Home Ingredients Serrapeptase (Serratiopeptidase)
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Serrapeptase (Serratiopeptidase)

Serratia E15 (originally) / fermentation-derived
Evidence Level
Limited
2 Clinical Trials
5 Documented Benefits
2/5 Evidence Score

Serrapeptase is a proteolytic enzyme originally isolated from silkworm intestinal bacteria (Serratia) — now produced via fermentation. Used widely in Japan and Europe (prescription drug status in some countries) for inflammation, sinusitis, fibrocystic breast disease, post-surgical edema, and pain. Anti-inflammatory enzyme that breaks down dead tissue and inflammatory proteins without affecting healthy tissue. Strong observational/clinical practice support but rigorous Western RCT evidence limited.

Studied Dose 10-60 mg/day (typically 10-30 mg/day), standardized to 20,000-80,000 enzymatic units.
Active Compound Serrapeptase (serratiopeptidase, serralysin-family metalloprotease).

Benefits

Sinusitis and Upper Respiratory Inflammation

Trials have shown serrapeptase reduces sinusitis symptoms (pain, nasal secretion, obstruction, swelling) compared to placebo. Used widely in Italy, Japan, and India as a chronic-sinusitis adjunct. Mechanism: liquefying mucus and reducing inflammatory mediators.

Supported by Trial 1, Trial 2

Post-Surgical Edema and Pain

Multiple trials, especially in oral/maxillofacial and orthopedic surgery, show serrapeptase reduces post-operative swelling and pain versus placebo. Used routinely in Japan post-operatively.

Supported by Trial 2

Fibrocystic Breast Disease

RCT showed serrapeptase (5 mg TID) reduced breast pain, swelling, and induration in fibrocystic breast disease vs placebo. Limited subsequent replication but referenced in supplement marketing.

Supported by Trial 1, Trial 2

Carpal Tunnel Syndrome (Limited Evidence)

A small trial suggested serrapeptase improves carpal tunnel symptoms. Sample size was limited; it is not a standard treatment (which includes wrist splinting, NSAIDs, corticosteroid injection, or surgery for refractory cases).

Supported by Trial 2, Trial 1

Atherosclerosis Plaque (Theoretical)

Theoretical mechanism: serrapeptase digests atherosclerotic plaque protein components. Marketed for cardiovascular health based on this mechanism. NO human clinical evidence demonstrating cardiovascular outcomes benefit. Speculative claim.

Supported by Trial 1, Trial 2

Mechanism of action

1

Selective Proteolytic Activity

Serrapeptase digests dead/inflammatory tissue and proteins (fibrin, bradykinin, histamine, C-reactive protein) but not healthy tissue. Selective activity attributed to enzyme's substrate specificity for inflammatory mediators.

2

Bradykinin Reduction

Bradykinin is a major inflammatory mediator causing pain, edema, vasodilation. Serrapeptase degrades bradykinin — basis for anti-inflammatory and analgesic effects.

3

Mucolytic Activity

Serrapeptase breaks down mucoprotein matrix in respiratory mucus — reducing viscosity. Basis for sinusitis, bronchitis, COPD adjunctive use.

4

Enteric Coating Required

Serrapeptase is destroyed by gastric acid — requires enteric coating to deliver intact enzyme to small intestine for absorption. Quality varies dramatically by manufacturer; non-enteric-coated products may be ineffective.

Clinical trials

1
Serrapeptase for Chronic Sinusitis

Multicenter trial of serrapeptase (15 mg BID) vs placebo for chronic sinusitis in 193 patients for 7 days. (J Int Med Res)

193 chronic sinusitis patients.

Serrapeptase significantly reduced sinusitis symptom scores (pain, nasal secretion, obstruction, swelling) vs placebo. Foundational European trial supporting clinical use in sinusitis.

2
Serrapeptase for Post-Surgical Edema

Clinical trial of serrapeptase vs placebo for post-operative swelling after wisdom tooth surgery.

Wisdom tooth extraction patients.

Serrapeptase significantly reduced post-operative edema and pain vs placebo. Foundational trial supporting routine post-surgical use in Japan and Europe.

Side effects and drug interactions

Common Potential side effects

GI distress (nausea, abdominal pain, diarrhea).
Bleeding risk — proteolytic activity may modestly affect coagulation; pre-surgery discontinuation prudent.
Skin reactions, allergic reactions rare.
Pneumonitis (rare but documented) — interstitial pneumonia case reports in Japanese literature; serious adverse event.
Coughing up blood (rare).
Liver enzyme elevation (rare).
Post-marketing pharmacovigilance in Japan led to restricted use — Japanese MHLW revoked some indications based on lack of efficacy in rigorous trials.

Important Drug interactions

Anticoagulants (warfarin, DOACs) — theoretical bleeding risk; monitor.
Antiplatelet drugs (aspirin, clopidogrel) — additive bleeding risk.
NSAIDs — additive bleeding risk and additive anti-inflammatory effects.
Antibiotics — serrapeptase historically promoted to enhance antibiotic penetration into infected tissue; clinical relevance limited.
Other proteolytic enzyme supplements (bromelain, papain, nattokinase) — additive effects; unclear clinical relevance.

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Frequently asked questions about Serrapeptase (Serratiopeptidase)

What is serrapeptase?

Serrapeptase is a protein-digesting enzyme originally derived from silkworms. It is taken on an empty stomach and marketed for easing inflammation, swelling, and mucus, and for breaking down excess proteins, though human evidence is limited.

What is serrapeptase used for?

It is used for proposed anti-inflammatory and mucus-thinning effects, such as supporting sinus and respiratory comfort and post-surgical swelling. The supporting research is mostly older or small, so claims should be viewed cautiously.

When should I take serrapeptase?

It is taken on an empty stomach, typically 30 minutes before or a couple of hours after meals, so it is absorbed rather than used on food. Enteric-coated forms are used to survive stomach acid.

Is serrapeptase safe?

It is generally tolerated short-term, but evidence and long-term safety data are limited. It may have a blood-thinning effect, so avoid it with anticoagulants or before surgery, and check with your doctor before use.

What is the recommended dosage of Serrapeptase?

The clinically studied dose is 10-60 mg/day (typically 10-30 mg/day), standardized to 20,000-80,000 enzymatic units. Always follow the product label and check with a healthcare provider for personal advice.

Is Serrapeptase safe, and does it have side effects?

For most healthy adults, Serrapeptase is well tolerated at studied doses. Reported effects can include: GI distress (nausea, abdominal pain, diarrhea). Bleeding risk — proteolytic activity may modestly affect coagulation; pre-surgery discontinuation prudent. It may also interact with some medications. Serrapeptase is not right for everyone, so check with a healthcare provider first if you are pregnant or breastfeeding, have a medical condition, or take prescription medication.

Does Serrapeptase interact with any medications?

Possible interactions include: Anticoagulants (warfarin, DOACs) — theoretical bleeding risk; monitor. Antiplatelet drugs (aspirin, clopidogrel) — additive bleeding risk. If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Serrapeptase?

NutraSmarts rates the evidence for Serrapeptase as Limited (2 out of 5). It is backed by 2 clinical trials and 3 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(3 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Mazzone A, Catalani M, Costanzo M, Drusian A, Mandoli A, Russo S, Guarini E, Vesperini G Evaluation of Serratia peptidase in acute or chronic inflammation of otorhinolaryngology pathology: a multicentre, double-blind, randomized trial versus placebo The Journal of International Medical Research. 1990;18(5):379-88. doi: 10.1177/030006059001800506.PubMedUsed to support: Multicentre double-blind RCT showing serratiopeptidase improved outcomes in acute and chronic otorhinolaryngologic inflammatory conditions vs. placebo; backs 'Sinusitis and Upper Respiratory Inflammation'.
  2. Tamimi Z, Al Habashneh R, Hamad I, Al-Ghazawi M, Roqa'a AA, Kharashgeh H Efficacy of serratiopeptidase after impacted third molar surgery: a randomized controlled clinical trial BMC Oral Health. 2021;21(1):91. doi: 10.1186/s12903-021-01451-0.PubMedUsed to support: Randomized controlled trial demonstrating serratiopeptidase reduced post-surgical swelling and pain following impacted third molar surgery; backs 'Post-Surgical Edema and Pain'.
  3. Tiwari M The role of serratiopeptidase in the resolution of inflammation Asian Journal of Pharmaceutical Sciences. 2017;12(3):209-215. doi: 10.1016/j.ajps.2017.01.003.PubMedUsed to support: Review summarizing the mechanisms and clinical evidence for serratiopeptidase's anti-inflammatory and anti-edema effects across multiple indications including sinusitis, fibrocystic breast disease, and post-surgical settings; backs 'Fibrocystic Breast Disease', 'Sinusitis and Upper Respiratory Inflammation', and 'Post-Surgical Edema and Pain'.