Drug & supplement interaction

Serrapeptase + Apixaban

Apixaban brand name: Eliquis.

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

Serrapeptase has a moderate interaction with Apixaban. Theoretically, taking serrapeptase with drugs that have antiplatelet or anticoagulant effects might increase the risk of bruising and bleeding.

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

Serrapeptase and Apixaban

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Apixaban

Apixaban falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Serrapeptase interacts with.

Theoretically, taking serrapeptase with drugs that have antiplatelet or anticoagulant effects might increase the risk of bruising and bleeding.
In vitro research shows that serrapeptase has fibrinolytic activity.
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 simple version: Eliquis (apixaban) is already a blood thinner that works by blocking a clotting protein called factor Xa. Serrapeptase is an enzyme that, at least in lab studies, seems to have some clot-breaking (fibrinolytic) activity of its own. Stack those two together and the worry is purely additive, meaning your blood may have an even harder time forming a clot when it should.

In real life, that could show up as easier bruising, nosebleeds, bleeding gums, or bleeding that takes longer to stop. I want to be honest with you though: this is a theoretical concern based on test-tube data, not strong human studies. Still, since apixaban is a serious medicine, please loop in your pharmacist or doctor before adding serrapeptase, and watch for any unusual bleeding.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Tachibana M, Mizukoshi O, Harada Y, et al. A multi-centre, double-blind study of serrapeptase versus placebo in post-antrotomy buccal swelling. Pharmatherapeutica 1984;3:526-30..
  2. Mazzone A, Catalani M, Costanzo M, et al. Evaluation of Serratia peptidase in acute or chronic inflammation of otorhinolaryngology pathology: a multicentre, double-blind, randomized trial versus placebo. J Int Med Res 1990;18:379-88.. PubMed

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

Serrapeptase Also Interacts With Other Medications

Serrapeptase has 121 moderate known drug interactions in our database — the Apixaban one above is one of them. If you take anything else, check it against the full list below.

Moderate 121 No known interaction 2,709 (incl. Apixaban)
Taking anything else?

Check Another of Your Medications Against Serrapeptase

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

From our Q&A

Questions About Serrapeptase or Apixaban

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Serrapeptase or Apixaban, 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 Apixaban

This page covers Serrapeptase only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Apixaban page lists 285 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 240 moderate · 40 minor.

From our pharmacist’s overview on the Apixaban page

“St. John's wort can weaken apixaban (Eliquis), speeding how the body clears this blood thinner and leaving you less protected from the strokes and clots it is prescribed to prevent.”

Reviewed by 2 · Jul 18, 2026

Open the Apixaban interaction page

One more smart check

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

We hold 9 real supplement products containing Serrapeptase, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Serrapeptase. Your product may carry other ingredients that interact with Apixaban too, on top of Serrapeptase — 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 Serrapeptase and Apixaban 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 Serrapeptase
Top half

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

29 days ago today
Medication Apixaban
Most looked up

#1 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 Serrapeptase

What is Serrapeptase?

  • Inflammation and swelling
  • Sinus and respiratory congestion
  • Pain after surgery or injury
  • Joint and back pain
  • Thinning mucus

Serrapeptase is an enzyme marketed to reduce inflammation, swelling, pain, and mucus, but the human evidence is limited and mostly low quality. If you want to try it, choose an enteric-coated product, follow the label, and check with your pharmacist or doctor first—especially if you are pregnant, breastfeeding, or take other medicines.

Read the full Serrapeptase monograph & all interactions
Medication

About Apixaban

What Is Apixaban Used For?

Brand name: Eliquis

Apixaban is used to reduce the risk of stroke and dangerous clots traveling through the body in adults with nonvalvular atrial fibrillation (an irregular heart rhythm not caused by a heart valve problem). It is also used to prevent deep vein thrombosis (DVT — a blood clot in the leg) in adults after hip or knee replacement surgery, and to treat DVT and pulmonary embolism (PE — a blood clot in the lungs) in adults, including reducing the risk of those clots coming back.

Eliquis (the brand-name tablet and kit) is additionally approved to treat venous thromboembolism (VTE — blood clots in the veins) and reduce the risk of recurrent VTE in pediatric patients from birth and older, after at least 5 days of initial anticoagulant treatment. The generic apixaban tablet carries the adult indications only.

See full Apixaban drug information
Keep checking

Other Drugs & Serrapeptase

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

0Major
121Moderate
0Minor
2,708No known interaction
121 Moderate 2,708 No interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Serrapeptase page.

No interaction 2,708 drugs checked — show the list

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

Showing the 60 most looked-up of 2,708 medications checked with no known interaction — see the full Serrapeptase list.

See the full Serrapeptase interactions page
See every supplement checked against Apixaban, 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
Serrapeptase monograph › Uses, safety, and every drug interaction in one place Apixaban supplement interactions › Every supplement checked against Apixaban, ranked by severity Apixaban 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 Serrapeptase and Apixaban Together: Common Questions

Can you take Serrapeptase with Apixaban?
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 Serrapeptase and Apixaban 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 Apixaban and Serrapeptase?

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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.