Do not take ginkgo with nattokinase until you talk to your healthcare provider first. They can help prevent possible interactions and side effects. They can also ensure that you're subjecting these supplements to a fair trial at the right doses. If you take any medications regularly, talk to your doctor before you start using 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. Amitriptyline and the risk of bleeding with DOACs: amlodipine, metoprolol, and weak p-gp activity. No interactions were found between nattokinase and vitamin E.
However, this does not necessarily mean that there are no interactions. A total of 226 drugs are known to interact with vitamin E. It is a serine protease from the subtilisin class by its technical name and is used as a health supplement due to its “fibrinolytic” properties (it is capable of enzymatically degrading fibrin, which is believed to reduce cardiovascular problems by preventing thrombus formation and subsequent blood clotting). Research on human intervention shows a mild blood pressure-lowering effect associated with nattokinase supplementation. In general, although the enzymatic activity and pharmacodynamics of nattokinase are new, there is insufficient evidence to support the use of nattokinase over other pharmacological or complementary options.
More studies are needed to determine if nattokinase taken as a supplement is safe for repeated or long-term use. If you have a blood clotting disorder, don't take nattokinase supplements unless your doctor says they're safe. A study shows that a nattokinase supplement reduces the risk of blood clots forming after long flights in an airplane.
