NutriStack
Nattokinase and Serrapeptase, a caution.
Combining these two fibrinolytic enzymes produces additive breakdown of fibrin and a higher risk of bruising, prolonged bleeding, and (rarely) serious hemorrhage, particularly in people also on antiplatelet or anticoagulant drugs.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Nattokinase and Serrapeptase
- Pair type
- Caution
- Evidence (highest tier)
- Emerging
- Source citations
- 3 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Supplement
- Last verified
- May 30, 2026
Caution · Emerging evidence
Caution
What is happening. Combining these two fibrinolytic enzymes produces additive breakdown of fibrin and a higher risk of bruising, prolonged bleeding, and (rarely) serious hemorrhage, particularly in people also on antiplatelet or anticoagulant drugs.
Mechanism. Both serrapeptase and nattokinase have fibrinolytic and mild antiplatelet activity, degrading fibrin and reducing clot stability. Taken together their effects on hemostasis are additive.
Recommendation. Avoid stacking both fibrinolytic enzymes unless supervised by a clinician. Stop both at least 1 to 2 weeks before any surgery or dental procedure, and do not combine with aspirin, warfarin, or DOACs without medical oversight.
Sources (3)
- Tiwari M. The role of serratiopeptidase in the resolution of inflammation. Asian J Pharm Sci. 2017;12(3):209-215. PMID 32104332
- Weng Y et al. Nattokinase: An Oral Antithrombotic Agent for the Prevention of Cardiovascular Disease. Int J Mol Sci. 2017;18(3). PMID 28264497
- Kurosawa Y et al. A single-dose of oral nattokinase potentiates thrombolysis and anti-coagulation profiles. Sci Rep. 2015;5:11601. PMID 26109079
Stack Score
How this pair moves the number.
Effect on the composite score
If both Nattokinase and Serrapeptase 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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