first-order discount. Order Bloodwork (https://anabolicinsights.ai/?ref=nwm2zjb) 04 Dosing Free with email ## Dosing No dose on record Our record lists no dose for Bromelain. This section holds what it does list. ### Unlock the Dosing section - Route 05 Prices ## Bromelain prices No listings We do not track a vendor for Bromelain yet, so this page states no price. 06 Chemistry ## Chemistry and structure Molecular mass About 24 kDa per protease form (bromelain is a mixture of proteins; PMID: 28238440) CAS number 9001-00-7 Half-life Estimated at 6 to 9 hours in plasma after oral intake in 19 healthy men (PMID: 9252520); after topical NexoBrid on burn wounds, a mean terminal half-life of 12 hours (SD 4.4) for absorbed bromelain (NexoBrid FDA label) 07 Related ## Related to Bromelain ### In the same category - Larazotide (AT-1001)Phase 3 Larazotide is an eight amino acid peptide with the sequence glycine-glycine-valine-leucine-valine-glutamine-proline-glycine, usually supplied as the acetate salt.: https://www.bodyhackguide.co/compound/larazotide - LL-37Phase 2 LL-37 is the only human cathelicidin, a 37-amino-acid amphipathic alpha-helical peptide (LLGDFFRKSKEKIGKEFKRIVQRIKDFLRNLVPRTES) cleaved from the C-terminus of the 170-amino-acid precursor hCAP-18 (human cationic antimicrobial protein, 18 kDa), which is encoded by the CAMP gene on chromosome 3p21.31.: https://www.bodyhackguide.co/compound/ll-37 - Thymosin Alpha-1 (TA1)FDA Approved Thymosin alpha-1 (Tα1) is a 28-amino-acid N-acetylated peptide (N-Ac-Ser-Asp-Ala-Ala-Val-Asp-Thr-Ser-Ser-Glu-Ile-Thr-Thr-Lys-Asp-Leu-Lys-Glu-Lys-Lys-Glu-Val-Val-Glu-Glu-Ala-Glu-Asn) isolated and characterized by Allan Goldstein's laboratory at George Washington University in the 1970s as the immunologically active cleavage product of a larger precursor (prothymosin alpha) found in thymic tissue.: https://www.bodyhackguide.co/compound/thymosin-alpha-1 - ThymulinNone labelled by phase Thymulin is a zinc-dependent nonapeptide hormone made by thymic epithelial cells, purified from pig serum in 1977 by Jean-Francois Bach's group in Paris and first called facteur thymique serique, or FTS.: https://www.bodyhackguide.co/compound/thymulin All compounds (https://www.bodyhackguide.co/wiki) ### Compare Bromelain - Alternatives to Bromelain: https://www.bodyhackguide.co/alternatives-to/bromelain ### Research tools - Peptide Calculator Reconstitution and syringe units: https://www.bodyhackguide.co/tools/reconstitution - Reconstitution Guide How to mix, step by step: https://www.bodyhackguide.co/guides/how-to-reconstitute-peptides - Nasal Spray Calc mL per actuation: https://www.bodyhackguide.co/tools/intranasal - Half-Life Visualizer Decay curves: https://www.bodyhackguide.co/tools/halflife All articles (https://www.bodyhackguide.co/blog) 08 Questions ## Frequently asked questions What is bromelain? Bromelain is a mixture of protein-digesting enzymes extracted from the stem and fruit of the pineapple plant (PMID: 11577981; PMID: 23304525). Bromelain usually refers to stem bromelain, which contains at least eight related protease forms of about 24 kDa each (PMID: 23304525; PMID: 28238440). Is bromelain an FDA-approved drug? A topical bromelain-enriched enzyme concentrate, NexoBrid (anacaulase-bcdb), was approved by the FDA on 28 December 2022 for removing eschar from deep partial-thickness and full-thickness thermal burns in adults, and the FDA extended NexoBrid to children on 15 August 2024 (FDA approval letters for BLA 761192; Drugs@FDA). Drugs@FDA lists no oral product with bromelain as its active ingredient (openFDA search, 25 October 2026). Bromelain is affirmed as generally recognized as safe for use as a food enzyme (21 CFR 184.1024), and oral bromelain is sold as a digestive aid (PMID: 15936249). What did the NexoBrid trials of bromelain-enriched enzymes show in burns? In the DETECT phase 3 trial, the bromelain-enriched gel NexoBrid removed eschar completely in 93 percent of adults against 4 percent with a plain gel, and 4 percent of NexoBrid patients needed surgical excision against 72 percent with standard care (PMID: 37715999). In the CIDS trial of 145 children, the bromelain-enriched gel cut the median time to eschar removal from 6 days to 1 day and the excised wound area from 48.1 percent to 1.5 percent (PMID: 40117996). Scar scores after bromelain-based debridement were noninferior to standard care at 12 months in both trials (PMID: 37715999; PMID: 40117996). Does oral bromelain reduce pain or swelling after surgery? Three 2019 meta-analyses of small trials found that oral bromelain reduced pain at some time points after wisdom tooth surgery, but they disagreed on swelling (PMID: 30986376; PMID: 30573710; PMID: 30224314). In an 84-patient trial, bromelain alone did not reduce swelling significantly compared with no drug (PMID: 27755433). After rhinoplasty, bromelain reduced bruising at day 7 but not swelling in a 46-patient trial (PMID: 39904804). Does bromelain help knee osteoarthritis? In a 12-week placebo-controlled trial of 47 patients with moderate to severe knee osteoarthritis, bromelain did not improve the main symptom score (PMID: 17121765). Trials comparing bromelain-containing enzyme tablets with diclofenac reported similar results, but those tablets also contained trypsin and rutoside, so the effect cannot be assigned to bromelain alone (PMID: 15278753; PMID: 11584936). Is bromelain absorbed when taken by mouth? In 19 healthy men, intact bromelain was detected in the blood after oral intake, with an estimated plasma half-life of 6 to 9 hours (PMID: 9252520). Bromelain in plasma was bound to protease inhibitors such as alpha-2-macroglobulin (PMID: 9252520), and a laboratory study found that plasma blocks most of bromelain's activity on white blood cells (PMID: 12165279). Who should be cautious with bromelain? The NexoBrid label lists allergy to bromelain, pineapple, papaya or papain as contraindications and advises caution with bromelain-based treatment in people on anticoagulants or with bleeding risks (NexoBrid FDA label). Inhaled bromelain powder has caused occupational asthma, and people sensitized to papain have reacted to bromelain (PMID: 3233722; PMID: 498486). Free 2026 Peptide Cheat Sheet (PDF) 38 compounds and blends: vial sizes, BAC water volumes, dosing ranges and bloodwork markers. Download Free (https://www.bodyhackguide.co/guides/peptide-cheat-sheet-download) BodyHackGuide (https://www.bodyhackguide.co/) Your biohacking research hub: compound pricing, brain health protocols, dosing tools, and vendor reviews. support@bodyhackguide.co Join our Discord: https://discord.gg/Mhq5UdRYBA r/BodyHackGuide on Reddit: https://reddit.com/r/BodyHackGuide **Affiliate Disclosure:** We rank every vendor on the same public, reproducible methodology (https://www.bodyhackguide.co/vendors/methodology). Full details in our affiliate disclosure (https://www.bodyhackguide.co/affiliate-disclosure). **Research Disclaimer:** All compounds listed are for laboratory and research purposes only. Not for human consumption. This site does not sell or ship any products. Always consult a qualified healthcare professional and comply with local regulations. © 2026 BodyHackGuide. All rights reserved. - Terms: https://www.bodyhackguide.co/terms - Privacy: https://www.bodyhackguide.co/privacy ## Structured data ```json [ { "@context": "https://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": 1, "name": "Home", "item": "https://www.bodyhackguide.co/" }, { "@type": "ListItem", "position": 2, "name": "Compounds", "item": "https://www.bodyhackguide.co/compare" }, { "@type": "ListItem", "position": 3, "name": "Bromelain" } ] }, { "@context": "https://schema.org", "@type": "MedicalWebPage", "name": "Bromelain", "description": "Bromelain is a mixture of protein-digesting enzymes (cysteine proteases) extracted from the stem and fruit of the pineapple plant, Ananas comosus (PMID: 11577981; PMID: 23304525). Oral bromelain is sold as a digestive aid (PMID: 12165279; PMID: 15936249), and the FDA affirmed bromelain as generally recognized as safe for use as a food enzyme in 1995 (21 CFR 184.1024). A topical concentrate of pineapple stem enzymes enriched in bromelain, NexoBrid (anacaulase-bcdb), is a prescription biologic for removing dead burned tissue (eschar) from deep burns: the European Union authorized it on 18 December 2012 and now lists it for all age groups, and the FDA approved it for adults on 28 December 2022 and added children on 15 August 2024 (EMA product page; Drugs@FDA). Oral bromelain trials are small and mixed: pooled analyses after wisdom tooth surgery found less pain at some time points (PMID: 30986376; PMID: 30573710), while a placebo-controlled knee osteoarthritis trial found no benefit (PMID: 17121765).", "lastReviewed": "2026-10-28T15:37:56.878Z", "url": "https://www.bodyhackguide.co/compound/bromelain", "author": { "@type": "Person", "name": "BioChonch", "url": "https://www.bodyhackguide.co/about", "jobTitle": "Founder & Lead Researcher", "sameAs": [ "https://reddit.com/r/BodyHackGuide", "https://reddit.com/r/BrainHackGuide", "https://reddit.com/r/Biohackingher" ], "worksFor": { "@type": "Organization", "name": "BodyHackGuide", "url": "https://www.bodyhackguide.co" } }, "reviewedBy": { "@type": "Person", "name": "BioChonch", "url": "https://www.bodyhackguide.co/about", "jobTitle": "Founder & Lead Researcher", "sameAs": [ "https://reddit.com/r/BodyHackGuide", "https://reddit.com/r/BrainHackGuide", "https://reddit.com/r/Biohackingher" ], "worksFor": { "@type": "Organization", "name": "BodyHackGuide", "url": "https://www.bodyhackguide.co" } }, "publisher": { "@type": "Organization", "name": "BodyHackGuide", "url": "https://www.bodyhackguide.co" }, "mainContentOfPage": { "@type": "WebPageElement", "cssSelector": "main" }, "about": { "@type": "Drug", "name": "Bromelain", "alternateName": [ "Bromelains", "Stem bromelain", "Fruit bromelain", "Pineapple protease", "Anacaulase-bcdb", "NexoBrid", "Concentrate of proteolytic enzymes enriched in bromelain" ], "description": "Bromelain is a mixture of protein-digesting enzymes (cysteine proteases) extracted from the stem and fruit of the pineapple plant, Ananas comosus (PMID: 11577981; PMID: 23304525). Oral bromelain is sold as a digestive aid (PMID: 12165279; PMID: 15936249), and the FDA affirmed bromelain as generally recognized as safe for use as a food enzyme in 1995 (21 CFR 184.1024). A topical concentrate of pineapple stem enzymes enriched in bromelain, NexoBrid (anacaulase-bcdb), is a prescription biologic for removing dead burned tissue (eschar) from deep burns: the European Union authorized it on 18 December 2012 and now lists it for all age groups, and the FDA approved it for adults on 28 December 2022 and added children on 15 August 2024 (EMA product page; Drugs@FDA). Oral bromelain trials are small and mixed: pooled analyses after wisdom tooth surgery found less pain at some time points (PMID: 30986376; PMID: 30573710), while a placebo-controlled knee osteoarthritis trial found no benefit (PMID: 17121765).", "activeIngredient": "Bromelain", "administrationRoute": "Topical, Oral", "mechanismOfAction": "What bromelain is Bromelain is a crude pineapple extract that contains several closely related proteases (enzymes that cut proteins) along with other components (PMID: 11577981). The name usually refers to stem bromelain, a mixture of cysteine endopeptidases (thiol proteases) with other enzymes and several protease inhibitors (PMID: 23304525). A 2017 purification found at least eight active protease forms in pineapple stem extract, each with a mass of about 24 kDa, typical of the papain family of plant proteases (PMID: 28238440). Commercial chemical and supplement preparations contain mainly stem bromelain, while the protease activity of pineapple fruit comes mostly from a related enzyme, fruit bromelain (PMID: 15710346). The FDA's food regulation describes bromelain as an enzyme preparation from Ananas comosus and A. bracteatus whose characteristic activity is that of a peptide hydrolase (EC 3.4.22.32) (21 CFR 184.1024). The drug substance in NexoBrid, anacaulase-bcdb, is 80 to 95 percent protein, mainly stem bromelain, ananain, a jacalin-like lectin and protease inhibitors (NexoBrid FDA label). Effects on immune cells: laboratory and animal studies Most of the immunology work comes from Laura Hale's laboratory at Duke University (PMID: 1281188; PMID: 12165279; PMID: 18482869). Human cells in the laboratory: bromelain stripped several surface molecules, including CD44 and CD45RA, from human T cells and increased their activation through the CD2 receptor (PMID: 1281188). In whole blood, bromelain altered 14 of 59 white cell surface markers, but plasma, through the protease inhibitor alpha-2-macroglobulin, blocked most of this activity, so the authors judged effective concentrations more likely in the gut than in the bloodstream (PMID: 12165279). Bromelain cut migration of human neutrophils toward the chemical signal interleukin-8 by 40 percent (PMID: 18482869) and reduced release of inflammatory signals, including TNF and interferon-gamma, by colon biopsies from people with inflammatory bowel disease (PMID: 18160345). Mice: bromelain reduced neutrophil migration into the inflamed abdominal cavity by 50 to 85 percent (PMID: 18482869). Oral bromelain reduced colitis in interleukin-10-deficient mice and needed to be enzymatically active to do so (PMID: 15936249), kept its protease activity through the gut when given with an antacid (PMID: 14996417), and with repeated doses produced antibodies against bromelain (PMID: 17161360). A 2001 review concluded that bromelain's effects in laboratory and animal studies depend only partly on its protease activity (PMID: 11577981). Effects on platelets and clotting Human cells in the laboratory: bromelain reduced platelet aggregation in blood from 10 healthy men (PMID: 16308185) and prevented thrombin-induced aggregation of isolated human platelets (PMID: 10218125). Rats: oral bromelain reduced clot formation in small blood vessels (PMID: 10218125). People: the NexoBrid label cites published reports that oral bromelain reduced platelet aggregation and plasma fibrinogen and moderately prolonged clotting times (partial thromboplastin and prothrombin times) (NexoBrid FDA label). Laboratory and animal data cited on the same label suggest that bromelain promotes the breakdown of clots (NexoBrid FDA label). Absorption by mouth In 19 healthy men, bromelain taken by mouth appeared intact in the blood, at least partly still active and bound to the plasma protease inhibitors alpha-2-macroglobulin and alpha-1-antichymotrypsin, with an estimated plasma half-life of 6 to 9 hours (PMID: 9252520). With repeated doses of 3 g a day in that study, plasma levels reached up to 5,000 pg/mL by 48 hours, and an average of 10.8 micrograms of bromelain was present in plasma over 3 to 51 hours (PMID: 9252520). Removing burn eschar The enzymes in NexoBrid dissolve burn eschar, and the components responsible have not been identified (NexoBrid FDA label). After application to burn wounds, bromelain reaches the blood with a median peak at 4 hours, exposure rises with the size of the treated area, most patients have no measurable level after 72 hours, and the mean terminal half-life is 12 hours (NexoBrid FDA label). In laboratory tests, bromelain inhibited the liver enzymes CYP2C8 and CYP2C9, and no clinical drug interaction studies have been done (NexoBrid FDA label).", "legalStatus": "Approved (prescription, topical)" } }, { "@context": "https://schema.org", "@type": "FAQPage", "mainEntity": [ { "@type": "Question", "name": "What is bromelain?", "acceptedAnswer": { "@type": "Answer", "text": "Bromelain is a mixture of protein-digesting enzymes extracted from the stem and fruit of the pineapple plant (PMID: 11577981; PMID: 23304525). Bromelain usually refers to stem bromelain, which contains at least eight related protease forms of about 24 kDa each (PMID: 23304525; PMID: 28238440)." } }, { "@type": "Question", "name": "Is bromelain an FDA-approved drug?", "acceptedAnswer": { "@type": "Answer", "text": "A topical bromelain-enriched enzyme concentrate, NexoBrid (anacaulase-bcdb), was approved by the FDA on 28 December 2022 for removing eschar from deep partial-thickness and full-thickness thermal burns in adults, and the FDA extended NexoBrid to children on 15 August 2024 (FDA approval letters for BLA 761192; Drugs@FDA). Drugs@FDA lists no oral product with bromelain as its active ingredient (openFDA search, 25 October 2026). Bromelain is affirmed as generally recognized as safe for use as a food enzyme (21 CFR 184.1024), and oral bromelain is sold as a digestive aid (PMID: 15936249)." } }, { "@type": "Question", "name": "What did the NexoBrid trials of bromelain-enriched enzymes show in burns?", "acceptedAnswer": { "@type": "Answer", "text": "In the DETECT phase 3 trial, the bromelain-enriched gel NexoBrid removed eschar completely in 93 percent of adults against 4 percent with a plain gel, and 4 percent of NexoBrid patients needed surgical excision against 72 percent with standard care (PMID: 37715999). In the CIDS trial of 145 children, the bromelain-enriched gel cut the median time to eschar removal from 6 days to 1 day and the excised wound area from 48.1 percent to 1.5 percent (PMID: 40117996). Scar scores after bromelain-based debridement were noninferior to standard care at 12 months in both trials (PMID: 37715999; PMID: 40117996)." } }, { "@type": "Question", "name": "Does oral bromelain reduce pain or swelling after surgery?", "acceptedAnswer": { "@type": "Answer", "text": "Three 2019 meta-analyses of small trials found that oral bromelain reduced pain at some time points after wisdom tooth surgery, but they disagreed on swelling (PMID: 30986376; PMID: 30573710; PMID: 30224314). In an 84-patient trial, bromelain alone did not reduce swelling significantly compared with no drug (PMID: 27755433). After rhinoplasty, bromelain reduced bruising at day 7 but not swelling in a 46-patient trial (PMID: 39904804)." } }, { "@type": "Question", "name": "Does bromelain help knee osteoarthritis?", "acceptedAnswer": { "@type": "Answer", "text": "In a 12-week placebo-controlled trial of 47 patients with moderate to severe knee osteoarthritis, bromelain did not improve the main symptom score (PMID: 17121765). Trials comparing bromelain-containing enzyme tablets with diclofenac reported similar results, but those tablets also contained trypsin and rutoside, so the effect cannot be assigned to bromelain alone (PMID: 15278753; PMID: 11584936)." } }, { "@type": "Question", "name": "Is bromelain absorbed when taken by mouth?", "acceptedAnswer": { "@type": "Answer", "text": "In 19 healthy men, intact bromelain was detected in the blood after oral intake, with an estimated plasma half-life of 6 to 9 hours (PMID: 9252520). Bromelain in plasma was bound to protease inhibitors such as alpha-2-macroglobulin (PMID: 9252520), and a laboratory study found that plasma blocks most of bromelain's activity on white blood cells (PMID: 12165279)." } }, { "@type": "Question", "name": "Who should be cautious with bromelain?", "acceptedAnswer": { "@type": "Answer", "text": "The NexoBrid label lists allergy to bromelain, pineapple, papaya or papain as contraindications and advises caution with bromelain-based treatment in people on anticoagulants or with bleeding risks (NexoBrid FDA label). Inhaled bromelain powder has caused occupational asthma, and people sensitized to papain have reacted to bromelain (PMID: 3233722; PMID: 498486)." } } ] }, { "@context": "https://schema.org", "@type": "Organization", "@id": "https://www.bodyhackguide.co#organization", "name": "BodyHackGuide", "alternateName": "BHG", "url": "https://www.bodyhackguide.co", "logo": { "@type": "ImageObject", "url": "https://www.bodyhackguide.co/logo.png", "width": 512, "height": 512 }, "description": "Evidence-based research reference for peptides and nootropics. 273 compound profiles, interactive dosing calculators, vendor price comparisons, and trust-scored vendor reviews scored on a public, reproducible methodology applied to every vendor. 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