{"entity":{"id":"bromelain","kind":"technology","name":"Bromelain (pineapple enzyme)","aka":["Pineapple stem enzyme","Ananas comosus protease"],"tldr":"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.","status":"phase-2","asOf":"2026-11-04","links":[{"label":"MSK About Herbs: Bromelain (page last updated 19 December 2023)","url":"https://www.mskcc.org/cancer-care/integrative-medicine/herbs/bromelain"}],"tags":["complementary","supportive-care","evidence:insufficient"],"related":["boswellia","glucosamine"],"cancers":[],"sections":["supportive-care"],"technologies":["integrative-oncology","dietary-supplements-treatment-interactions","acupuncture-aromatase-inhibitor-arthralgia"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["aromatase-inhibitor"],"trials":[],"people":[],"bottlenecks":["b-misinformation"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"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"]},"route":"/technologies/bromelain/","neighbours":{"technology":[{"id":"acupuncture-aromatase-inhibitor-arthralgia","kind":"technology","name":"Acupuncture for aromatase-inhibitor joint pain","route":"/technologies/acupuncture-aromatase-inhibitor-arthralgia/"},{"id":"boswellia","kind":"technology","name":"Boswellia (frankincense) extracts","route":"/technologies/boswellia/"},{"id":"dietary-supplements-treatment-interactions","kind":"technology","name":"Dietary supplements during cancer treatment: interactions and harms","route":"/technologies/dietary-supplements-treatment-interactions/"},{"id":"integrative-oncology","kind":"technology","name":"Evidence-based integrative oncology","route":"/technologies/integrative-oncology/"},{"id":"glucosamine","kind":"technology","name":"Glucosamine and chondroitin","route":"/technologies/glucosamine/"}],"section":[{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"term":[{"id":"aromatase-inhibitor","kind":"term","name":"Aromatase inhibitor","route":"/terms/aromatase-inhibitor/"}],"bottleneck":[{"id":"b-misinformation","kind":"bottleneck","name":"Misinformation and unproven therapies","route":"/bottlenecks/b-misinformation/"}]}}