Drug & supplement interaction

Nattokinase + Fentanyl citrate

Fentanyl citrate brand name: Innovar.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Nattokinase and Fentanyl citrate in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Nattokinase and Fentanyl citrate

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Fentanyl citrate and Nattokinase in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Nattokinase safety at a glance

Nattokinase overall Use caution Generally tolerated short-term, but its blood-thinning effect means caution for people with bleeding risk.
Pregnancy Avoid Not enough safety data, so it is best avoided during pregnancy.
Breastfeeding Avoid Safety is unknown while breastfeeding, so avoid it to be safe.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Fentanyl citrate and Nattokinase? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Fentanyl citrate

Interactions in our licensed database are recorded against drug classes, not just single drug names. Fentanyl citrate is filed under 9 classifications — including narcotic drugs, serotonergic drugs, serotonergic drugs. Nattokinase has documented interactions with 2 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate) and antihypertensive drugs (moderate) — and none of Fentanyl citrate’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Nattokinase Does Interact With Other Medications

Nattokinase has 289 moderate known drug interactions in our database — Fentanyl citrate isn’t one of them. If you take anything else, check it against the full list below.

Moderate 289 No known interaction 2,541 (incl. Fentanyl citrate)
Taking anything else?

Check Another of Your Medications Against Nattokinase

Covers the 2,830 medications we’ve checked against Nattokinase. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Nattokinase and Fentanyl citrate May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 3 of them are worth acting on rather than waiting out — marked below.

  • Shortness of breath / A severe allergic reaction / An allergic reaction Worth acting on Additional detail

    Nattokinase

    “Orally, nattokinase can cause hypersensitivity reactions, including anaphylaxis, in individuals sensitive to natto. A case series examining hypersensitivity reactions to natto shows that the causative allergen can be either nattokinase or polygamma glutamic acid (PGA), both of which are found in the sticky substance surrounding natto soybeans.”

    Nattokinase · Natural Medicines adverse-effect record, reported in dermatitis.

    2 sources cited
    1. 109552. Awatani-Yoshidome K, Hashimoto T, Satoh T. Anaphylaxis from nattokinase in a patient with fermented soybean (natto) allergy. Allergol Int 2022;71(1):153-4. PubMed
    2. 111253. Suzuki K, Nakamura M, Sato N, Futamura K, Matsunaga K, Yagami A. Nattokinase, a subtilisin family serine protease, is a novel allergen contained in the traditional Japanese fermented food natto. Allergol Int 2022.

    Fentanyl citrate

    Listed in the ADVERSE REACTIONS section of the FDA label for Fentanyl citrate. Read the label on DailyMed ›

  • Itching / Swelling / A skin rash Additional detail

    Nattokinase

    Recorded for Nattokinase in the same Natural Medicines adverse-effect record shown under Shortness of breath / A severe allergic reaction / An allergic reaction above.

    Fentanyl citrate

    Listed in the ADVERSE REACTIONS section of the FDA label for Fentanyl citrate. Read the label on DailyMed ›

  • Dizziness Additional detail

    Nattokinase

    “Orally, nattokinase has been associated with rare reports of hemorrhage. A case of intracranial hemorrhage (ICH) has been reported in a 52-year-old female who took nattokinase while taking low-dose aspirin for secondary prevention of ischemic stroke. Seven days after initiating nattokinase 400 mg daily, the patient reported vertigo and unsteady gait and was diagnosed with an acute cerebellar hemorrhage.”

    Nattokinase · Natural Medicines adverse-effect record, reported in atrial fibrillation.

    2 sources cited
    1. 64834. Chang, Y. Y., Liu, J. S., Lai, S. L., Wu, H. S., and Lan, M. Y. Cerebellar hemorrhage provoked by combined use of nattokinase and aspirin in a patient with cerebral microbleeds. Intern Med 2008;47(5):467-469. PubMed
    2. 109551. Ramachandran L, Aqeel A, Jafri A, Sidhu Y, Mohamed Djirdeh T. Nattokinase-associated hemoperitoneum in an elderly woman. Cureus 2021;13(12):e20074. PubMed

    Fentanyl citrate

    Listed in the ADVERSE REACTIONS section of the FDA label for Fentanyl citrate. Read the label on DailyMed ›

Reported for Nattokinase but not commonly for Fentanyl citrate: bleeding or bruising, an irregular heartbeat and a stroke or mini-stroke.

Effects for Fentanyl citrate come from the ADVERSE REACTIONS section of its FDA label; effects for Nattokinase come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 17,764 voluntary FDA FAERS reports for Fentanyl citrate that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

From our Q&A

Questions About Nattokinase or Fentanyl citrate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Nattokinase or Fentanyl citrate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Fentanyl citrate

This page covers Nattokinase only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Fentanyl citrate page lists 223 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 10 major · 174 moderate · 39 minor.

From our pharmacist’s overview on the Fentanyl citrate page

“The single most important thing to know about fentanyl citrate, an extremely potent opioid pain medicine, is that anything else with a sedating effect can deepen the slowed breathing that makes opioids dangerous. Alcohol, whether beer or wine, carries a major rating for exactly this reason, and 78 of the 223 ingredients on file add sed…”

Reviewed by 2 · Jul 18, 2026

Open the Fentanyl citrate interaction page

One more smart check

Taking Nattokinase as Part of a Dietary Supplement Product? Check It for Interactions

We hold 509 real supplement products containing Nattokinase, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Nattokinase. Even though Nattokinase itself has no known interaction with Fentanyl citrate, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Nattokinase and Fentanyl citrate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Nattokinase
Top 25%

#246 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Fentanyl citrate
Top half

#1,372 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Nattokinase reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Nattokinase and Fentanyl citrate records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Nattokinase

What is Nattokinase?

Nattokinase
  • Heart and circulatory health
  • Blood clot prevention
  • High blood pressure
  • Improving blood flow
  • Cholesterol support

Nattokinase is an enzyme from the fermented soybean food natto that may have mild blood-thinning and blood-flow effects. Some small studies hint at benefits for blood pressure and circulation, but the evidence is limited and more research is needed. Because it can affect clotting, talk to your pharmacist or doctor before trying it, especially if you take medicines or have a bleeding risk.

Enzyme extracted from natto (fermented soybeans) · Capsules, tablets, softgels

An interaction check asks whether these two react with each other — it does not ask whether Nattokinase is a good idea for someone in your situation. Here is what our Nattokinase record says about it on its own.

Nattokinase: dosing

There is no official or standardized dose of nattokinase. Products are often measured in "fibrinolytic units" (FU), and the amount varies a lot from brand to brand.Because of this, the best approach is to follow the directions on the product label and not take more than recommended.

From our Nattokinase monograph — the full record covers uses, side effects and every documented interaction.

Read the full Nattokinase monograph & all interactions
Medication

About Fentanyl citrate

Most-Reported Side Effects for Fentanyl citrate

From FAERS, the FDA’s public side-effect reporting system (17,764 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Dependence 3,935 reports
Overdose 2,450 reports
Drug abuse 1,734 reports
Toxicity to various agents 1,383 reports
Ill-defined disorder 1,288 reports
Keep checking

Other Drugs & Nattokinase

Browse every other medication we’ve checked against Nattokinase — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
289Moderate
0Minor
2,540No known interaction
289 Moderate 2,540 No interaction
Moderate

289 interactions

Showing 60 of 289 moderate interactions — see all 289 on the Nattokinase page.

No interaction 2,540 drugs checked — show the list

We also checked Nattokinase against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,540 medications checked with no known interaction — see the full Nattokinase list.

See the full Nattokinase interactions page
See every supplement checked against Fentanyl citrate, ranked by severity
Evidence & sources

Nattokinase References

The 9 references that drive our Nattokinase monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Suzuki Y, Kondo K, Matsumoto Y, et al. Dietary supplementation of fermented soybean, natto, suppresses intimal thickening and modulates the lysis of mural thrombi after endothelial injury in rat femoral artery. Life Sci 2003;73:1289-98.. PubMed
  2. Sumi H, Hamada H, Nakanishi K, Hiratani H. Enchancement of fibrinolytic activity in plasma by oral administration of nattokinase. Acta Haematol 1990;84:139-43.
  3. Chang, Y. Y., Liu, J. S., Lai, S. L., Wu, H. S., and Lan, M. Y. Cerebellar hemorrhage provoked by combined use of nattokinase and aspirin in a patient with cerebral microbleeds. Intern Med 2008;47(5):467-469. PubMed
  4. Kim, J. Y., Gum, S. N., Paik, J. K., Lim, H. H., Kim, K. C., Ogasawara, K., Inoue, K., Park, S., Jang, Y., and Lee, J. H. Effects of nattokinase on blood pressure: a randomized, controlled trial. Hypertens.Res 2008;31(8):1583-1588. PubMed
  5. <p>Maruyama M, Sumi H (eds): Effect of natto diet on blood pressure, in Basic and Clinical Aspects of Japanese Traditional Food Natto II. Japan Technology Transfer Association (JTTAS), 1998, pp 1–3.</p>
  6. Kurosawa Y, Nirengi S, Homma T, et al. A single-dose of oral nattokinase potentiates thrombolysis and anti-coagulation profiles. Sci Rep 2015;5:11601. PubMed
  7. Ramachandran L, Aqeel A, Jafri A, Sidhu Y, Mohamed Djirdeh T. Nattokinase-associated hemoperitoneum in an elderly woman. Cureus 2021;13(12):e20074. PubMed
  8. Awatani-Yoshidome K, Hashimoto T, Satoh T. Anaphylaxis from nattokinase in a patient with fermented soybean (natto) allergy. Allergol Int 2022;71(1):153-4. PubMed
  9. Suzuki K, Nakamura M, Sato N, Futamura K, Matsunaga K, Yagami A. Nattokinase, a subtilisin family serine protease, is a novel allergen contained in the traditional Japanese fermented food natto. Allergol Int 2022.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Nattokinase and Fentanyl citrate Together: Common Questions

Is it safe to take Nattokinase with Fentanyl citrate?
We do not list a known interaction between Nattokinase and Fentanyl citrate. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Nattokinase and Fentanyl citrate have any of the same side effects?
Yes — our sources link each of them separately to 7 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Nattokinase and Fentanyl citrate combination checked?
Interactions in our licensed database are recorded against drug classes. Fentanyl citrate is filed under 9 classifications, and Nattokinase has documented interactions with 2 drug classes — none of Fentanyl citrate's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Nattokinase interact with any other medications?
Yes. Nattokinase has 289 documented drug interactions in our database — Fentanyl citrate is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Fentanyl citrate interact with any supplements?
Yes. Fentanyl citrate has documented interactions with 223 supplements in our database — Nattokinase is not one of them. The Fentanyl citrate interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Nattokinase monograph Uses, safety profile, and every drug interaction in one place Fentanyl citrate supplement interactions Every supplement checked against Fentanyl citrate, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 9 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Fentanyl citrate and Nattokinase?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.