Drug & supplement interaction

Nattokinase + Leniolisib

Leniolisib brand name: Joenja.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Nattokinase and Leniolisib 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 Leniolisib

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 Leniolisib 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 Leniolisib and Nattokinase? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Leniolisib

Interactions in our licensed database are recorded against drug classes, not just single drug names. Leniolisib is filed under 3 classifications — cytochrome p450 1a2 (cyp1a2) inhibitors, cytochrome p450 3a4 (cyp3a4) substrates, oral drugs. Nattokinase has documented interactions with 2 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate) and antihypertensive drugs (moderate) — and none of Leniolisib’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 — Leniolisib 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. Leniolisib)
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 Leniolisib 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. 2 of them are worth acting on rather than waiting out — marked below.

  • 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.

    Leniolisib

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

  • A skin rash Additional detail

    Nattokinase

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

    Leniolisib

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

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

Effects for Leniolisib come from the ADVERSE REACTIONS section of its FDA label; effects for Nattokinase come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Overlapping uses

What Leniolisib Is Prescribed For, and What Nattokinase Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Leniolisib is a prescription medicine with approved uses on its FDA label. Nattokinase is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Leniolisib is prescribed for: Joenja (leniolisib) is approved to treat activated phosphoinositide 3-kinase delta syndrome, commonly called APDS — a rare genetic immune disorder in which certain immune cells (B and T cells) don't work properly. It is approved for adults and pediatric patients who are at least 12 years old. APDS is caused by gene variants that make a specific enzyme (PI3K-delta) overactive, leading to immune system dysfunction. Joenja is the brand name for leniolisib in tablet form, taken by mouth.

Nattokinase has been studied for:

  • Cancer studied, not established Nattokinase has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Nattokinase for cancer

    Although there has been interest in using oral nattokinase for cancer, there is insufficient reliable information about the clinical effects of nattokinase for this condition.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Leniolisib on your own; if you are taking Nattokinase for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Nattokinase or Leniolisib

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 Leniolisib, 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 Leniolisib

This page covers Nattokinase only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Leniolisib page lists 145 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 100 moderate · 42 minor.

From our pharmacist’s overview on the Leniolisib page

“Leniolisib (Joenja) treats APDS, a rare immune disorder, and it is cleared by the CYP3A4 enzyme, a pathway that runs through nearly this whole page: 121 of the 145 supplements and herbs on file can push its blood level up or down that way. That deserves genuine vigilance, starting with the three major entries.”

Reviewed by 2 · Jul 18, 2026

Open the Leniolisib 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 Leniolisib, 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 Leniolisib 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%

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

29 days ago today
Medication Leniolisib
Top half

#1,039 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 20, 2026. The Nattokinase and Leniolisib 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 Leniolisib

What Is Leniolisib Used For?

Brand name: Joenja

Joenja (leniolisib) is approved to treat activated phosphoinositide 3-kinase delta syndrome, commonly called APDS — a rare genetic immune disorder in which certain immune cells (B and T cells) don't work properly. It is approved for adults and pediatric patients who are at least 12 years old.

APDS is caused by gene variants that make a specific enzyme (PI3K-delta) overactive, leading to immune system dysfunction. Joenja is the brand name for leniolisib in tablet form, taken by mouth.

See full Leniolisib drug information
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 Leniolisib, 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 Leniolisib Together: Common Questions

Is it safe to take Nattokinase with Leniolisib?
We do not list a known interaction between Nattokinase and Leniolisib. 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 Leniolisib have any of the same side effects?
Yes — our sources link each of them separately to 3 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.
Are Nattokinase and Leniolisib used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Nattokinase in each. That is a conversation for your prescriber, especially if Leniolisib is being adjusted to a target.
How was the Nattokinase and Leniolisib combination checked?
Interactions in our licensed database are recorded against drug classes. Leniolisib is filed under 3 classifications, and Nattokinase has documented interactions with 2 drug classes — none of Leniolisib'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 — Leniolisib 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 Leniolisib interact with any supplements?
Yes. Leniolisib has documented interactions with 145 supplements in our database — Nattokinase is not one of them. The Leniolisib 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 Leniolisib drug information The full plain-English guide to this medication Leniolisib supplement interactions Every supplement checked against Leniolisib, 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 Leniolisib 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.