Bromelain and Warfarin

Bromelain is a group of powerful protein-digesting enzymes that are found naturally in pineapple. Discovered in 1957, this enzyme has been widely studied and appears in over one million websites through popular website search engines.

What is bromelain used for?

Bromelain is used for reducing muscle and tissue inflammation as well as digestive disorders. Additional uses include: acute postoperative and post-traumatic conditions where swelling is common, reduction of inflammation in burn victims and enhancement of antibiotic absorption.1

Interactions with warfarin?

Bromelain is described as a natural blood thinner by breaking down fibrin, an important component of normal blood clotting.2

Studies out of Germany in 1995 found that 59 people with injuries consistent with sprains and general muscle aches found equal pain to those using prescription NSAIDS (non-steroidal anti-inflammatory drugs). Bromelain demonstrated the added feature of helping excessive fluid to drain from the injury site. Like NSAIDS and aspirin, Bromelain has been linked to prolonging bleeding time. For this reason patients on warfarin should expect an increase in bleeding time and possible increase in INR test results.3

Patients thinking of using Bromelain in any of its three forms (tablet, capsule, powder) should consult their doctor before doing so.

  1. Bush TM, Rayburn KS, Holloway SW, et al. Adverse interactions between herbal and dietary substances and prescription medications: a clinical survey. Altern Ther Health Med 2007;13:30-5.
  2. Heck, AM, DeWitt, BA, Lukes, AL. Potential interactions between alternative therapies and warfarin. American Journal of Health-System Pharmacy, Vol 57, Issue 13, 1221-1227.
  3. Taussiga, S, Batkin, S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. Journal of Ethnopharmacology. Vol 22, Iss 2, February-March 1988, 191-203.