LongCovidPharmDNov 29, 2022
Not much information is known about the pharmacokinetics of nattokinase, making it difficult to predict drug interactions. There are no known trials investigating nattokinase drug interactions in vivo. However, I have parsed through the primary literature in order to find hints about what interactions are more or less likely with this popular Long Covid, Lyme and ME/CFS supplement. All info gathered is consolidated in a chart here - check it out if you're taking NK!
https://pharmd.substack.com/p/drug-interactions-with-nattokinase
Drug Interactions with Nattokinase?

A handy chart containing evidence-based speculations drawing upon primary sources, pharmacokinetics, chemical structures and my pharmacy knowledge.

Studies, Surveys, & Supplements
Show thread[email protected]Dec 5, 2022
@LongCovidPharmD thank you so much for this. I started apixaban a few weeks ago and clopidogrel today, so my giant bottle of nattokinase is going on holiday for a while.
Show threadLongCovidPharmDDec 6, 2022
@jaseygalore oh wow, I hope apixaban & clopidogrel helps you!
Show thread[email protected]
@LongCovidPharmD I’m having bloods taken again on Monday to check d-dimer, and seeing my doctor again in about 2 weeks or so. I’ve since read though that high d-dimer isn’t likely caused by microclots 😩 but that many ME peeps may have had microclots before covid19+ was even a thing. Regardless, it’ll be a big relief if d-dimer is now dropping otherwise I think we’re then looking for malignant cancer?
Dec 16, 2022 at 10:34amWeb
Show threadGethin ColesDec 16, 2022
@jaseygalore @LongCovidPharmD I've had ME for 12 years, I don't think my doc has ever tested for d-dimer. I've never heard of it. (I'm saying this because it's so hard to find a doc that thinks outside the box)
Show thread[email protected]Dec 20, 2022
@geth @LongCovidPharmD I’m not entirely sure it is a ME or even a LC thing, just that mine is being a dork and we’re trying to find out why (essentially to rule out malignant cancer as that is the biggest concern given no clots appeared on a range of scans, and microclots allegedly don’t raise d-dimer).
Show thread[email protected]Dec 20, 2022
@geth @LongCovidPharmD oops, my GP didn’t test for it before either. I went to hospital by ambulance for suspected cardiac issues and they tested. Went back again with worse symptoms, tested again and it was a bit higher. Back a third time for suspected DVT, tested again and still high. Had new bloods taken this morning so I suppose I find out in a day or two if the triple med therapy has helped 🥺
Show threadGethin ColesDec 20, 2022
@jaseygalore @LongCovidPharmD I hope so! Good luck
Show threadLongCovidPharmDDec 29, 2022
@jaseygalore Any updates?
Show thread[email protected]Jan 5, 2023
@LongCovidPharmD alas no. I see my GP on the 17th. I think he’s on vacation at the moment so if I’m already dead then he’s not at work to tell me.
Show threadLongCovidPharmDDec 29, 2022
@jaseygalore OMG, that sounds really scary! Sorry for delayed response. Did you rule out malignant cancer I hope?!