Drug & supplement interaction

Nattokinase + Penbutolol Sulfate

Penbutolol Sulfate brand name: Levatol.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Nattokinase has a moderate interaction with Penbutolol Sulfate. Theoretically, nattokinase might increase the risk of hypotension when used with antihypertensive drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Nattokinase and Penbutolol Sulfate

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Penbutolol Sulfate

Penbutolol Sulfate falls under ANTIHYPERTENSIVE DRUGS — the group Nattokinase interacts with.

Theoretically, nattokinase might increase the risk of hypotension when used with antihypertensive drugs.
Some clinical research suggests that nattokinase may reduce systolic and diastolic blood pressure.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the basic idea: penbutolol (Levatol) already lowers your blood pressure by slowing your heart and easing up your blood vessels. Nattokinase, in a few small studies, seems to nudge blood pressure down a little on its own. Put them together and those two effects could stack up, theoretically pushing your numbers lower than intended.

If that happens, you might feel dizzy, lightheaded, unusually tired, or wobbly when you stand up quickly. I want to be honest, though: this concern is based on pharmacology and some early research, not strong proof, so for many people it stays minor. Penbutolol isn't a prodrug, so this is about added blood-pressure lowering, not changes in how the drug is processed. Please check with your pharmacist or doctor before adding nattokinase, and keep an eye on your home readings.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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
  2. <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>

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Nattokinase Also Interacts With Other Medications

Nattokinase has 288 moderate known drug interactions in our database — the Penbutolol Sulfate one above is one of them. If you take anything else, check it against the full list below.

Moderate 288 No known interaction 2,542 (incl. Penbutolol Sulfate)
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.

From our Q&A

Questions About Nattokinase or Penbutolol Sulfate

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 Penbutolol Sulfate, 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 Penbutolol Sulfate

This page covers Nattokinase only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Penbutolol Sulfate page lists 139 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Indian Snakeroot (major) and Tyramine (major).

By severity: 5 major · 113 moderate · 21 minor.

From our pharmacist’s overview on the Penbutolol Sulfate page

“Penbutolol sulfate (Levatol) is a beta-blocker that lowers blood pressure and slows the heart, and its supplement file earns real vigilance, since five of the 139 ingredients on record carry a major rating. The great majority, 119 ingredients, tug on blood pressure one way or the other, some stacking with the drug until it falls too fa…”

Reviewed by 2 · Jul 18, 2026

Open the Penbutolol Sulfate 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. Your product may carry other ingredients that interact with Penbutolol Sulfate too, on top of Nattokinase — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Nattokinase and Penbutolol Sulfate 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%

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

29 days ago today
Medication Penbutolol Sulfate
Top half

#1,141 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.

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.

Read the full Nattokinase monograph & all interactions
Medication

About Penbutolol

What Is Penbutolol Used For?

Brand name: Levatol

  • Penbutolol is used to treat high blood pressure. Penbutolol is in a class of medications called beta blockers. It works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure.

See full Penbutolol 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
288Moderate
0Minor
2,541No known interaction
288 Moderate 2,541 No interaction
Moderate

288 interactions

Showing 60 of 288 moderate interactions — see all 288 on the Nattokinase page.

No interaction 2,541 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 2,541 medications checked with no known interaction — see the full Nattokinase list.

See the full Nattokinase interactions page
See every supplement checked against Penbutolol Sulfate, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Nattokinase monograph › Uses, safety, and every drug interaction in one place Penbutolol Sulfate supplement interactions › Every supplement checked against Penbutolol Sulfate, ranked by severity Penbutolol drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Nattokinase and Penbutolol Sulfate Together: Common Questions

Can you take Nattokinase with Penbutolol Sulfate?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Nattokinase and Penbutolol Sulfate interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Penbutolol Sulfate and Nattokinase?

Our pharmacists answer your medication & supplement questions — free.

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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.