Amylase/Papain Shortage: What Providers and Prescribers Need to Know in 2026

Your patients are asking about Amylase/Papain digestive enzyme supplements — and many of them can't find their preferred products. While there's no formal FDA shortage listing for these OTC supplements, the practical reality is that availability has been inconsistent for the past several years.

This briefing covers the current landscape, the historical context that shaped today's market, and actionable strategies for helping your patients navigate availability and cost challenges.

Provider Briefing: The Current Situation

Amylase/Papain digestive enzyme supplements remain commercially available in the United States as over-the-counter dietary supplements. However, intermittent stock-outs affecting specific brands and formulations have become common. Patients who depend on particular products — such as NaturesPlus Papaya Enzyme chewable tablets or professional-grade multi-enzyme blends — may go weeks without access to their preferred supplement.

The availability picture is complicated by the fact that OTC supplements are not tracked by the FDA's drug shortage surveillance system. This means there is no centralized data on supply disruptions, and providers must rely on patient reports and market-level observations to assess availability.

Timeline: How We Got Here

Understanding the current availability challenges requires context:

• Pre-2008: Papain was widely used in both oral digestive supplements and topical wound-care products (Accuzyme, Panafil, Ethezyme, Gladase). These topical products were marketed without FDA approval.
• 2008-2009: The FDA ordered companies to stop manufacturing unapproved topical papain products due to serious adverse events including hypersensitivity reactions and anaphylaxis. Approximately 35 topical papain products were removed from the U.S. market. This action specifically targeted topical formulations, not oral supplements.
• 2009-2020: Oral Amylase/Papain supplements continued to be sold as dietary supplements under DSHEA (Dietary Supplement Health and Education Act). However, some retailers and distributors reduced their papain product offerings due to perceived regulatory risk.
• 2020-Present: Global supply chain disruptions, rising consumer demand for digestive health products, and ongoing market confusion have created persistent availability challenges for Amylase/Papain supplements.

Prescribing Implications

Since Amylase/Papain is an OTC supplement rather than a prescription medication, providers don't prescribe it directly. However, there are several clinical considerations:

When Patients Ask for Guidance

• Safety: Oral papain supplements are generally well-tolerated. The most significant risks are allergic reactions in patients with latex, papaya, fig, or kiwi allergies, and increased bleeding risk in patients taking anticoagulants (warfarin, heparin, direct oral anticoagulants).
• Drug interactions: Papain may potentiate the effects of warfarin and other anticoagulants. Bromelain (a common alternative) carries similar interaction risks. Screen for anticoagulant use before recommending any proteolytic enzyme supplement.
• Special populations: Advise pregnant and breastfeeding patients to avoid papain supplements due to insufficient safety data. Patients scheduled for surgery should discontinue papain at least 2 weeks prior.

When to Consider Prescription Alternatives

For patients with diagnosed exocrine pancreatic insufficiency (EPI), prescription pancreatic enzyme replacement therapy (PERT) is the standard of care:

• Creon (pancrelipase) — available in multiple strengths
• Zenpep (pancrelipase) — delayed-release capsules
• Pancreaze (pancrelipase) — delayed-release capsules

These products are FDA-approved, covered by most insurance plans, and provide a standardized combination of lipase, protease, and amylase.

Current Availability Picture

The OTC Amylase/Papain market remains fragmented with variable availability:

• Chain pharmacies (CVS, Walgreens, Rite Aid): Limited selection, frequent stock-outs of popular brands
• Big-box retailers (Walmart, Target): Moderate selection, some brands consistently available
• Online retailers (Amazon, iHerb, Vitacost): Best overall availability, though individual products may be temporarily out of stock
• Independent health food stores: Often carry specialty and professional-grade brands not found in chain stores

Cost and Access

OTC Amylase/Papain supplements typically range from $8 to $55 depending on brand and formulation. Most are not covered by insurance. Key pricing data points:

• NaturesPlus Papaya Enzyme (180 chewable tablets): $12–$18
• American Health Papaya Enzyme (600 tablets): $15–$22
• Professional-grade blends (XYMOGEN XymoZyme): $45–$55

For patients who need prescription PERT, insurance coverage is generally available. Creon's cash price ranges from approximately $300 to $900/month, but copay cards and patient assistance programs (AbbVie's Creon Cares) can significantly reduce out-of-pocket costs.

Tools and Resources for Your Practice

Medfinder for Providers offers tools to help your practice and patients:

• Real-time availability search: Help patients locate Amylase/Papain supplements in stock at nearby locations
• Alternative medication information: Access information on comparable enzyme products
• Patient education resources: Share articles on finding medications, understanding side effects, and saving money

Recommended patient-facing resources from Medfinder:

• How to find Amylase/Papain in stock
• Alternatives to Amylase/Papain
• Amylase/Papain drug interactions

Looking Ahead

The OTC digestive enzyme market is expected to continue growing through 2026 and beyond. Key trends to monitor:

• Supply chain stabilization: Raw material sourcing for papain has been gradually improving as tropical agriculture recovers from pandemic-era disruptions.
• New product launches: Several supplement companies are expanding their digestive enzyme lines, which should improve overall market availability.
• Regulatory clarity: The FDA's 2008 action was specific to topical papain products. Oral supplements remain regulated under DSHEA, and there are no indications of additional enforcement actions targeting oral formulations.

Final Thoughts

While Amylase/Papain availability challenges are real, they are manageable with the right tools and information. Providers can help patients by screening for drug interactions (especially anticoagulants), recommending appropriate alternatives when needed, and directing patients to Medfinder for Providers for real-time availability information.

For a patient-facing perspective on the same issue, see our article on what patients need to know about the Amylase/Papain shortage in 2026.