NutriStack
Diclofenac and Nattokinase, a caution.
Nattokinase may compound diclofenac-related bleeding risk through fibrinolytic and anticoagulant effects. Diclofenac can cause NSAID-related GI mucosal injury, and nattokinase may reduce clot stability. The combination is more concerning with ulcer history, scheduled diclofenac, procedures, or other blood-thinning medicines.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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What the row says.
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At a glance
- Substances
- Diclofenac and Nattokinase
- Pair type
- Caution
- Evidence (highest tier)
- Emerging
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Emerging evidence
Caution
What is happening. Nattokinase may compound diclofenac-related bleeding risk through fibrinolytic and anticoagulant effects. Diclofenac can cause NSAID-related GI mucosal injury, and nattokinase may reduce clot stability. The combination is more concerning with ulcer history, scheduled diclofenac, procedures, or other blood-thinning medicines.
Mechanism. Nattokinase can enhance thrombolytic and anticoagulant profiles, while diclofenac inhibits COX-mediated prostaglandins and can damage GI mucosa. These effects can converge on a higher bleeding burden.
Recommendation. Avoid nattokinase while using diclofenac regularly. Stop nattokinase before surgery or dental procedures unless your clinician specifically directs otherwise.
Sources (2)
- Kurosawa Y, Nirengi S, Homma T, Esaki K, Ohta M, Clark JF, et al. A single-dose of oral nattokinase potentiates thrombolysis and anti-coagulation profiles. Sci Rep. 2015;5:11601. PMID 26109079
- Castellsague J, Riera-Guardia N, Calingaert B, Varas-Lorenzo C, Fourrier-Reglat A, Nicotra F, et al. Individual NSAIDs and upper gastrointestinal complications: a systematic review and meta-analysis of observational studies (the SOS project). Drug Saf. 2012;35(12):1127-1146. PMID 23137151
Stack Score
How this pair moves the number.
Effect on the composite score
If both Diclofenac and Nattokinase are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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