Supplement·Interactions·Reviewed June 9, 2026
Nattokinase interactions.
Nattokinase has 22 documented interactions in the NutriStack database: 22 that need timing or caution. The full list, with what each pairing does, is below.
Nattokinase at a glance.
A quick, data-grounded summary. The full table is below.
Nattokinase has 22 documented interactions in the NutriStack database: 22 that need timing or caution. The full list, with what each pairing does, is below.
Everything that interacts with nattokinase.
Every supplement and medication in the NutriStack database with a documented interaction with this substance, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| Apixaban | Caution | Nattokinase is a fibrinolytic enzyme that degrades fibrin and reduces clotting factor levels. Combined with apixaban's factor Xa inhibition, the... |
| Aspirin | Caution | Documented cerebellar hemorrhage from nattokinase + aspirin after only 7 days. Both inhibit platelet aggregation via thromboxane blockade. |
| Aspirin Low-Dose | Caution | Nattokinase is a fibrinolytic enzyme that directly degrades fibrin and reduces clotting factors. A documented case describes cerebellar hemorrhage... |
| Bromelain | Caution | Both have fibrinolytic and antiplatelet activity; combined use additively raises bleeding risk. |
| Celecoxib | Caution | Nattokinase may add fibrinolytic effects to celecoxib-related bleeding risk, especially when celecoxib is used with aspirin or in patients with... |
| Clopidogrel | Caution | Nattokinase is a fibrinolytic enzyme that degrades fibrin and reduces clotting factors. Combined with clopidogrel's P2Y12-mediated platelet... |
| Dabigatran | Caution | Nattokinase has fibrinolytic activity and can reduce clotting factors. Dabigatran directly inhibits thrombin, so combining the two may create... |
| Diclofenac | Caution | Nattokinase may compound diclofenac-related bleeding risk through fibrinolytic and anticoagulant effects. Diclofenac can cause NSAID-related GI... |
| Enoxaparin | Caution | Nattokinase has fibrinolytic activity and can reduce clotting factor levels. Enoxaparin potentiates antithrombin activity against factor Xa, so the... |
| Garlic Extract | Caution | Garlic has antiplatelet activity and nattokinase has fibrinolytic activity, so combining them can additively impair clotting and raise bleeding... |
| Ginger Extract | Caution | Both have anticoagulant or antiplatelet activity, so combining them may increase bleeding risk, especially alongside blood-thinning medication. |
| Ginkgo Biloba | Caution | Combining ginkgo with nattokinase increases bleeding risk because both reduce the blood's tendency to clot through different mechanisms. |
| Grape Seed Extract | Caution | Both can reduce platelet aggregation or affect clotting, so combining them may additively increase bleeding risk. |
| Ibuprofen | Caution | Nattokinase has fibrinolytic and anticoagulant effects that may add to ibuprofen-related bleeding risk. Ibuprofen can irritate the GI tract and... |
| Meloxicam | Caution | Nattokinase may add fibrinolytic effects to meloxicam's NSAID bleeding risk. Meloxicam can still cause GI injury with daily use, and nattokinase may... |
| Naproxen | Caution | Nattokinase may add fibrinolytic and anticoagulant effects to naproxen's GI bleeding risk. Naproxen is a higher-GI-risk NSAID, so a supplement that... |
| Prasugrel | Caution | Nattokinase has fibrinolytic and anticoagulant effects that can stack with prasugrel's potent antiplatelet effect. A case report describes... |
| Rivaroxaban | Caution | Nattokinase is a direct fibrinolytic enzyme that also reduces clotting factor levels. Combined with rivaroxaban's factor Xa inhibition, the additive... |
| Royal Jelly | Caution | Both supplements independently lower the body's clotting capacity, Royal Jelly by potentiating anticoagulation (as shown in a warfarin case report)... |
| Serrapeptase | Caution | Combining these two fibrinolytic enzymes produces additive breakdown of fibrin and a higher risk of bruising, prolonged bleeding, and (rarely)... |
| Ticagrelor | Caution | Nattokinase can add fibrinolytic and anticoagulant effects to ticagrelor's potent antiplatelet action. Human studies show nattokinase lowers... |
| Warfarin | Caution | Nattokinase is a fibrinolytic enzyme that degrades fibrin directly and reduces clotting factors. Combined with warfarin, the additive effects... details → |
The full nattokinase profile.
Benefits, dosing by goal, forms, and the cited evidence for this supplement.
Common nattokinase questions.
Quick answers drawn from the table above.
What interacts with Nattokinase?
In the NutriStack database, Nattokinase has 22 documented interactions with other supplements and medications. The most notable include Apixaban, Aspirin, Aspirin Low-Dose, Bromelain, and Celecoxib.
Can you take Nattokinase with Apixaban?
NutriStack classifies the Nattokinase and Apixaban pairing as caution: Nattokinase is a fibrinolytic enzyme that degrades fibrin and reduces clotting factor levels. Combined with apixaban's factor Xa inhibition, the additive effects... Do not combine nattokinase with apixaban. If you have been taking both, stop the nattokinase and call your prescriber, especially if you notice...
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