Serrapeptase (Serratiopeptidase)

Commonly used for
Joint Health
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Wellness uses some people report: sinus support. This is anecdotal, and there isn't strong clinical evidence that it works for everyone. Serrapeptase is a proteolytic enzyme proposed to reduce edema by thinning inflammatory fluids and breaking down fibrin, but a systematic review found the supporting evidence insufficient and of poor quality, with long-term safety data lacking -- rare reports of pneumonitis and skin reactions have also been documented.
Form: Serratiopeptidase (a zinc metalloprotease from Serratia E-15), enteric-coated to survive gastric acid
Typical dose studied: ~10-60 mg/day (units vary by product)
Timing: On an empty stomach for systemic anti-inflammatory intent
Ships without symptom/goal triggers given how thin the supporting evidence actually is despite widespread popularity -- flag bleeding/perioperative risk and the rare pulmonary/skin reaction reports if surfaced.
? Emerging / limited evidence
Avoid with: Bleeding disorder / Coagulopathy; End-stage liver disease / Cirrhosis; Chronic kidney disease (Stage 3, 4, or 5) — NOT on dialysis
Interacts with: Anticoagulants, antiplatelets -- additive bleeding risk (fibrinolytic activity)
Already taking it? A systematic review found the supporting trials for serrapeptase to be of poor methodology and long-term safety data lacking -- reasonable to continue if genuinely helpful, but the evidence base is honestly thinner than its popularity suggests.
Bhagat S et al. (2013). Serratiopeptidase: A Systematic Review of the Existing Evidence. International Journal of Surgery.
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