Usage
This combination is not an FDA-approved drug but a combination of supplements. While not officially recognized as a treatment for specific medical conditions, it is sometimes used for various health concerns related to cardiovascular health, inflammation, and immune function. Nattokinase and serrapeptidase are primarily investigated for their fibrinolytic and anti-inflammatory properties, though robust human clinical trials are lacking. Vitamin D3 is essential for calcium absorption and bone health. It also plays roles in immune modulation and overall well-being.
- Pharmacological Classification: Nattokinase (fibrinolytic enzyme), Serratiopeptidase (proteolytic enzyme), Vitamin D3 (fat-soluble vitamin, hormone)
- Mechanism of Action: Nattokinase may break down fibrin directly, potentially impacting blood viscosity. Serrapeptidase reduces inflammation by breaking down inflammatory proteins. Vitamin D3 modulates calcium and phosphorus metabolism, supporting bone health and immune function.
Alternate Names
- Nattokinase: Cardiokinase, Subtilisin NAT, Subtilisin natto
- Serratiopeptidase: Serrapeptase, Serratia peptidase, Serralysin
- Vitamin D3: Cholecalciferol
- Brand Names: This combination is typically available as a supplement and is marketed under various brand names by different manufacturers. Examples of brands containing these ingredients (or similar combinations) may include Doctor’s Best Natto-Serra, Heartstrong Nutraceuticals, and others. Brand names may vary internationally and regionally.
How It Works
Precise pharmacodynamic and pharmacokinetic data for this combination are not well-established. Information on individual components is as follows:
- Nattokinase: Fibrinolytic activity is attributed to direct action on fibrin. Absorption, metabolism, and elimination pathways are not clearly defined. It is thought to be absorbed in the intestines and excreted mostly via the kidneys and to a lesser extent through feces.
- Serratiopeptidase: Anti-inflammatory effects are linked to proteolytic action. Pharmacokinetic data are limited. It is believed to be primarily absorbed in the small intestine with hepatic and renal clearance as the main routes of excretion.
- Vitamin D3: Undergoes hepatic and renal metabolism. The active form, calcitriol (1,25-dihydroxyvitamin D3), binds to vitamin D receptors (VDRs) in target tissues, influencing gene expression related to calcium homeostasis, immune function, and cellular growth and differentiation. Elimination occurs through both biliary and renal excretion, with some being metabolized by CYP enzymes.
Dosage
No standardized dosage guidelines exist for this combined supplement. Dosages mentioned in some sources are presented below but should not be interpreted as medical recommendations. Consultation with a healthcare professional is crucial.
Standard Dosage
Because this is not a recognized, FDA-approved drug but a combination of supplements, there are no standardized dosing guidelines. Dosages for the individual components are mentioned in some sources, but clinical studies are lacking.
Adults:
- Nattokinase: 2000-7000 fibrinolytic units (FU) daily has been used in some studies.
- Serratiopeptidase: 10 mg three times daily (maximum 60 mg/day) is mentioned in some sources.
- Vitamin D3: 4000-5000 IU/day (adjustments may be needed based on individual vitamin D levels).
Children:
Pediatric dosing has not been established and is generally not recommended without physician consultation.
Special Cases:
Insufficient data are available for dose adjustment in elderly patients, those with renal or hepatic impairment, or with comorbid conditions. Professional guidance is vital.
Clinical Use Cases
There are no established dosage recommendations for this combination in clinical settings like intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations.
Dosage Adjustments
No standardized dose modifications exist for this combination.
Side Effects
Common Side Effects
- Nattokinase: Increased bleeding risk (especially when taken with anticoagulants), allergic reactions (rare).
- Serratiopeptidase: Gastrointestinal upset (nausea, vomiting, diarrhea), skin reactions, allergic reactions (rare).
- Vitamin D3: High doses can cause hypercalcemia, nausea, vomiting, constipation.
Rare but Serious Side Effects
- Nattokinase: Severe bleeding, possible stroke (if an existing clot dislodges).
- Serratiopeptidase: Severe allergic reactions (angioedema, difficulty breathing).
- Vitamin D3: Symptoms of hypercalcemia can range from mild to severe and can include dehydration, confusion, muscle weakness, and cardiac arrhythmias.
Long-Term Effects
Long-term effects of this combination are unknown.
Adverse Drug Reactions (ADR)
Clinically significant ADRs are rare but should be reported to a healthcare professional immediately.
Contraindications
- Nattokinase: Contraindicated in individuals with bleeding disorders, active peptic ulcer disease, recent ischemic stroke, those planning surgery, and those taking anticoagulants or antiplatelet medications.
- Serratiopeptidase: Contraindicated during pregnancy and breastfeeding. Use with caution in those with bleeding disorders or before surgery.
- Vitamin D3: Contraindicated in individuals with hypercalcemia or hypersensitivity to vitamin D.
Drug Interactions
- Nattokinase: Interacts with anticoagulants, antiplatelet drugs, and antihypertensive medications.
- Serratiopeptidase: Potential interactions with anticoagulants and antiplatelet agents.
- Vitamin D3: Potential interactions with certain medications, such as thiazide diuretics, corticosteroids, and some heart medications. It may also interfere with the absorption of other minerals, such as magnesium.
Pregnancy and Breastfeeding
This combination is generally contraindicated during pregnancy and breastfeeding due to the lack of safety data.
Drug Profile Summary (See individual sections for details)
Popular Combinations
There are no established “popular” pharmaceutical combinations for this supplement mix as it isn’t a recognized drug. However, as a supplement, some sources suggest combining it with vitamin K2 for potential synergistic benefits related to cardiovascular and bone health. Always consult a physician before combining supplements.
Precautions (See individual sections for details)
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Nattokinase + Serratiopeptidase + Vitamin D3?
A: No standardized dosage exists for this combination. (See Dosage section for information about individual components and note that this is not medical advice.)
Q2: Is this combination safe for patients with bleeding disorders?
A: No. Nattokinase and serrapeptidase may increase bleeding risk. This combination should be avoided in patients with bleeding disorders.
Q3: Can this combination be used during pregnancy or breastfeeding?
A: No. Safety during pregnancy and breastfeeding has not been established. It is generally advised to avoid use.
Q4: Are there any drug interactions I should be aware of?
A: Yes. Nattokinase and serrapeptidase can interact with anticoagulants and antiplatelet drugs, potentially increasing bleeding risk. (See Drug Interactions section.)
Q5: What are the potential side effects of this combination?
A: Side effects can include gastrointestinal upset, increased bleeding risk, and allergic reactions. (See Side Effects section for a complete list.)
Q6: Can this combination be used to treat deep vein thrombosis (DVT)?
A: While nattokinase has shown some fibrinolytic activity in preclinical studies, there is insufficient evidence to support using this combination to treat DVT. Consult a physician for appropriate DVT management. Never self-treat.
Q7: How does Vitamin D3 contribute to this supplement combination?
A: Vitamin D3 supports bone health, calcium absorption and plays a role in immune function, adding to the potential benefits related to cardiovascular health and overall well-being.
Q8: Are there any long-term effects associated with this combination?
A: Long-term effects of this combination are currently unknown due to the lack of long-term studies.
Q9: Should I consult with a healthcare professional before taking this combination?
A: Yes, consulting a healthcare professional is essential before taking any supplements, especially if you have underlying health conditions or are taking other medications.
