Several clinical studies (1) have indicated the therapeutic efficacy and low toxicity of bromelain. It is also present in pineapple juice – and is no less effective. A patient on Warfarin, for instance (2) who drank a cup of pineapple juice for a few days experienced advanced anti-coagulant effects including blood in her urine, intra-abdominal haemorrhages, a badly swollen left leg and signs of visible skin bruising. Bromelain potentiates the effects of warfarin and it is important to correct excessive anticoagulation.

Bromelain is a proteolytic (protein digesting) enzyme that is concentrated in the stems and leaves of pineapple plants and is one of the most versatile, non-toxic and completely natural drugs we have at our disposal [Image: Freepik].

The identification of the cause (pineapple juice/bromelain!) and temporary suspension of anticoagulants with the administration of vitamin K is a widely accepted protocol. (3) While eating small amounts of foods that are rich in vitamin K shouldn’t interfere with an anti-coagulant, patients should avoid consuming large amounts of greens such as Kale, Spinach, Brussels sprouts, Mustard greens, Chard and Broccoli. Green smoothies concentrate levels of vitamin K (4) and may be in conflict with Bromelain or warfarin.

Anti-viral effects of bromelain. During our Covid-19 pandemic, the aim is to target the spike protein, the hub of coronavirus infections. (5, 6) If these protein-based pathogens are deprived of protein, the game is over, so look no further than bromelain! What other advantages would a Covid-19 patient using bromelain have? The anti –inflammatory and mucolytic effects, (7) as well as treating coughs and preventing troublesome and dangerous blood clotting (8) make it a one-stop solution. Its mucolytic effects help to break up and remove mucous-related respiratory problems that are also associated with fibrocystic lungs, asthma and allergies. Bromelain’s penetration into the blood and sino-nasal mucosa  (9) is beneficial for patients with chronic rhinosinusitis. Bromelain elicits an anti-inflammatory response by reducing prostaglandin E2 (PGE-2) and cyclooxygenase-2 (COX-2) synthesis. This purely natural approach may be worth considering for patients who would prefer alternatives (10) to drugs that are causing problems. (11)

Bromelain acts as an antibacterial  (12) agent by inhibiting Vibrio cholera and Escherichia coli, prevents associated diarrhoea and soothes gut inflammation. As an anthelmintic, bromelain works against gastrointestinal nematodes like Heligmosomoides polygyrus, Trichoderma viride, and Trichurismuris. The synergistic impact of bromelain has also been observed when it is used concurrently with antibiotics and can treat fungal infections as well. Most conditions (13) associated with inflammation are linked to excessive fibrin and can benefit from bromelain. For example: many types of cancer, arthritis, atherosclerosis, back pain, chronic fatigue, chronic pain, fibrocystic breasts, fibromyalgia, high blood pressure, sciatica, spinal stenosis, strains and sprains, post-operative scar tissue and uterine fibroids, to name a few. When applied as a cream, bromelain assists with the debridement of necrotic tissue and overall acceleration of the skin healing and eases irritation, itching and inflammation of the skin.

Precautions when using bromelain: Pineapples and bromelain are freely available to us – but using a medicinal food such as a pineapple/bromelain includes a number of side effects that are dose related. The usual bromelain capsule contains 500mg. Overdosing can cause nausea, vomiting, diarrhoea, palpitations, indigestion, loss of appetite, headache, muscle pains, dizziness, drowsiness and lethargy. Bruising, internal bleeding and heavy menstruation may also occur. Bromelain can increase the absorption (12) of medications, including antibiotics, such as amoxicillin and tetracycline; chemotherapy drugs, such as 5-fluorouracil and vincristine; and blood pressure medications, specifically ACE inhibitors, such as captopril (Capoten) and lisinopril (Zestril) so the dose may need adjusting. Patients on blood thinners, anti-inflammatories and medications that potentiate or compete with bromelain must discuss their intention to use bromelain with their practitioner beforehand. If you are pregnant, nursing, taking any medications or have allergies or intolerances, please consult with your healthcare practitioner before taking bromelain therapeutically (or drinking pineapple smoothies!).

As a green, totally natural medicine, bromelain that is locally extracted from discarded pineapple stems by Enzyme Technologies (14) in Kwazulu Natal wins hands down.

Bromelain can effectively compete against a number of patent drugs (12) head to head, helping to reduce the carbon footprint of imported products and our dependence on patent medicines.

Conclusion: Even eating fresh pineapple or drinking the juice will unleash enough bromelain to help you better digest a rich meal and will clear excess protein from the bloodstream. This helps us to control blood coagulation (clotting), cholesterol levels, tenacious mucous (heavy cough) and inflammation caused by an excess of fibrin. Inflammation, pain and the suffering associated with fibromyalgia or any inflammatory disease is caused by an overgrowth of fibrin. (13) But we can’t really tell patients to eat pineapples three times a day! Bromelain capsules are much easier to include in a drug regimen and can be accurately dispensed and monitored by a medical doctor.





3) (Effectiveness and safety of a management protocol to correct over-anticoagulation with oral vitamin K)

4) Vitamin K for improved anticoagulation control in patients receiving warfarin


Bromelain Inhibits SARS-CoV-2 Infection in VeroE6 Cells

“News Article: Could pineapples be a new weapon against COVID-19?”



Bromelain inhibits SARS-CoV-2 infection via targeting ACE-2, TMPRSS2, and spike protein.

8)  Fibrinolytic and antithrombotic action of bromelain may eliminate thrombosis in heart patients

9) Bromelain’s penetration into the blood and sinonasal mucosa in patients with chronic rhinosinusitis (

10) Adverse interactions between warfarin and nonsteroidal antiinflammatory drugs: mechanisms, clinical significance, and avoidance – PubMed (

11) The dangers of NSAIDs: look both ways (

12) PDF Review: Bromelain a Potential Bioactive Compound: A Comprehensive Overview from a Pharmacological Perspective

13) Reducing Inflammation and Excess Fibrin with Proteolytic Enzymes. (