Papain

Papain/Drug Interactions:

  • AntiandrogensAntiandrogens: Based on an open trial, Prosta-Q (ingredients: quercetin, saw palmetto, cranberry, bromelain, papain, zinc) may reduce prostatitis symptoms (22).
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: Papain may interact with warfarin (40). Based on a case report of a woman taking coumadin and Wobenzym?, which contains pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin, papain and warfarin may cause coumadin overdose, possibly due to coumadin contamination of the Wobenzym? (34).
  • AntidiarrhealsAntidiarrheals: Based on a randomized controlled trial assessing the effects of papain, trypsin, and chymotrypsin on adverse effects from radiation therapy, papain may increase diarrhea, however, this adverse effect cannot be definitively ascribed to papain due to the use of a combination product (16).
  • Antiulcer agentsAntiulcer agents: Based on case reports of phytobezoars treated with papain, papain may cause gastric ulcer and esophageal perforation (15).
  • ImmunosuppressantsImmunosuppressants: Based on in vitro and clinical study, Wobenzym? (ingredients: pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have immunostimulatory activity (24).
  • WarfarinWarfarin: Papain may interact with warfarin (40). Based on a case report of a woman taking coumadin and Wobenzym?, which contains pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin, papain and warfarin may cause coumadin overdose, possibly due to coumadin contamination of the Wobenzym? (34).
  • Xerotic skin treatmentsXerotic skin treatments: Based on a randomized controlled study, topical papain may ameliorate soap-induced xerotic skin, most likely by increasing the proteolysis of desmosomes within corneocytes (41).

    • Papain/Herb/Supplement Interactions:

  • Alpha chymotrypsinAlpha chymotrypsin: Based on in vitro and clinical study, Wobenzym? (ingredients: pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have immunostimulatory activity (24). Based on a case report, Wobenzym? (ingredients: pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have anticoagulation activity (34). Based on conflicting clinical studies, trypsin, chymotrypsin, and papain as an adjuvant to radiation therapy may or may not reduce the intensity of some adverse effects associated with radiation (33; 16).
  • AmylaseAmylase: Based on in vitro and clinical study, Wobenzym? (ingredients: pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have immunostimulatory activity (24). Based on a case report, Wobenzym? (ingredients: pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have anticoagulation activity (34).
  • AntiandrogensAntiandrogens: Based on an open trial, Prosta-Q (quercetin, saw palmetto, cranberry, bromelain, papain, zinc) may reduce prostatitis symptoms (22).
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: Papain may interact with warfarin (40). Based on a case report of a woman taking coumadin and Wobenzym?, which contains pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin, papain and warfarin may cause coumadin overdose, possibly due to coumadin contamination of the Wobenzym? (34).
  • AntidiarrhealsAntidiarrheals: Based on a randomized controlled trial assessing the effects of papain, trypsin, and chymotrypsin on adverse effects from radiation therapy, papain may increase diarrhea, however, this adverse effect cannot be definitively ascribed to papain due to the use of a combination product (16).
  • Antiulcer agentsAntiulcer agents: Based on case reports of phytobezoars treated with papain, papain may cause gastric ulcer and esophageal perforation (15).
  • BromelainBromelain: Based on in vitro and clinical study, Wobenzym? (ingredients: pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have immunostimulatory activity (24). Based on a case report, Wobenzym? (ingredients: pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have anticoagulation activity (34).
  • ImmunosuppressantsImmunosuppressants: Based on in vitro and clinical study, Wobenzym? (ingredients: pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have immunostimulatory activity (24).
  • LipaseLipase: Based on in vitro and clinical study, Wobenzym? (ingredients: pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have immunostimulatory activity (24). Based on a case report, Wobenzym? (pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have anticoagulation activity (34).
  • PancreatinPancreatin: Based on in vitro and clinical study, Wobenzym? (ingredients: pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have immunostimulatory activity (24). Based on a case report, Wobenzym? (ingredients: pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have anticoagulation activity (34).
  • RutinRutin: Based on in vitro and clinical study, Wobenzym? (ingredients: pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have immunostimulatory activity (24). Based on a case report, Wobenzym? (ingredients: pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have anticoagulation activity (34).
  • SodiumSodium: Based on case reports of phytobezoars treated with papain, papain may cause hypernatremia (15).
  • TrypsinTrypsin: Based on in vitro and clinical study, Wobenzym? (ingredients: pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have immunostimulatory activity (24). Based on a case report, Wobenzym? (ingredients: pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have anticoagulation activity (34). Based on conflicting clinical studies, trypsin, chymotrypsin, and papain as an adjuvant to radiation therapy may or may not reduce the intensity of some adverse effects associated with radiation (33; 16).
  • Xerotic skin treatmentsXerotic skin treatments: Based on a randomized controlled study, topical papain may ameliorate soap-induced xerotic skin, most likely by increasing the proteolysis of desmosomes within corneocytes (41).

    • Papain/Food Interactions:

  • Insufficient available evidence.

    • Papain/Lab Interactions:

  • Coagulation panelCoagulation panel: Papain may interact with warfarin (40). Based on a case report of a woman taking coumadin and Wobenzym?, which contains pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin, papain and warfarin may cause coumadin overdose, possibly due to coumadin contamination of the Wobenzym? (34).
  • PSA levelsPSA levels: Based on an open trial, Prosta-Q (quercetin, saw palmetto, cranberry, bromelain, papain, zinc) may reduce prostatitis symptoms (22).
  • Radiation therapyRadiation therapy: Based on one randomized controlled open study, supplementation with trypsin, chymotrypsin, and papain as an adjuvant to radiation therapy may reduce the intensity of some adverse effects associated with radiation (33). However, another double-blind randomized trial found no such effect (16).
  • Serum sodium levelsSerum sodium levels: Based on case reports of phytobezoars treated with papain, papain may cause hypernatremia (15).
  • WBC countWBC count: Based on in vitro and clinical study, Wobenzym? (ingredients: pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, and rutin) may have immunostimulatory activity (24).