# Bromelain (pineapple enzyme)

Source: https://onco.cc/technologies/bromelain/  
OnCo record `bromelain` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Bromelain is an enzyme from pineapple stems used for swelling, pain and wound clean-up. In cancer the evidence is a mixed formula for aromatase-inhibitor joint pain and a single case report, so its anti-cancer claims are untested. It can cause allergic reactions and may increase bleeding with blood thinners.

## Summary

Bromelain is a protein-digesting enzyme from pineapple stems. Memorial Sloan Kettering's About Herbs entry reports clinical evidence for a bromelain-based product in debriding burns and chronic wounds, small studies for postoperative pain and swelling, and mixed results for arthritis pain and inflammation. In cancer, a formulation of alpha-lipoic acid, boswellia, methylsulfonylmethane and bromelain improved aromatase-inhibitor joint symptoms in postmenopausal women with early breast cancer, which cannot be attributed to bromelain alone, and a case report described PSA reduction with bromelain alongside immunotherapy in prostate cancer. MSK states that well-designed randomised trials are needed to evaluate its anticancer potential. Allergic reactions are reported; it may increase bleeding with anticoagulants in preclinical studies, inhibits CYP2C9 in vitro and may raise blood levels of tetracycline antibiotics.

## Fields

- Kind: Technology
- Status: phase-2
- Last checked: 2026-11-04
- Also known as: Pineapple stem enzyme; Ananas comosus protease
- Tags: complementary; supportive-care; evidence:insufficient
- Principle: Cysteine proteases that break down fibrin and inflammatory mediators locally; how much intact enzyme is absorbed from the gut is uncertain.
- Strengths: Approved topical debridement use for burns; Small postoperative swelling studies
- Limitations: Cancer evidence is a mixed formula and a case report; Allergy and possible bleeding risk; May raise tetracycline levels

## Sources

- MSK About Herbs: Bromelain (page last updated 19 December 2023): https://www.mskcc.org/cancer-care/integrative-medicine/herbs/bromelain

## Connected records

- technologies: [Acupuncture for aromatase-inhibitor joint pain](https://onco.cc/technologies/acupuncture-aromatase-inhibitor-arthralgia/), [Boswellia (frankincense) extracts](https://onco.cc/technologies/boswellia/), [Dietary supplements during cancer treatment: interactions and harms](https://onco.cc/technologies/dietary-supplements-treatment-interactions/), [Evidence-based integrative oncology](https://onco.cc/technologies/integrative-oncology/), [Glucosamine and chondroitin](https://onco.cc/technologies/glucosamine/)
- fronts: [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- terms: [Aromatase inhibitor](https://onco.cc/terms/aromatase-inhibitor/)
- bottlenecks: [Misinformation and unproven therapies](https://onco.cc/bottlenecks/b-misinformation/)

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