✓ No active regulatory warningsFDA MedWatch, EMA EudraVigilance, WHO VigiBase, WADA Prohibited List · 2026-05-29
Updated: 2026-05-29 · v2.0 · Prof. G. Pkhakadze, MD, MPH, PhDCiteEditorial
3
Limited
Serrapeptase
Serratiopeptidase
Limited EvidenceLimitedOther
RDA
Typical 10–60 mg
Target
N/A
Upper limit
No UL
Products
—
Dosage by population group — reference
🔗 Best with: Bromelain, Nattokinase, Turmeric / Curcumin✅ USP Verified, NSF Contents Certified, ConsumerLab Approved
⚠ Systematic review: INSUFFICIENT evidence for all claimed indications [2]
⚠ Bromelain is better-evidenced (Commission E approved) [1]
⚠ Anticoagulant interaction (theoretical fibrinolytic) [1]
ℹ️ Not obtained from food. Not applicable — this is not obtained from food in meaningful amounts; supplementation is the practical route.
🔬 Lab interpreter
ℹ️ No validated blood test. There is no established laboratory test to assess status or guide dosing for this ingredient. Clinical response and symptoms are the practical guide.
⚕ For professionals — confirm ranges against your local laboratory.
Clinical verdict
Serrapeptase has a NEGATIVE systematic review — insufficient evidence for ANY clinical recommendation. Marketing dramatically exceeds evidence. Bromelain is the better-evidenced proteolytic enzyme (Commission E approved). Choose bromelain over serrapeptase [1] [2].
1 How much do I need?
👤 Adults: Specific dosage data under clinical review
👴 Elderly: Specific dosage data under clinical review
🤰 Pregnancy: See guidance
No data. Avoid [1].
👦 Pediatric: See guidance
No data [1].
🏃 Athletes: Standard dose
⚖️ Obesity: Standard dose
Fat-soluble compounds may require dose adjustment in obesity.
🩺 Renal: Consult specialist
Dose adjustment may be needed in renal impairment.
🌱 Vegan: Standard dose

How to take

🍽 Timing: Empty stomach. Enteric-coated [1].
💊 With food: Empty stomach required [1].
🚫 Avoid: Anticoagulants [1].
2 Which form?
FormBioavailabilityVeganCost
['Enteric-coated serrapeptase', 'common', 'Enteric coating needed to survive stomach acid [1].']StandardCheck label
3 Common questions
Does serrapeptase work? ▼
Systematic review conclusion: evidence is INSUFFICIENT to recommend for any condition. The trials that exist are mostly poor quality, small, and old. Despite widespread marketing, this enzyme lacks adequate human evidence [2].
Serrapeptase vs bromelain? ▼
Bromelain has better evidence (Commission E approval for post-surgical swelling, sinusitis). Serrapeptase has weaker evidence and a negative systematic review. Bromelain is the better-evidenced choice [1] [2].
4 Clinical evidence

Strong

Proteolytic enzyme activity: confirmed [1]. Systematic review: evidence INSUFFICIENT for any clinical recommendation [2]. HIGH

Moderate

Post-surgical swelling: some European trials positive (poor quality) [2]. Sinusitis: mucolytic effect in some trials [2]. Pain: limited data [2]. MODERATE

Insufficient

ALL indications per systematic review [2]. Carpal tunnel [1]. Atherosclerosis (fibrinolytic) [1]. Chronic bronchitis [1]. The marketing dramatically exceeds the evidence [2]. LOW
5 Safety, toxicity & adverse events

Absolute contraindications

✕ Active bleeding or bleeding disorder

Relative

⚠ Concurrent anticoagulants/antiplatelets — bleeding risk
⚠ Discontinue before surgery
⚠ Rare lung/skin reactions reported

🚩 Red flags

● Patient spending money on serrapeptase — evidence insufficient; switch to bromelain [2]
6 Interactions

Drug interactions

Anticoagulants Moderate
Mechanism: Theoretical fibrinolytic activity. [1]
Effect: Bleeding risk. [1]
Action: Monitor [1].
7 Regulatory
Europe: Available as supplement. Was once Rx in some countries (largely withdrawn) [1].
Japan: Available as supplement [1].
United States: Dietary supplement [1].
Serrapeptase vs BromelainSerrapeptase vs Nattokinase
8 References (2)
[1]National Institutes of Health, MedlinePlus. Serrapeptase. Updated 2024. medlineplus.gov REVIEW Accessed: 2026-05-29
[2]Bhagat S, et al. Serratiopeptidase: a systematic review of the existing evidence. Int J Surg. 2013;11(3):209-217. doi:10.1016/j.ijsu.2013.01.010 META-ANALYSIS Accessed: 2026-05-29
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10 Cite this page
Vancouver: Pkhakadze G. Serrapeptase — safety profile [Internet]. Tbilisi: PHIG; 2026 [cited 2026 Jun 01]. Available from: https://supplement.ge/ingredients/serrapeptase/
APA 7th: Pkhakadze, G. (2026). Serrapeptase — Safety profile. Public Health Institute of Georgia. https://supplement.ge/ingredients/serrapeptase/
📋 Editorial information
Author: Prof. G. Pkhakadze, MD, MPH, PhD
Institution: Public Health Institute of Georgia (PHIG)
Affiliation: David Tvildiani Medical University (DTMU)
First published: January 2026
Last reviewed: 2026-05-29
Next review: December 2026
References: 2 cited sources
COI: SupplementIndex receives no funding from supplement manufacturers. All content independently authored by PHIG.
Process: Systematic literature review
📄 License & reuse
Published under Creative Commons Attribution 4.0 International (CC BY 4.0). You may share and adapt for any purpose with attribution.
Pkhakadze G. "Serrapeptase — Safety Profile." SupplementIndex, PHIG, 2026. https://supplement.ge/ingredients/serrapeptase/ CC BY 4.0.
GP
Prof. G. Pkhakadze, MD, MPH, PhD
Professor of Public Health · Head of Department, DTMU
Editor-in-Chief, Georgian Medical Journal (ISSN 3088-4322)
Chair, Public Health Institute of Georgia · UEMS Public Health Section
Educational and public health purposes. CC BY 4.0. Consult your healthcare provider before starting any supplement. Corrections: info@accreditation.ge. Publisher: PHIG