A fixed-dose combination of proteolytic enzymes (Bromelain and Trypsin) and a bioflavonoid (Rutoside) used primarily as an anti-inflammatory, anti-edematous, and fibrinolytic agent. It is widely prescribed in India for the management of post-operative and post-traumatic inflammation, swelling, and pain, as well as for venous disorders. The combination works synergistically to reduce capillary permeability, improve microcirculation, and degrade inflammatory mediators and fibrin deposits.
Adult: 1 tablet (Bromelain 90mg + Trypsin 48mg + Rutoside 100mg) two to three times daily. For acute conditions (post-op/trauma): Typically TDS for 5-7 days. For chronic conditions (CVI): Typically BD for 4-6 weeks.
Note: Take tablet whole with a glass of water, on an empty stomach (at least 30 minutes before or 2 hours after meals) for optimal absorption of enzymes. Do not crush or chew enteric-coated tablets.
The combination exerts a multi-targeted anti-inflammatory, anti-edema, and fibrinolytic action. Bromelain and Trypsin are proteolytic enzymes that systemically degrade kininogen, bradykinin, and fibrin, reducing the formation of inflammatory mediators and edema. They also improve tissue permeability to antibiotics. Rutoside (a hydroxyethylrutoside analogue) strengthens capillary walls by reducing capillary fragility and permeability through an anti-elastase activity and PAF antagonism, improving microcirculation and reducing venous stasis.
Pregnancy: Category C: Animal reproduction studies have not been conducted. Use only if potential benefit justifies potential risk to the fetus, especially due to fibrinolytic properties and lack of safety data. Avoid in third trimester.
Driving: Unlikely to affect driving ability. However, if dizziness or headache occurs as a side effect, caution is advised.
| Warfarin, Acenocoumarol | Increased risk of bleeding due to additive antiplatelet/fibrinolytic effect of Bromelain and potential protein binding displacement by Rutoside. | Major |
| Aspirin, Clopidogrel, NSAIDs (e.g., Diclofenac) | Increased risk of gastrointestinal irritation and bleeding. | Moderate |
| Antibiotics (especially Amoxicillin, Tetracyclines) | Bromelain/Trypsin may increase tissue penetration of antibiotics. This can be a beneficial interaction but may also alter antibiotic distribution. | Moderate |
| Chemotherapeutic agents (e.g., 5-Fluorouracil) | Bromelain may increase absorption and bioavailability, potentially increasing toxicity. | Moderate |
| Sedatives (e.g., Benzodiazepines) | Rutoside may have mild CNS depressant effects; theoretical additive sedation. | Minor |
Same composition (Bromelain (90mg) + Trypsin (48mg) + Rutoside (100mg)), different brands: