If you take any medications regularly, talk to your doctor before starting to use nattokinase supplements. Supplements may interact with blood thinners and other drugs that reduce clotting, such as aspirin and ibuprofen. They may cause excessive bleeding and bruising. Taking nattokinase together with medications that also slow blood clotting may increase the risk of bruises and bleeding.
You can see that I mention P-glycoprotein (P-gp) in quite a few of the interactions. In my readings, I found in vitro studies showing that nattokinase inhibits this protein. Gp-p is an efflux pump, which means that it basically expels drugs, thus reducing their bioavailability. P-gp appears in the blood-brain barrier, in the small intestine, in the kidneys, in the liver, and in tumor cells.
It limits the absorption of the drug in these tissues. If a substance inhibits p-gp (such as nattokinase), it can increase the absorption of certain drugs (known as p-gp substrates) taken together with it. P-gp substrates include apixaban and colchicine, among others to varying degrees. You can read more about Gp-p here.
For professional medical information on natural medicines, see the professional version of the full natural medicines database. This material is provided for educational purposes only and is not intended as medical advice, diagnosis or treatment. Not much information is known about the pharmacokinetics of nattokinase, making it difficult to predict drug interactions. Nattokinase, together with medications that lower blood pressure, can cause blood pressure to drop.
too much. When warfarin is administered with an enteral diet (tube), you can stop feeding for one hour before and one hour after the warfarin dose to minimize the chance of interaction. It is noteworthy that many of the interactions involving nattokinase probably also apply to lumbrokinase, since both degrade peptide bonds. Talk to a healthcare provider if you are not sure what foods or medicines you are on taking and that may interact with warfarin.
