Usage
Nattokinase is primarily used for its potential fibrinolytic (clot-dissolving) and antithrombotic (clot-preventing) properties. It is currently being investigated for its potential benefits in various cardiovascular conditions, though robust clinical evidence supporting its efficacy is still limited. While it is often marketed as a dietary supplement for promoting heart health, lowering blood pressure, and improving blood flow, its true clinical utility in these areas remains to be conclusively established through large-scale clinical trials.
It is not classified as a drug in the traditional sense, as it is typically available as a dietary supplement. However, considering its mechanism of action, it could be pharmacologically categorized as a fibrinolytic agent or an antithrombotic agent.
Nattokinase’s mechanism of action involves the direct enzymatic degradation of fibrin, the protein that forms the meshwork of blood clots. It also appears to enhance the body’s own endogenous fibrinolytic pathways by increasing the production of plasmin, another clot-dissolving enzyme, and by inhibiting plasminogen activator inhibitor-1 (PAI-1), a protein that blocks plasmin activity.
Alternate Names
- Subtilisin NAT
- Subtilisin natto
- Cardiokinase
How It Works
Pharmacodynamics: Nattokinase exhibits fibrinolytic activity, meaning it directly breaks down fibrin clots. It also appears to enhance the body’s natural fibrinolytic system by increasing plasmin levels and reducing PAI-1 activity. It may also exert antihypertensive effects, potentially through its ability to inhibit angiotensin-converting enzyme (ACE).
Pharmacokinetics: Information on the absorption, distribution, metabolism, and elimination of nattokinase is currently limited. It is assumed to be absorbed through the gastrointestinal tract, though the extent of absorption is unknown. Data on its metabolism and elimination pathways are also lacking.
Mode of Action: At the molecular level, nattokinase acts as a serine protease, cleaving specific peptide bonds within the fibrin molecule, leading to clot dissolution. It also degrades other proteins involved in clot formation and stability, such as von Willebrand factor and thromboxane.
Receptor Binding, Enzyme Inhibition, or Neurotransmitter Modulation: The primary mechanism of nattokinase involves direct enzyme activity rather than receptor binding or neurotransmitter modulation. It inhibits enzymes involved in clot formation and stability, such as PAI-1.
Elimination Pathways: Information on the specific elimination pathways of nattokinase is not currently available.
Dosage
Due to the lack of rigorous clinical studies, standardized dosage guidelines for nattokinase are not yet established. Dosages used in research have varied widely, typically ranging from 100 mg to 200 mg per day (equivalent to 2000 to 7000 fibrinolytic units). The dosage should be individualized based on the patient’s specific condition and clinical response.
Standard Dosage
Adults:
Standard dosing is not well-defined, but studies have often used 100 mg to 200 mg daily.
Children:
Nattokinase use in children is not recommended due to insufficient safety data.
Special Cases:
Due to limited information, careful consideration and dose adjustment might be needed for elderly patients and those with renal or hepatic impairment. Nattokinase should be used cautiously in patients with bleeding disorders or those taking anticoagulant medications.
Clinical Use Cases
Currently, there are no established dosage recommendations for specific clinical situations like intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations.
Dosage Adjustments
Dose adjustments may be necessary in patients with renal or hepatic impairment, bleeding disorders, or those taking anticoagulant or antiplatelet medications.
Side Effects
Common Side Effects
While generally well-tolerated, some individuals may experience mild gastrointestinal discomfort, such as nausea, diarrhea, or bloating.
Rare but Serious Side Effects
Rarely, more serious adverse effects like bleeding or allergic reactions have been reported.
Long-Term Effects
Data on the long-term effects of nattokinase supplementation are limited.
Adverse Drug Reactions (ADR)
Significant ADRs are rare but could include severe allergic reactions or bleeding complications.
Contraindications
- Hypersensitivity to natto or nattokinase.
- Active bleeding or bleeding disorders.
- Recent surgery or planned surgery.
- Concomitant use of anticoagulant or antiplatelet medications.
Drug Interactions
- Anticoagulants/Antiplatelets: Nattokinase may potentiate the effects of these medications, increasing the risk of bleeding.
- Antihypertensives: May enhance the blood pressure-lowering effects of these drugs.
Pregnancy and Breastfeeding
Nattokinase use is generally not recommended during pregnancy and breastfeeding due to the lack of safety data.
Drug Profile Summary
- Mechanism of Action: Fibrinolytic enzyme, potentially enhances endogenous fibrinolysis.
- Side Effects: Generally well-tolerated, rarely bleeding or allergic reactions.
- Contraindications: Hypersensitivity, active bleeding, recent/planned surgery, concomitant use of anticoagulants/antiplatelets.
- Drug Interactions: Anticoagulants/antiplatelets, antihypertensives.
- Pregnancy & Breastfeeding: Not recommended.
- Dosage: Not standardized, studies use 100 mg to 200 mg daily.
- Monitoring Parameters: Blood pressure, coagulation tests (if concomitant use with anticoagulants).
Popular Combinations
There are no established “popular combinations” of nattokinase with other drugs in conventional medical practice.
Precautions
- Use with caution in patients with bleeding disorders or those taking anticoagulant/antiplatelet medications.
- Discontinue use at least two weeks before surgery.
- Monitor blood pressure and coagulation parameters if necessary.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Nattokinase?
A: Currently, there is no standardized dosage recommendation. Dosages used in studies often range from 100 mg to 200 mg daily.
Q2: Is Nattokinase safe to use during pregnancy or breastfeeding?
A: Not recommended due to the lack of safety data.
Q3: Can Nattokinase interact with other medications?
A: Yes, it can interact with anticoagulants/antiplatelets and antihypertensive medications.
Q4: What are the potential side effects of Nattokinase?
A: Generally well-tolerated, but some may experience mild gastrointestinal upset. Rarely, bleeding or allergic reactions can occur.
Q5: How does Nattokinase work?
A: It acts as a fibrinolytic enzyme, directly breaking down blood clots, and may also enhance the body’s natural fibrinolytic pathways.
Q6: What are the contraindications for Nattokinase use?
A: Hypersensitivity, active bleeding, recent/planned surgery, and concomitant use of anticoagulant/antiplatelet medications.
Q7: Can Nattokinase be used to treat deep vein thrombosis (DVT)?
A: While some preliminary research suggests a potential benefit, more studies are needed to confirm its effectiveness in treating DVT. It should not be used as a replacement for standard medical treatment.
Q8: Is Nattokinase approved by the FDA?
A: Nattokinase is typically marketed as a dietary supplement and is not subject to the same FDA approval process as drugs.
Q9: What conditions is Nattokinase used for?
A: It is primarily investigated for its potential benefits in cardiovascular conditions due to its fibrinolytic properties, although further research is needed to confirm these effects.
A: Consult with a qualified healthcare professional for personalized advice and refer to reputable medical resources for evidence-based information.
