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Ask A Pharmacist: A Question of Pineapple Juice

Pineapple Juice Has Been Found to Contain Anti-inflammatory Enzyme, Bromelain

Pineapple Juice Has Been Found to Contain Anti-inflammatory Enzyme, Bromelain

A long time ago, I had discussed with another pharmacist some of the side effects of the MS drugs that he (the pharmacist) deals with, because my cousin actually has MS. The pharmacist had mentioned that Avonex causes a lot of flu-like symptoms and that a lot of patients have found relief from this by drinking pineapple juice. Well, my cousin is not on Avonex, but takes tecfidera. She says since she began taking this she stays sick and has symptoms of flushing with it. I just wondered if this drug was similar to the Avonex where she could try drinking more pineapple juice to keep from getting sick all the time?

-K.A., Memphis, TN

Pineapple juice is not a one size fits all for MS medications. Tecfidera’s MOA is completely different from that of Avonex. Avonex competitively inhibits interferons in the body, to prevent progression of MS. As such, pineapple juice has proven to be effective in some patients in relieving Avonex’s flu like symptoms, but mostly for its anti-inflammatory properties.
You see, pineapple juice, in research studies, has been found to be rich in other substances (beside vitamin C) that decrease inflammation. For example, bromelain, an enzyme in pineapple juice, has been found to decrease swelling, bruising, and pain in musculoskeletal injuries; including, but not limited to arthritis, bursitis, and tendonitis (Klein, 2000 and Klein 2006). In addition, pineapple juice has been found to be effective in other autoimmune conditions, such as inflammatory bowel disease (Hale, 2006).
I did an extensive search of literature and was unable to find anything about flushing from Tecfidera being relieved with pineapple juice. In retrospect, though, it would not hurt your cousin for her to try the juice (assuming that she is not diabetic and/or allergic to pineapple of course). After all, given the benefits mentioned, what is the worst that could happen?
Hale, L.P., Dietary supplementation with fresh pineapple juice decreases inflammation and colonic neoplasia in IL-10 deficient mice with colitis. Inflammatory Bowel Disease. 2010. 16(12); 2012-2021.
Klein G, Kullich W. Short-term treatment of painful osteoarthritis of the knee with oral enzymes. A randomized, double-blind study versus diclofenac. Clin Drug Invest. 2000;19(1):15-23.

Klein G, Kullich W, Schnitker J, Schwann H. Efficacy and tolerance of an oral enzyme combination in painful osteoarthritis of the hip. A double-blind, randomised study comparing oral enzymes with non-steroidal anti-inflammatory drugs. Clin Exp Rheumatol. 2006 Jan-Feb;24(1):25-30.

Felicity Udoji, Pharm.D., M.S. (1 Posts)

Felicity Udoji is a pharmacist, scientist, and former educator with the Metropolitan Nashville School System. After teaching chemistry at magnet schools, she obtained her Pharm.D. from Samford University in 1998. She serves as Senior Advisor for and currently resides in Brentwood, Tennessee.

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