Bromelan

Bromelan is available in the form of film-coated tablets, packaged in boxes containing 30 units. This pharmaceutical form allows for easy administration and controlled release of the active ingredients in the intestine, thanks to the presence of a gastro-resistant film, which protects bromelain from gastric acidity.

Bromelan is indicated as an adjuvant in supporting the function of the paranasal sinuses, especially in cases of acute or chronic inflammation of the sinus mucosa, such as:

• sinusitis (acute or recurrent);
• rhinosinusitis;
• allergic rhinitis accompanied by nasal obstruction and persistent secretions;
• post-operative in ENT interventions (e.g., sinus drainage interventions), to reduce edema and accelerate healing;
• supporting immune function and reducing oxidative stress associated with respiratory infections.

Elderflower extract and rutoside play complementary roles in the Bromelan formula, supporting sinus health and immune response. Elderflowers have immunostimulatory, anti-inflammatory, and diaphoretic properties, while rutoside (a natural flavonoid) has antioxidant and vasoprotective effects. 

The recommended dose varies according to age:

• Children over 6 years of age: 1 tablet per day;
• Adults: 1 to 2 tablets per day.

The tablets should be swallowed whole, without chewing, and taken between meals to maximize bromelain absorption.

Bromelan is contraindicated in the following situations:

• Known hypersensitivity to bromelain, pineapple, or any of the product's excipients;
• Pregnancy and breastfeeding, in the absence of sufficient data on the safety of administration;
• Coagulation disorders or anticoagulant treatments, due to the potential antiplatelet effect of bromelain.

It is recommended to avoid administration with food, as bromelain exerts its most effective action in a neutral or slightly alkaline environment, without competition from other dietary protein substrates.

In case of surgery, the product should be discontinued 2 weeks prior to the procedure to avoid possible interactions with hemostasis.

Bromelan is generally well tolerated. However, in some cases, mild to moderate side effects may occur, such as:

• Digestive disorders: nausea, epigastric discomfort, bloating;
• Allergic skin reactions: rash, pruritus, urticaria;
• Coagulation disorders: nosebleeds or gum bleeding, in rare cases;
• Headache or dizziness.

If any unusual symptoms occur, use should be discontinued and medical advice sought.

Bromelain may interact with certain drugs:

• Oral anticoagulants (e.g., warfarin), antiplatelet agents (e.g., aspirin): increased risk of bleeding;
• Antibiotics (e.g., amoxicillin, tetracycline): bromelain may increase their absorption and effectiveness;
• Sedatives (benzodiazepines, barbiturates).

No significant interactions with food have been reported, but it is recommended to avoid taking it with meals in order to preserve its enzymatic bioavailability.

If doses higher than those recommended are taken, the following may occur:

• Gastrointestinal disorders: diarrhea, nausea, abdominal discomfort;
• Hemorrhagic manifestations (when combined with anticoagulants);
• Skin rashes or allergic reactions.

Treatment consists of discontinuing administration and adopting symptomatic treatment. 

To maintain the stability of the active ingredients and the effectiveness of the product, Bromelan should be stored in a dry, dark place, away from moisture and direct light, at room temperature (15-25°C), away from heat sources and out of the reach of small children. Do not use the product after the expiry date stated on the packaging.

• PubMed, Bromelain penetration into the blood and sinonasal mucosa in patients with chronic rhinosinusitis
• WebMD, Bromelain
• Healthline, Bromelain
• PubMed, Properties and therapeutic application of bromelain: A review