Papaya

Last Editorial Review: 6/11/2021
Other Name(s):

Banane de Prairie, Caricae Papayae Folium, Carica papaya, Carica peltata, Carica posoposa, Chirbhita, Erandachirbhita, Erand Karkati, Green Papaya, Mamaerie, Melonenbaumblaetter, Melon Tree, Papaw, Papaya Fruit, Papayas, Papaye, Papaye Verte, Papayer, Papita, Paw Paw, Pawpaw.

Overview

Papaya is a plant. The leaves are used to make medicine.

Papaya is used for preventing and treating gastrointestinal tract disorders, intestinal parasite infections, and as a sedative and diuretic. It is also used for nerve pains (neuralgia) and elephantoid growths. Elephantoid growths are large swollen areas of the body that are symptoms of a rare disorder of the lymphatic system caused by parasitic worms.

Papaya contains a chemical called papain, which is commonly used as a meat tenderizer.

How does it work?

Papaya contains a chemical called papain. Papain breaks down proteins, carbohydrates, and fats. That's why it works as a meat tenderizer. However, papain is changed by digestive juices, so there is some question about whether it could be effective as a medicine when taken by mouth.

Papaya also contains a chemical called carpain. Carpain seems to be able to kill certain parasites, and it might affect the central nervous system.

SLIDESHOW

Vitamin D Deficiency: How Much Vitamin D Is Enough? See Slideshow

Uses & Effectiveness

Insufficient Evidence to Rate Effectiveness for...

  • Cancer. Research suggests that consuming papaya is linked to a reduced risk of developing gallbladder and colorectal cancers.
  • Diabetes. Early research suggests that consuming fermented papaya daily for 2 months can reduce blood sugar levels in people with diabetes.
  • Human papillomavirus (HPV) infection. Research suggests that consuming papaya is linked to a reduced risk of HPV infection.
  • Stomach and intestine problems.
  • Parasite infections.
  • Other conditions.
More evidence is needed to rate the effectiveness of papaya for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

Side Effects

Papaya is LIKELY SAFE for most people when taken by mouth in amounts commonly found in foods.

Papaya is POSSIBLY SAFE when taken by mouth as medicine.

Papaya is POSSIBLY UNSAFE when taken by mouth in large amounts or when applied to the skin as papaya latex. Taking large amounts of papaya by mouth could damage the esophagus, which is the food tube in the throat. Applying papaya latex to the skin can cause severe irritation and allergic reactions in some people.

QUESTION

Next to red peppers, you can get the most vitamin C from ________________. See Answer

Special Precautions & Warnings

Pregnancy and breast-feeding: Papaya is POSSIBLY UNSAFE when taken by mouth during pregnancy. Do not take papaya by mouth in medicinal amounts if you are pregnant. There is some evidence that unprocessed papain, one of the chemicals found in papaya, might poison the fetus or cause birth defects. Not enough is known about the safety of papaya during breast-feeding. It is best to avoid taking it in amounts higher than normal food amounts.

Diabetes: Papaya that has been fermented can lower blood sugar. People with diabetes who are taking medications to lower their blood sugar should pay close attention to their blood sugar as adjustments to medications might be needed.

Low blood sugar: Papaya that has been fermented can lower blood sugar. Taking this form of papaya might make blood sugar too low in people who already have low blood sugar.

Papain allergy: Papaya contains papain. If you are allergic to papain, avoid eating papaya or taking products that contain papaya.

Latex allergy: If you are allergic to latex, there is a good chance you are also be allergic to papaya. If you have a latex allergy, avoid eating papaya or taking products that contain papaya.

Surgery: Papaya that has been fermented can lower blood sugar. In theory, this form of papaya might affect blood sugary during and after surgery. If you are taking papaya, you should stop 2 weeks before surgery.

Interactions


Medications for diabetes (Antidiabetes drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Papaya that has been fermented might decrease blood sugar in people with type 2 diabetes. Diabetes medications are also used to lower blood sugar. Taking fermented papaya along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.


Warfarin (Coumadin)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Warfarin (Coumadin) is used to slow blood clotting. Papaya might increase the effects of warfarin (Coumadin) and increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

Dosing

The appropriate dose of papaya for use as treatment depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for papaya. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

FDA Logo

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

References

Ahmad, K. Regression in keloid scar by intralesional injection of papaya milk. Br.J.Plast.Surg. 1998;51(3):261. View abstract.

Alam, M. G., Snow, E. T., and Tanaka, A. Arsenic and heavy metal contamination of vegetables grown in Samta village, Bangladesh. Sci Total Environ 6-1-2003;308(1-3):83-96. View abstract.

Alvarenga, C. D., Silva, M. A., Lopes, G. N., Lopes, E. N., Brito, E. S., Querino, R. B., and Matrangolo, C. A. [Occurrence of Ceratitis capitata Wied. (Diptera: Tephritidae) on papaya fruits in Minas Gerais State, Brazil]. Neotrop.Entomol. 2007;36(5):807-808. View abstract.

Aruoma, O. I., Colognato, R., Fontana, I., Gartlon, J., Migliore, L., Koike, K., Coecke, S., Lamy, E., Mersch-Sundermann, V., Laurenza, I., Benzi, L., Yoshino, F., Kobayashi, K., and Lee, M. C. Molecular effects of fermented papaya preparation on oxidative damage, MAP Kinase activation and modulation of the benzo[a]pyrene mediated genotoxicity. Biofactors 2006;26(2):147-159. View abstract.

Ballot, D., Baynes, R. D., Bothwell, T. H., Gillooly, M., MacFarlane, B. J., MacPhail, A. P., Lyons, G., Derman, D. P., Bezwoda, W. R., Torrance, J. D., and . The effects of fruit juices and fruits on the absorption of iron from a rice meal. Br J Nutr 1987;57(3):331-343. View abstract.

Barua, A. B. and Olson, J. A. Reversed-phase gradient high-performance liquid chromatographic procedure for simultaneous analysis of very polar to nonpolar retinoids, carotenoids and tocopherols in animal and plant samples. J Chromatogr.B Biomed.Sci Appl 4-10-1998;707(1-2):69-79. View abstract.

Bhat, G. P. and Surolia, N. In vitro antimalarial activity of extracts of three plants used in the traditional medicine of India. Am.J.Trop.Med.Hyg. 2001;65(4):304-308. View abstract.

Bourdy, G. and Walter, A. Maternity and medicinal plants in Vanuatu. I. The cycle of reproduction. J.Ethnopharmacol. 1992;37(3):179-196. View abstract.

Breithaupt, D. E., Bamedi, A., and Wirt, U. Carotenol fatty acid esters: easy substrates for digestive enzymes? Comp Biochem.Physiol B Biochem.Mol.Biol 2002;132(4):721-728. View abstract.

Breithaupt, D. E., Weller, P., Wolters, M., and Hahn, A. Plasma response to a single dose of dietary beta-cryptoxanthin esters from papaya (Carica papaya L.) or non-esterified beta-cryptoxanthin in adult human subjects: a comparative study. Br.J Nutr 2003;90(4):795-801. View abstract.

Castillo, R., Delgado, J., Quiralte, J., Blanco, C., and Carrillo, T. Food hypersensitivity among adult patients: epidemiological and clinical aspects. Allergol.Immunopathol.(Madr.) 1996;24(3):93-97. View abstract.

Chaudhuri, R. N., Ghosh, B. N., and Chatterjee, B. N. Diet intake patterns of non-Bengali Muslim mothers during pregnancy and lactation. Indian J Public Health 1989;33(2):82-83. View abstract.

Chota, A., Sikasunge, C. S., Phiri, A. M., Musukwa, M. N., Haazele, F., and Phiri, I. K. A comparative study of the efficacy of piperazine and Carica papaya for the control of helminth parasites in village chickens in Zambia. Trop.Anim Health Prod. 2010;42(3):315-318. View abstract.

Colombetti, G. [On local treatment of tropical phagedenic ulcer with papaya pulp]. Minerva Med 12-1-1965;56(96):4200-4201. View abstract.

Costanza, D. J. Carotenemia associated with papaya ingestion. Calif.Med 1968;109(4):319-320. View abstract.

Danese, C., Esposito, D., D'Alfonso, V., Cirene, M., Ambrosino, M., and Colotto, M. Plasma glucose level decreases as collateral effect of fermented papaya preparation use. Clin Ter. 2006;157(3):195-198. View abstract.

Datla, K. P., Bennett, R. D., Zbarsky, V., Ke, B., Liang, Y. F., Higa, T., Bahorun, T., Aruoma, O. I., and Dexter, D. T. The antioxidant drink effective microorganism-X (EM-X) pre-treatment attenuates the loss of nigrostriatal dopaminergic neurons in 6-hydroxydopamine-lesion rat model of Parkinson's disease. J Pharm Pharmacol 2004;56(5):649-654. View abstract.

Dawkins, G., Hewitt, H., Wint, Y., Obiefuna, P. C., and Wint, B. Antibacterial effects of Carica papaya fruit on common wound organisms. West Indian Med J 2003;52(4):290-292. View abstract.

Deiana, M., Dessi, M. A., Ke, B., Liang, Y. F., Higa, T., Gilmour, P. S., Jen, L. S., Rahman, I., and Aruoma, O. I. The antioxidant cocktail effective microorganism X (EM-X) inhibits oxidant-induced interleukin-8 release and the peroxidation of phospholipids in vitro. Biochem.Biophys.Res Commun. 9-6-2002;296(5):1148-1151. View abstract.

Edwards-Jones, V. and Greenwood, J. E. What's new in burn microbiology? James Laing Memorial Prize Essay 2000. Burns 2003;29(1):15-24. View abstract.

Freye, H. B. Papain anaphylaxis: a case report. Allergy Proc 1988;9(5):571-574. View abstract.

Fruitful meeting between the Pope and Montagnier. Nature 9-12-2002;419(6903):104. View abstract.

Gibbs, R., Pingault, N., Mazzucchelli, T., O'Reilly, L., MacKenzie, B., Green, J., Mogyorosy, R., Stafford, R., Bell, R., Hiley, L., Fullerton, K., and Van, Buynder P. An outbreak of Salmonella enterica serotype Litchfield infection in Australia linked to consumption of contaminated papaya. J Food Prot. 2009;72(5):1094-1098. View abstract.

Giordani, R., Cardenas, M. L., Moulin-Traffort, J., and Regli, P. Fungicidal activity of latex sap from Carica papaya and antifungal effect of D(+)-glucosamine on Candida albicans growth. Mycoses 1996;39(3-4):103-110. View abstract.

Giuliano, A. R., Siegel, E. M., Roe, D. J., Ferreira, S., Baggio, M. L., Galan, L., Duarte-Franco, E., Villa, L. L., Rohan, T. E., Marshall, J. R., and Franco, E. L. Dietary intake and risk of persistent human papillomavirus (HPV) infection: the Ludwig-McGill HPV Natural History Study. J Infect.Dis. 11-15-2003;188(10):1508-1516. View abstract.

Gololobov, M. Y., Wang, W., and Bateman, R. C., Jr. Substrate and inhibitor specificity of glutamine cyclotransferase (QC). Biol Chem.Hoppe Seyler 1996;377(6):395-398. View abstract.

Gross, K. C. and Acosta, P. B. Fruits and vegetables are a source of galactose: implications in planning the diets of patients with galactosaemia. J Inherit.Metab Dis. 1991;14(2):253-258. View abstract.

Guerin, B., Leynadier, F., Baligadoo, S., and Dry, J. [Relation of papaya ingestion and the presence of chymopapain-specific immunoglobulins E]. Presse Med 3-10-1990;19(9):429. View abstract.

Hemmer, W., Focke, M., Gotz, M., and Jarisch, R. Sensitization to Ficus benjamina: relationship to natural rubber latex allergy and identification of foods implicated in the Ficus-fruit syndrome. Clin.Exp.Allergy 2004;34(8):1251-1258. View abstract.

Hernandez, M., Cabrera-Ponce, J. L., Fragoso, G., Lopez-Casillas, F., Guevara-Garcia, A., Rosas, G., Leon-Ramirez, C., Juarez, P., Sanchez-Garcia, G., Cervantes, J., Acero, G., Toledo, A., Cruz, C., Bojalil, R., Herrera-Estrella, L., and Sciutto, E. A new highly effective anticysticercosis vaccine expressed in transgenic papaya. Vaccine 5-22-2007;25(21):4252-4260. View abstract.

Hewitt, H., Whittle, S., Lopez, S., Bailey, E., and Weaver, S. Topical use of papaya in chronic skin ulcer therapy in Jamaica. West Indian Med.J. 2000;49(1):32-33. View abstract.

Holt, H. T. Carica papaya as ancillary therapy for athletic injuries. Curr.Ther.Res.Clin.Exp. 1969;11(10):621-624. View abstract.

Hsu, S. Green tea and the skin. J Am Acad.Dermatol 2005;52(6):1049-1059. View abstract.

Iliev, D. and Elsner, P. Generalized drug reaction due to papaya juice in throat lozenges. Dermatology 1997;194(4):364-366. View abstract.

Imao, K., Wang, H., Komatsu, M., and Hiramatsu, M. Free radical scavenging activity of fermented papaya preparation and its effect on lipid peroxide level and superoxide dismutase activity in iron-induced epileptic foci of rats. Biochem.Mol.Biol Int 1998;45(1):11-23. View abstract.

Irwig, M. S., El-Sohemy, A., Baylin, A., Rifai, N., and Campos, H. Frequent intake of tropical fruits that are rich in beta-cryptoxanthin is associated with higher plasma beta-cryptoxanthin concentrations in Costa Rican adolescents. J Nutr 2002;132(10):3161-3167. View abstract.

Izzo, A. A., Di Carlo, G., Borrelli, F., and Ernst, E. Cardiovascular pharmacotherapy and herbal medicines: the risk of drug interaction. Int J Cardiol. 2005;98(1):1-14. View abstract.

Jayarajan, P., Reddy, V., and Mohanram, M. Effect of dietary fat on absorption of beta carotene from green leafy vegetables in children. Indian J Med Res 1980;71:53-56. View abstract.

Kato, S., Bowman, E. D., Harrington, A. M., Blomeke, B., and Shields, P. G. Human lung carcinogen-DNA adduct levels mediated by genetic polymorphisms in vivo. J Natl.Cancer Inst. 6-21-1995;87(12):902-907. View abstract.

Kinlay, J. R., O'Connell, D. L., and Kinlay, S. Risk factors for mastitis in breastfeeding women: results of a prospective cohort study. Aust.N.Z.J Public Health 2001;25(2):115-120. View abstract.

Krasniuk, E. P. [Efficiency of papaya sublimate as a means for detoxication in chronic lead poisoning]. Med Tr.Prom Ekol. 1999;(4):43-46. View abstract.

Le Marchand, L., Hankin, J. H., Kolonel, L. N., and Wilkens, L. R. Vegetable and fruit consumption in relation to prostate cancer risk in Hawaii: a reevaluation of the effect of dietary beta-carotene. Am J Epidemiol. 2-1-1991;133(3):215-219. View abstract.

Le, Grand A. [Anti-infective phytotherapies of the tree-savannah, Senegal (occidental Africa). III: A review of phytochemical substances and the antimicrobial activity of 43 species]. J Ethnopharmacol. 1989;25(3):315-338. View abstract.

Lee, A. S. and Yap, K. L. Recovery of poliovirus from cut surface of stored fresh papaya fruit. Southeast Asian J Trop.Med Public Health 1999;30(2):280-283. View abstract.

Lohiya, N. K., Kothari, L. K., Manivannan, B., Mishra, P. K., and Pathak, N. Human sperm immobilization effect of Carica papaya seed extracts: an in vitro study. Asian J Androl 2000;2(2):103-109. View abstract.

Lohiya, N. K., Manivannan, B., Bhande, S. S., Panneerdoss, S., and Garg, S. Perspectives of contraceptive choices for men. Indian J Exp.Biol 2005;43(11):1042-1047. View abstract.

Lohsoonthorn, P. and Danvivat, D. Colorectal cancer risk factors: a case-control study in Bangkok. Asia Pac.J Public Health 1995;8(2):118-122. View abstract.

Lourencao, A. L., Fancelli, M., Costa, V. A., and Ribeiro, N. C. [Parasitism in Trialeurodes variabilis (Quaintance) (Hemiptera: Aleyrodidae) by Encarsia hispida De Santis (Hymenoptera: Aphelinidae), in papaya, in Brazil]. Neotrop.Entomol. 2007;36(1):147-149. View abstract.

Lu, Y. W., Shen, W. T., Tang, Q. J., Niu, Y. M., and Zhou, P. [Sequence analysis of the complete genome of papaya ringspot virus hainan isolate]. Bing.Du Xue.Bao. 2008;24(2):152-154. View abstract.

Marotta, F., Barreto, R., Tajiri, H., Bertuccelli, J., Safran, P., Yoshida, C., and Fesce, E. The aging/precancerous gastric mucosa: a pilot nutraceutical trial. Ann.N.Y.Acad.Sci 2004;1019:195-199. View abstract.

Marotta, F., Pavasuthipaisit, K., Yoshida, C., Albergati, F., and Marandola, P. Relationship between aging and susceptibility of erythrocytes to oxidative damage: in view of nutraceutical interventions. Rejuvenation.Res 2006;9(2):227-230. View abstract.

Marotta, F., Safran, P., Tajiri, H., Princess, G., Anzulovic, H., Ideo, G. M., Rouge, A., Seal, M. G., and Ideo, G. Improvement of hemorheological abnormalities in alcoholics by an oral antioxidant. Hepatogastroenterology 2001;48(38):511-517. View abstract.

Marotta, F., Tajiri, H., Barreto, R., Brasca, P., Ideo, G. M., Mondazzi, L., Safran, P., Bobadilla, J., and Ideo, G. Cyanocobalamin absorption abnormality in alcoholics is improved by oral supplementation with a fermented papaya-derived antioxidant. Hepatogastroenterology 2000;47(34):1189-1194. View abstract.

Marotta, F., Weksler, M., Naito, Y., Yoshida, C., Yoshioka, M., and Marandola, P. Nutraceutical supplementation: effect of a fermented papaya preparation on redox status and DNA damage in healthy elderly individuals and relationship with GSTM1 genotype: a randomized, placebo-controlled, cross-over study. Ann.N.Y.Acad.Sci 2006;1067:400-407. View abstract.

Marotta, F., Yoshida, C., Barreto, R., Naito, Y., and Packer, L. Oxidative-inflammatory damage in cirrhosis: effect of vitamin E and a fermented papaya preparation. J Gastroenterol.Hepatol. 2007;22(5):697-703. View abstract.

Matinian, L. A., Nagapetian, KhO, Amirian, S. S., Mkrtchian, S. R., Mirzoian, V. S., and Voskanian, R. M. [Papain phonophoresis in the treatment of suppurative wounds and inflammatory processes]. Khirurgiia (Mosk) 1990;(9):74-76. View abstract.

Menon, V., Ram, M., Dorn, J., Armstrong, D., Muti, P., Freudenheim, J. L., Browne, R., Schunemann, H., and Trevisan, M. Oxidative stress and glucose levels in a population-based sample. Diabet.Med 2004;21(12):1346-1352. View abstract.

Mikhal'chik, E. V., Ivanova, A. V., Anurov, M. V., Titkova, S. M., Pen'kov, L. Y., Kharaeva, Z. F., and Korkina, L. G. Wound-healing effect of papaya-based preparation in experimental thermal trauma. Bull Exp.Biol Med 2004;137(6):560-562. View abstract.

Misra, V. C. and Randhawa, H. S. Occurrence and significance of Cryptococcus neoformans in vegetables and fruits. Indian J Chest Dis.Allied Sci 2000;42(4):317-321. View abstract.

Miyoshi, N., Uchida, K., Osawa, T., and Nakamura, Y. Selective cytotoxicity of benzyl isothiocyanate in the proliferating fibroblastoid cells. Int J Cancer 2-1-2007;120(3):484-492. View abstract.

Mojica-Henshaw, M. P., Francisco, A. D., De, Guzman F., and Tigno, X. T. Possible immunomodulatory actions of Carica papaya seed extract. Clin Hemorheol.Microcirc. 2003;29(3-4):219-229. View abstract.

Mourvaki, E., Gizzi, S., Rossi, R., and Rufini, S. Passionflower fruit-a "new" source of lycopene? J Med Food 2005;8(1):104-106. View abstract.

Nakamura, Y. and Miyoshi, N. Cell death induction by isothiocyanates and their underlying molecular mechanisms. Biofactors 2006;26(2):123-134. View abstract.

Nana, C. P., Brouwer, I. D., Zagre, N. M., Kok, F. J., and Traore, A. S. Community assessment of availability, consumption, and cultural acceptability of food sources of (pro)vitamin A: toward the development of a dietary intervention among preschool children in rural Burkina Faso. Food Nutr Bull 2005;26(4):356-365. View abstract.

Nkuo-Akenji, T., Ndip, R., McThomas, A., and Fru, E. C. Anti-Salmonella activity of medicinal plants from Cameroon. Cent.Afr.J Med 2001;47(6):155-158. View abstract.

Odani, S., Yokokawa, Y., Takeda, H., Abe, S., and Odani, S. The primary structure and characterization of carbohydrate chains of the extracellular glycoprotein proteinase inhibitor from latex of Carica papaya. Eur.J Biochem. 10-1-1996;241(1):77-82. View abstract.

Oderinde, O., Noronha, C., Oremosu, A., Kusemiju, T., and Okanlawon, O. A. Abortifacient properties of aqueous extract of Carica papaya (Linn) seeds on female Sprague-Dawley rats. Niger.Postgrad.Med J 2002;9(2):95-98. View abstract.

Ooi, P. L., Goh, K. T., Neo, K. S., and Ngan, C. C. A shipyard outbreak of salmonellosis traced to contaminated fruits and vegetables. Ann.Acad.Med Singapore 1997;26(5):539-543. View abstract.

Osato, J. A., Korkina, L. G., Santiago, L. A., and Afanas'ev, I. B. Effects of bio-normalizer (a food supplementation) on free radical production by human blood neutrophils, erythrocytes, and rat peritoneal macrophages. Nutrition 1995;11(5 Suppl):568-572. View abstract.

Otsuki, N., Dang, N. H., Kumagai, E., Kondo, A., Iwata, S., and Morimoto, C. Aqueous extract of Carica papaya leaves exhibits anti-tumor activity and immunomodulatory effects. J Ethnopharmacol. 2-17-2010;127(3):760-767. View abstract.

Owoyele, B. V., Adebukola, O. M., Funmilayo, A. A., and Soladoye, A. O. Anti-inflammatory activities of ethanolic extract of Carica papaya leaves. Inflammopharmacology. 2008;16(4):168-173. View abstract.

Pandey, M. and Shukla, V. K. Diet and gallbladder cancer: a case-control study. Eur.J Cancer Prev 2002;11(4):365-368. View abstract.

Pieper, B. and Caliri, M. H. Nontraditional wound care: A review of the evidence for the use of sugar, papaya/papain, and fatty acids. J.Wound.Ostomy.Continence.Nurs. 2003;30(4):175-183. View abstract.

Potischman, N. and Brinton, L. A. Nutrition and cervical neoplasia. Cancer Causes Control 1996;7(1):113-126. View abstract.

Pousset, J. L. [Antihemolytic action of an extract of Carica papaya bark. Possibilities of use in glucose-6-phosphate dehydrogenase deficiencies]. Dakar Med. 1979;24(3):255-262. View abstract.

Rakhimov, M. R. [Pharmacological study of papain from the papaya plant cultivated in Uzbekistan]. Eksp.Klin.Farmakol. 2000;63(3):55-57. View abstract.

Ratcliffe, J. M., Schrader, S. M., Steenland, K., Clapp, D. E., Turner, T., and Hornung, R. W. Semen quality in papaya workers with long term exposure to ethylene dibromide. Br.J Ind.Med 1987;44(5):317-326. View abstract.

Rimbach, G., Guo, Q., Akiyama, T., Matsugo, S., Moini, H., Virgili, F., and Packer, L. Ferric nitrilotriacetate induced DNA and protein damage: inhibitory effect of a fermented papaya preparation. Anticancer Res 2000;20(5A):2907-2914. View abstract.

Rimbach, G., Park, Y. C., Guo, Q., Moini, H., Qureshi, N., Saliou, C., Takayama, K., Virgili, F., and Packer, L. Nitric oxide synthesis and TNF-alpha secretion in RAW 264.7 macrophages: mode of action of a fermented papaya preparation. Life Sci 6-30-2000;67(6):679-694. View abstract.

Roychowdhury, T., Uchino, T., Tokunaga, H., and Ando, M. Survey of arsenic in food composites from an arsenic-affected area of West Bengal, India. Food Chem Toxicol 2002;40(11):1611-1621. View abstract.

Sachs, M., von Eichel, J., and Asskali, F. [Wound management with coconut oil in Indonesian folk medicine]. Chirurg 2002;73(4):387-392. View abstract.

Sakuanrungsirikul, S., Sarindu, N., Prasartsee, V., Chaikiatiyos, S., Siriyan, R., Sriwatanakul, M., Lekananon, P., Kitprasert, C., Boonsong, P., Kosiyachinda, P., Fermin, G., and Gonsalves, D. Update on the development of virus-resistant papaya: virus-resistant transgenic papaya for people in rural communities of Thailand. Food Nutr Bull 2005;26(4):422-426. View abstract.

Salleh, M. N., Runnie, I., Roach, P. D., Mohamed, S., and Abeywardena, M. Y. Inhibition of low-density lipoprotein oxidation and up-regulation of low-density lipoprotein receptor in HepG2 cells by tropical plant extracts. J Agric.Food Chem. 6-19-2002;50(13):3693-3697. View abstract.

Sanghvi, P. K. Epidemiological studies on guinea-worm in some newly discovered villages of Jhabua District (M.P.) and test of carica papaya leaves of guinea worm infection. Indian J Med Sci 1989;43(5):123-124. View abstract.

Schilling, S., Manhart, S., Hoffmann, T., Ludwig, H. H., Wasternack, C., and Demuth, H. U. Substrate specificity of glutaminyl cyclases from plants and animals. Biol Chem. 2003;384(12):1583-1592. View abstract.

Schrader, S. M., Ratcliffe, J. M., Turner, T. W., and Hornung, R. W. The use of new field methods of semen analysis in the study of occupational hazards to reproduction: the example of ethylene dibromide. J Occup.Med 1987;29(12):963-966. View abstract.

Schrader, S. M., Turner, T. W., and Ratcliffe, J. M. The effects of ethylene dibromide on semen quality: a comparison of short-term and chronic exposure. Reprod.Toxicol. 1988;2(3-4):191-198. View abstract.

Sciutto, E., Fragoso, G., Manoutcharian, K., Gevorkian, G., Rosas-Salgado, G., Hernandez-Gonzalez, M., Herrera-Estrella, L., Cabrera-Ponce, J., Lopez-Casillas, F., Gonzalez-Bonilla, C., Santiago-Machuca, A., Ruiz-Perez, F., Sanchez, J., Goldbaum, F., Aluja, A., and Larralde, C. New approaches to improve a peptide vaccine against porcine Taenia solium cysticercosis. Arch Med Res 2002;33(4):371-378. View abstract.

Silverstone, S. E. and Nelson, M. Food production and nutrition in Biosphere 2: results from the first mission September 1991 to September 1993. Adv.Space Res 1996;18(4-5):49-61. View abstract.

Silverstone, S. E. Food production and nutrition for the crew during the first 2-year closure of Biosphere 2. Life Support.Biosph.Sci 1997;4(3-4):167-178. View abstract.

Sriboonlue, P., Prasongwatana, V., Suwantrai, S., Bovornpadungkitti, S., Tungsanga, K., and Tosukhowong, P. Potassium contents of northeastern Thai foods. J Med Assoc.Thai. 1998;81(8):616-626. View abstract.

Starley, I. F., Mohammed, P., Schneider, G., and Bickler, S. W. The treatment of paediatric burns using topical papaya. Burns 1999;25(7):636-639. View abstract.

Steenland, K., Carrano, A., Ratcliffe, J., Clapp, D., Ashworth, L., and Meinhardt, T. A cytogenetic study of papaya workers exposed to ethylene dibromide. Mutat.Res 1986;170(3):151-160. View abstract.

Thomas, K. D. and Ajani, B. Antisickling agent in an extract of unripe pawpaw fruit (Carica papaya). Trans.R.Soc Trop.Med Hyg. 1987;81(3):510-511. View abstract.

Vallis, C. P. and Lund, M. H. Effect of treatment with Carica papaya on resolution of edema and ecchymosis following rhinoplasty. Curr.Ther.Res.Clin.Exp. 1969;11(6):356-359. View abstract.

Wilson, R. K., Kwan, T. K., Kwan, C. Y., and Sorger, G. J. Effects of papaya seed extract and benzyl isothiocyanate on vascular contraction. Life Sci 6-21-2002;71(5):497-507. View abstract.

Wimalawansa, S. J. Papaya in the treatment of chronic infected ulcers. Ceylon Med J 1981;26(3):129-132. View abstract.

Yamamoto, T., Ohno-Shosaku, T., Furukawa-Uenoyama, E., Nagata, K., and Okada, Y. Electrostatic cell-to-cell adhesion by a non-proteolytic component in a protease preparation. Cell Struct.Funct. 1994;19(3):165-172. View abstract.

Zhang, J., Mori, A., Chen, Q., and Zhao, B. Fermented papaya preparation attenuates beta-amyloid precursor protein: beta-amyloid-mediated copper neurotoxicity in beta-amyloid precursor protein and beta-amyloid precursor protein Swedish mutation overexpressing SH-SY5Y cells. Neuroscience 11-17-2006;143(1):63-72. View abstract.

Blanco C, Diaz-Perales A, Collada C, et al. Class I chitinases as potential panallergens involved in the latex-fruit syndrome. J Allergy Clin Immunol 1999;103(3 Pt 1):507-13.

Brehler, R., Theissen, U., Mohr, C., and Luger, T. "Latex-fruit syndrome": frequency of cross-reacting IgE antibodies. Allergy 1997;52(4):404-410. View abstract.

Diaz-Perales A, Collada C, Blanco C, et al. Cross-reactions in the latex-fruit syndrome: A relevant role of chitinases but not of complex asparagine-linked glycans. J Allergy Clin Immunol 1999;104:681-7. View abstract.

Dukes JA. CRC Handbook of Medicinal Herbs. first ed. Boca Raton, FL: CRC Press, Inc., 1985.

Ebo, D. G., Bridts, C. H., Hagendorens, M. M., De Clerck, L. S., and Stevens, W. J. The prevalence and diagnostic value of specific IgE antibodies to inhalant, animal and plant food, and ficus allergens in patients with natural rubber latex allergy. Acta Clin Belg. 2003;58(3):183-189. View abstract.

Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182

Foster S, Tyler VE. Tyler's Honest Herbal, 4th ed., Binghamton, NY: Haworth Herbal Press, 1999.

Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm 2000;57:1221-7. View abstract.

Manufacturer: Walgreens. Deerfield, IL.

Ncube, T. N., Greiner, T., Malaba, L. C., and Gebre-Medhin, M. Supplementing lactating women with puréed papaya and grated carrots improved vitamin A status in a placebo-controlled trial. J Nutr 2001;131(5):1497-1502. View abstract.

Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf 1997;17:342-56. View abstract.