Nattokinase +BioPerine Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Nattokinase +BioPerine against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Nattokinase +BioPerine is a dietary supplement by Approved Science with 2 active ingredients. Its ingredients are commonly taken for heart and circulatory health, blood clot prevention, high blood pressure.Based on those ingredients, 1,142 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are BioPerine, Nattokinase. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Nattokinase +BioPerine by Approved Science
Ask about any prescription or over-the-counter medication and we check it for interactions with Nattokinase +BioPerine by Approved Science — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Nattokinase +BioPerine by Approved Science
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
This product contains 2 active ingredients. Nattokinase is an enzyme extracted from natto, a fermented soy food, that's thought to work by thinning the blood and breaking down clots.
BioPerine is a concentrated extract of black pepper that contains piperine, the compound that gives pepper its bite — it's added to enhance absorption of the nattokinase. The capsule also contains inactive ingredients: cellulose and rice flour, which are fillers and binders that hold the formula together.
Does it work?
Not established
The evidence for nattokinase is currently incomplete. We hold data on several possible uses — angina, atherosclerosis, cancer, cardiovascular disease, and chronic fatigue syndrome — but none of them have enough reliable evidence to rate how well it works.
Similarly, BioPerine as a standalone supplement lacks established evidence for its own direct health effects. The data we hold covers allergic rhinitis, asthma, athletic performance, headache, depression, and diarrhea, but none have sufficient reliable evidence to rate.
How safe is it?
Well-documented data
Nattokinase is generally well tolerated in the short term, but because it thins your blood, you need to be cautious if you have a bleeding disorder or take any bleeding-risk medications. It's not recommended during pregnancy — there isn't enough safety data.
It should also be avoided while breastfeeding because safety is unknown. BioPerine (black pepper extract) is generally safe when used in food amounts or as a single dose.
The most common side effects are minor — a burning aftertaste, indigestion, or reduced taste. In sensitive individuals, an allergic reaction is rare but possible.
Concentrated piperine supplements haven't been well studied during pregnancy or breastfeeding, so caution is warranted.
Meds to double-check
Moderate interaction found
Before you take Nattokinase + BioPerine, double-check any blood thinners (anticoagulants) or antiplatelet drugs like aspirin or warfarin, and any blood pressure medications you're on — all Moderate concern. Also flag propranolol, phenytoin, rifampin, nevirapine, cyclosporine, pentobarbital, atorvastatin, and theophylline if you take them, since BioPerine may increase their blood levels.
Your pharmacist can run your medication list through our tool to be sure.
The bottom line
Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
This product isn't for everyone. If you take blood thinners, antiplatelet drugs, blood pressure medications, or certain specific drugs metabolized by the liver — especially propranolol, phenytoin, rifampin, nevirapine, cyclosporine, pentobarbital, atorvastatin, or theophylline — check with your pharmacist before starting.
Skip it if you're pregnant or breastfeeding. If you don't take any of those medications and want to try it, talk to your pharmacist about whether it makes sense for you.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 2 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Dec 21, 2024.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Nattokinase +BioPerine, straight from the product label.
| Brand | Approved Science |
|---|---|
| Barcode (UPC) | X0043F9KMN |
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Dec 21, 2024 |
| DSLD ID | 319797 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), Women (not pregnant or lactating), Dairy Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Nattokinase +BioPerine by Approved Science, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Nattokinase | 200 mg | -- |
| BioPerine | 5 mg | -- |
Other ingredients: Cellulose, Rice Flour
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions
Directions: As a dietary supplement, take one capsule twice daily before meals.
Precautions
Caution: Do not exceed recommended dose. Do not use if safety seal is damaged or missing.
Women who are pregnant or nursing should not take this product. Children under 18, and individuals with a known medical condition, or taking anti-coagulant medication, should consult with a physician before taking this or any other dietary supplement.
Children under 18, and individuals with a known medical condition, or taking anti-coagulant medication, should consult with a physician before taking this or any other dietary supplement. Keep out of reach of children.
Contains soy
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Storage
Store at room temperature.
Formulation
Manufactured in the USA according to current Good Manufacturing Practice (cGMP) and conforms to the tested ingredients grade, strength and purity of industry Quality Standards.
Vegan friendly
Made with GMO free ingredients
Premium grade High potency Safe Fast Natural formula Optimal strength GMP Certified
100% vegan friendly
Seals/Symbols
Vegan friendly Made in USA No animal testing GMP Good Manufacturing Practice Quality Product
Formula
High absorption Nattokinase Nattokinase + Bioperine 4,000 FU (200mg) per serving
FDA Statement of Identity
Dietary Supplement
Brand IP Statement(s)
BioPerine the Patented Bioavailability Enhancer
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Nattokinase +BioPerine by Approved Science label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Nattokinase +BioPerine by Approved Science
These are the 2 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Nattokinase
Interacts with289 drugs
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 be...
Nattokinase monograph & interactionsBioPerine
Interacts with1,019 drugs
Black pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to he...
BioPerine monograph & interactionsOther (inactive) ingredients: Cellulose, Rice Flour. These complete the product’s ingredient list but are not active constituents.
Nattokinase +BioPerine by Approved Science Drug Interactions
HelloPharmacist Interaction Report
Nattokinase + BioPerine by Approved Science can interact with a range of medications, so you'll want to check any prescriptions you're taking before starting it.
Read the full breakdown — every affected drug type, severity by severity
Nattokinase's main concern is with blood thinners (anticoagulants) and antiplatelet drugs like aspirin, warfarin, and clopidogrel — the interaction is Moderate severity. Nattokinase thins the blood on its own, and adding it to these drugs raises your bleeding risk.
There's even a case report of someone who took nattokinase alongside low-dose aspirin and had a brain bleed. It can also lower blood pressure, so if you're already on blood pressure medication (antihypertensive drugs), there's a Moderate risk of your pressure dropping too far.
BioPerine, the black pepper extract in this formula, affects how your liver and intestines handle several specific medications — all Moderate severity. These include propranolol (a beta-blocker), nevirapine (an HIV drug), rifampin (a tuberculosis antibiotic), phenytoin (an anti-seizure medication), cyclosporine (an immunosuppressant), pentobarbital (a sedative), atorvastatin (a cholesterol drug), and theophylline (used for breathing problems).
BioPerine can increase blood levels of these drugs, which may boost both their effects and side effects.
Altogether, these interactions span 1,127 individual medications. Use the search tool on this page to check your exact prescriptions before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Nattokinase +BioPerine?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Nattokinase +BioPerine interact with 1,142 drugs. Click any drug to see the details.
2 of the 2 ingredients in Nattokinase +BioPerine interact with drugs. Each result below shows which ingredient is responsible. BioPerine Nattokinase
Ado-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with Nattokinase +BioPerine — through 2 ingredients. Tap an ingredient for the detail:
NattokinaseAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Nattokinase might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Read the full Nattokinase + Abciximab interactionBioperineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Nattokinase +BioPerine — through 2 ingredients. Tap an ingredient for the detail:
NattokinaseAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Nattokinase might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Read the full Nattokinase + Abrocitinib interactionBioperineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Bioperine + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
NattokinaseAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, nattokinase might increase the risk of hypotension when used with antihypertensive drugs.
Read the full Nattokinase + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Nattokinase +BioPerine — through 2 ingredients. Tap an ingredient for the detail:
BioperineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Acenocoumarol interactionNattokinaseAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Nattokinase might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Read the full Nattokinase + Acenocoumarol interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Nattokinase +BioPerine — through 2 ingredients. Tap an ingredient for the detail:
BioperineCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Aspirin interactionNattokinaseAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Nattokinase might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Read the full Nattokinase + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Nattokinase +BioPerine — through 2 ingredients. Tap an ingredient for the detail:
BioperineAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Acetaminophen, Aspirin, Caffeine interactionNattokinaseAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Nattokinase might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Read the full Nattokinase + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
How Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
How Acetaminophen, Chlorpheniramine, Phenylephrine interacts with Nattokinase +BioPerine — through 1 ingredient. Tap an ingredient for the detail:
BioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Chlorpheniramine, Phenylephrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Nattokinase +BioPerine with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
BioPerine
Anticoagulant/Antiplatelet Drugs
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit platelet aggregation. This has not been reported in humans.
Antidiabetes Drugs
Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of black pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Atorvastatin (Lipitor)
Theoretically, black pepper might increase blood levels of atorvastatin.
Animal research shows that taking piperine, a constituent of black pepper, 35 mg/kg can increase the maximum serum concentration of atorvastatin three-fold. This has not been reported in humans.
Cyclosporine (Neoral, Sandimmune)
Theoretically, black pepper might increase the effects and side effects of cyclosporine.
In vitro research shows that piperine, a constituent of black pepper, increases the bioavailability of cyclosporine. This has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
In vitro research suggests that some constituents of black pepper inhibit CYP2D6. This has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
In vitro research and pharmacokinetic simulation data suggest that piperine, a constituent of black pepper, as well as the pepper fruit seem to inhibit CYP3A4. This has not been reported in humans.
Lithium
Theoretically, black pepper might increase blood levels of lithium due to its diuretic effects. The dose of lithium might need to be reduced.
Black pepper is thought to have diuretic properties.
Nevirapine (Viramune)
Black pepper might increase blood levels of nevirapine.
Clinical research shows that piperine, a constituent of black pepper, increases the plasma concentration of nevirapine. However, no adverse effects were observed in this study.
P-Glycoprotein Substrates
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit P-glycoprotein.
Pentobarbital (Nembutal)
Theoretically, black pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of black pepper, increases pentobarbital-induced sleeping time.
Phenytoin (Dilantin)
Black pepper might increase blood levels of phenytoin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption, slow elimination, and increase levels of phenytoin. Taking a single dose of black pepper 1 gram along with phenytoin seems to double the serum concentration of phenytoin. Consuming a soup with black pepper providing piperine 44 mg/200 mL of soup along with phenytoin also seems to increase phenytoin levels when compared with consuming the same soup without black pepper.
Propranolol (Inderal)
Black pepper might increase blood levels of propranolol.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of propranolol.
Rifampin (Rifadin)
Black pepper might increase blood levels of rifampin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and serum levels of rifampin.
Theophylline
Black pepper might increase blood levels of theophylline.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of theophylline.
Amoxicillin (Amoxil, Trimox)
Theoretically, black pepper might increase the effects and side effects of amoxicillin.
Animal research shows that taking piperine, a constituent of black pepper, with amoxicillin increases plasma levels of amoxicillin. This has not been reported in humans.
Carbamazepine (Tegretol)
Theoretically, black pepper might increase blood levels of carbamazepine, potentially increasing the effects and side effects of carbamazepine.
One clinical study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that taking a single 20 mg dose of purified piperine, a constituent of black pepper, increases carbamazepine levels. Piperine may increase carbamazepine absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or inhibiting cytochrome P450 3A4 (CYP3A4) in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects. In vitro research also shows that piperine can increase carbamazepine levels by 11% in a time-dependent manner.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that black pepper induces CYP1A2. This has not been reported in humans.
Nattokinase
Anticoagulant/Antiplatelet Drugs
Nattokinase might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Nattokinase has thrombolytic and anticoagulant effects. There is a case report of intracranial hemorrhage in a patient who added nattokinase to aspirin therapy.
Antihypertensive Drugs
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.
Brand information
Manufacturer and brand details for Nattokinase +BioPerine, from the product label.
Approved Science
See all Approved Science products- Name
- Approved Science
- City
- New York
- State
- NY
- ZipCode
- 10003
- Phone Number
- 888-307-4790
- Web Address
- www.approvedscience.com
Nattokinase +BioPerine by Approved Science: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Nattokinase +BioPerine’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Nattokinase
Interacts with 289 drugsNattokinase 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 circulatio...
Read the full Nattokinase monograph → Herb & supplement monographBlack Pepper
Interacts with 1,019 drugsBlack pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to help the body absorb other ingredients (li...
Read the full Black Pepper monograph →Sources & How We Checked
Nattokinase +BioPerine's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 38 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Nattokinase 9 references
- 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
- 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.
- 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
- 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
- <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>
- 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
- Ramachandran L, Aqeel A, Jafri A, Sidhu Y, Mohamed Djirdeh T. Nattokinase-associated hemoperitoneum in an elderly woman. Cureus 2021;13(12):e20074. PubMed
- 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
- 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.
Black Pepper 29 references
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Bano G, Amla V, Raina RK, et al. The effect of piperine on pharmacokinetics of phenytoin in healthy volunteers. Planta Med 1987;53:568-9. PubMed
- Bano G, et al. Effect of piperine on bioavailability and pharmacokinetics of propranolol and theophylline in healthy volunteers. Eur J Clin Pharmacol 1991;41;615-7. PubMed
- Cohle SD, Trestrail JD III, Graham MA, et al. Fatal pepper aspiration. Am J Dis Child 1988;142:633-6. PubMed
- Bhardwaj RK, Glaeser H, Becquemont L, et al. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther 2002;302:645-50. PubMed
- Velpandian T, Jasuja R, Bhardwaj RK, et al. Piperine in food: interference in the pharmacokinetics of phenytoin. Eur J Drug Metab Pharmacokinet 2001;26:241-7. PubMed
- Pattanaik S, Hota D, Prabhakar S, et al. Pharmacokinetic interaction of a single dose of piperine with steady-state carbamazepine in epilepsy patients. Phytother Res 2009;23:1281-6.
- Munakata, M., Kobayashi, K., Niisato-Nezu, J., Tanaka, S., Kakisaka, Y., Ebihara, T., Ebihara, S., Haginoya, K., Tsuchiya, S., and Onuma, A. Olfactory stimulation using black pepper oil facilitates oral feeding in pediatric patients receiving long-term en
- Myers, B. M., Smith, J. L., and Graham, D. Y. Effect of red pepper and black pepper on the stomach. Am J Gastroenterol 1987;82(3):211-214.
- Raghavendra, R. H. and Naidu, K. A. Spice active principles as the inhibitors of human platelet aggregation and thromboxane biosynthesis. Prostaglandins Leukot.Essent.Fatty Acids 2009;81(1):73-78. PubMed
- Subehan, Usia, T., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of human liver microsomal cytochrome P450 2D6 (CYP2D6) by alkamides of Piper nigrum. Planta Med 2006;72(6):527-532.
- Kasibhatta, R. and Naidu, M. U. Influence of piperine on the pharmacokinetics of nevirapine under fasting conditions: a randomised, crossover, placebo-controlled study. Drugs R.D. 2007;8(6):383-391. PubMed
- Usia, T., Iwata, H., Hiratsuka, A., Watabe, T., Kadota, S., and Tezuka, Y. CYP3A4 and CYP2D6 inhibitory activities of Indonesian medicinal plants. Phytomedicine. 2006;13(1-2):67-73. PubMed
- Mujumdar, A. M., Dhuley, J. N., Deshmukh, V. K., Raman, P. H., Thorat, S. L., and Naik, S. R. Effect of piperine on pentobarbitone induced hypnosis in rats. Indian J Exp.Biol. 1990;28(5):486-487.
- Panda, S. and Kar, A. Piperine lowers the serum concentrations of thyroid hormones, glucose and hepatic 5'D activity in adult male mice. Horm.Metab Res. 2003;35(9):523-526. PubMed
- Lawless, H. and Stevens, D. A. Effects of oral chemical irritation on taste. Physiol Behav. 1984;32(6):995-998. PubMed
- Hiwale, A. R., Dhuley, J. N., and Naik, S. R. Effect of co-administration of piperine on pharmacokinetics of beta-lactam antibiotics in rats. Indian J Exp.Biol. 2002;40(3):277-281.
- Han, Y., Chin Tan, T. M., and Lim, L. Y. In vitro and in vivo evaluation of the effects of piperine on P-gp function and expression. Toxicol.Appl.Pharmacol. 8-1-2008;230(3):283-289. PubMed
- Sharma, P., Varma, M. V., Chawla, H. P., and Panchagnula, R. In situ and in vivo efficacy of peroral absorption enhancers in rats and correlation to in vitro mechanistic studies. Farmaco 2005;60(11-12):874-883. PubMed
- Aher, S., Biradar, S., Gopu, C. L., and Paradkar, A. Novel pepper extract for enhanced P-glycoprotein inhibition. J Pharm.Pharmacol. 2009;61(9):1179-1186. PubMed
- Zutshi, R. K., Singh, R., Zutshi, U., Johri, R. K., and Atal, C. K. Influence of piperine on rifampicin blood levels in patients of pulmonary tuberculosis. J Assoc.Physicians India 1985;33(3):223-224.
- Marotta, R. B. and Floch, M. H. Diet and nutrition in ulcer disease. Med Clin North Am 1991;75(4):967-979. PubMed
- Subehan, Usia, T., Iwata, H., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of CYP3A4 and CYP2D6 by Indonesian medicinal plants. J Ethnopharmacol. 5-24-2006;105(3):449-455. PubMed
- Gimenez L, Zacharisen M. Severe pepper allergy in a young child. WMJ. 2011 Jun;110(3):138-9.
- Ren T, Yang M, Xiao M, Zhu J, Xie W, Zuo Z. Time-dependent inhibition of carbamazepine metabolism by piperine in anti-epileptic treatment. Life Sci. 2019;218:314-323. PubMed
- Thomas AB, Choudhary DC, Raje A, Nagrik SS. Pharmacokinetics and pharmacodynamic herb-drug interaction of piperine with atorvastatin in rats. J Chromatogr Sci 2021;59(4):371-80. PubMed
- Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
- Lin F, Hu Y, Zhang Y, Zhao L, Zhong D, Liu J. Predicting Food-Drug Interactions between Piperine and CYP3A4 Substrate Drugs Using PBPK Modeling. Int J Mol Sci 2024;25(20):10955. PubMed
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