Sinusitis and Bromelain

Bromelain is not actually a single substance, but rather a collection of protein-digesting enzymes (also called proteolytic enzymes) found in pineapple juice and in the stem of pineapple plants.

The enzyme bromelain has also been advocated for treatment of sinusitis.

Read more details about Bromelain.

However, the only support for the use of bromelain as a treatent for sinusitis comes from a few poor-quality, double-blind studies performed in the 1960s.^4-6 It is not apparent from the published study reports whether the participants in these studies had viral or bacterial sinusitis.

Safety Issues

Bromelain appears to be essentially nontoxic, and it seldom causes side effects other than occasional mild gastrointestinal distress or allergic reactions. ¹ However, because bromelain "thins" the blood to some extent, it shouldn't be combined with drugs such as warfarin (Coumadin) without a doctor's supervision.

According to one small animal study, bromelain might interact with sedative medications, increasing their effect. ² As noted above, it might also increase blood levels of various antibiotics , which could present risks in some cases. In addition, one trial suggests that doses of bromelain eight times higher than standard recommendations might increase heart rate (but not blood pressure). ³ Safety in young children, pregnant or nursing women, or those with liver or kidney disease has not been established.

Interactions You Should Know About

• If you are taking medications that thin the blood, such as warfarin (Coumadin) or heparin , sedative drugs such as benzodiazepines , or antibiotics : Bromelain might amplify their effect as it can increase the absorption of various drugs.

1. Blumenthal M, ed. The Complete German Commission E Monographs, Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications; 1998:94.
2. MOSS JN, FRAZIER CV, MARTIN GJ. BROMELAINS. THE PHARMACOLOGY OF THE ENZYMES. Arch Int Pharmacodyn Ther. 145():166-89.
3. Gutfreund AE, Taussig SJ, Morris AK. Effect of oral bromelain on blood pressure and heart rate of hypertensive patients. Hawaii Med J. 37(5):143-6.

4. Ryan RE. A double-blind clinical evaluation of bromelains in the treatment of acute sinusitis. Headache. 1967;7:13-17.

5. Taub SJ. The use of ananase in sinusitis: A study of 60 patients. Eye Ear Nose Throat Mon. 1966;45:96, 98.

6. Seltzer AP. Adjunctive use of bromelains in sinusitis: a controlled study. Eye Ear Nose Throat Mon. 1967;46:1281-1288.