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Dietary supplement

Nattokinase Ingredients & Drug Interactions

by Carotec

Capsule Category: Non-nutrient/non-botanical
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Nattokinase is a dietary supplement by Carotec with 1 active ingredient. Its ingredients are commonly taken for heart and circulatory health, blood clot prevention, high blood pressure.Based on those ingredients, 289 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are NSK-SD. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Nattokinase by Carotec

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.

From our pharmacy team — supplement deep dive

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 1 of its 1 active ingredient.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains one active ingredient: nattokinase (a fibrinolytic enzyme derived from fermented soy). It's designed to support circulation and cardiovascular function by working on blood clotting mechanisms.

The capsule also contains microcrystalline cellulose, dextrin, hypromellose, and L-leucine as inactive ingredients.

Does it work?

Not established
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use — see Nattokinase's own graded uses on its monograph.

Why this rating?
  • The label markets this product for: Heart and circulatory health support.
  • We looked for evidence on: Angina, Atherosclerosis, Cardiovascular disease (CVD), Hyperlipidemia, Hypertension, Peripheral arterial disease (PAD) — and 4 related terms.
  • The closest evidence on file: Nattokinase is rated "Insufficient Reliable Evidence To Rate" for Angina (Natural Medicines).
  • Also on file: Nattokinase is rated "Insufficient Reliable Evidence To Rate" for Atherosclerosis, Cardiovascular disease (CVD), Hyperlipidemia, Hypertension, and more.

The evidence for nattokinase isn't established enough for us to rate it. The data we hold shows insufficient reliable evidence for angina, atherosclerosis, cancer, cardiovascular disease, and chronic fatigue syndrome.

That doesn't mean it doesn't work—it means the studies we have aren't strong enough yet to say either way.

The evidence, ingredient by ingredient Nattokinase

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 1 of the 1 matched ingredient.
  • Pregnancy & breastfeeding safety ratings cover 1 of 1.
  • General safety write-ups exist for 1 of 1.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Nattokinase is generally well tolerated in the short term, but its blood-thinning properties mean you need to be cautious if you have any bleeding risk. Rarely, people taking nattokinase have reported hemorrhage, including a serious case of brain bleeding.

Because nattokinase can trigger allergic reactions in people sensitive to natto (including anaphylaxis in severe cases), mention any soy allergies to your pharmacist. There isn't enough safety data to use nattokinase during pregnancy, so the safety data advises against it.

Safety while breastfeeding is unknown, so the data advises against it as well. If you're pregnant or nursing and interested in this supplement, talk with your doctor or pharmacist about your options.

Side effects, ingredient by ingredient Nattokinase

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 1 of the 1 matched ingredient can interact with medications — Nattokinase.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs.
  • For scale: 289 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before you take nattokinase, double-check if you're on any blood thinners or antiplatelet drugs—that's the most serious interaction. Also flag any blood pressure medications you take.

These are the two medication types documented to interact with this supplement.

Check your own medication Run your meds through the checker above

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.

Nattokinase is worth considering if you're looking for circulatory support and you don't take blood thinners or blood pressure medications. If you do take either of those, or if you have any bleeding concerns, check with your pharmacist first.

Pregnant women and those nursing should avoid it based on current safety data.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated Jan 23, 2025.

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

At a glance

General information

Key facts about Nattokinase, straight from the product label.

Brand Carotec
Barcode (UPC) 671891821205
Net contents 60 Capsule(s)
Market status On market
Date entered into DSLD Jan 23, 2025
DSLD ID 320971
Product type Non-nutrient/non-botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
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 by Carotec, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
Servings per container
60
UPC/BARCODE
671891821205
IngredientAmount% DV
NSK-SD100 mg--

Other ingredients: Microcrystalline Cellulose, Dextrin, Hypromellose, L-Leucine

Tap any ingredient to jump to its full detail below.

Label statements
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.
Precautions

Warning: Keep out of reach of children.

If you are pregnant, nursing, or taking medication, consult physician before use.

Discontinue use and consult physician if adverse reactions occur. Do not use if shrink-wrap is broken or missing.

Contains: soy.

Storage

Store in a cool dry place (59F-85F) away from direct sunlight.

Brand IP Statement(s)

NSK-SD is a registered trademark of Japan Bio Science Laboratory directions

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Suggested Use: Take one (1) capsule twice per day, twelve hours apart, with or without meals, or as directed by physician.

See for yourself

Nattokinase by Carotec label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

What’s inside

The Ingredients in Nattokinase by Carotec

This is the 1 active ingredient this product is made of. Select it to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container60 Amounts shown are per serving.

NSK-SD

Interacts with
289 drugs
100 mg per serving Form: Nattokinase Complex

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...

NSK-SD monograph & interactions

Other (inactive) ingredients: Microcrystalline Cellulose, Dextrin, Hypromellose, L-Leucine. These complete the product’s ingredient list but are not active constituents.

Interaction report

Nattokinase by Carotec Drug Interactions

Want to check YOUR meds against Nattokinase?

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 checker
289Drugs
289 Moderate

Ingredients driving the most interactions

NSK-SD 289

Each ingredient & the kinds of drugs it affects

For each ingredient in Nattokinase with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.

NSK-SD2 drug types · 289 drugs

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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
The maker

Brand information

Manufacturer and brand details for Nattokinase, from the product label.

Carotec

See all Carotec products
Name
Carotec, Inc.
Street Address
PO Box 140940
City
Coral Gables
State
FL
ZipCode
33114
Phone Number
1-800-522-4279
Web Address
www.carotec.com
Pharmacist Counseling Corner

Nattokinase by Carotec: Common Questions

Does Nattokinase by Carotec interact with any medications?
Yes. Based on its ingredients, Nattokinase has a known interaction with 289 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Nattokinase contains a single active ingredient, and that one ingredient can interact with many different medications on its own. We check it against each medication and show the mechanism responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take nattokinase if I'm on aspirin?
No. There's a documented case of someone who developed brain bleeding after taking nattokinase alongside aspirin. Talk to your pharmacist or doctor before adding nattokinase to any blood-thinning medication.
What's nattokinase actually made from?
It's an enzyme pulled from fermented soy (natto). If you have a soy allergy or sensitivity to natto, you're at risk for allergic reactions, including serious ones, so let your pharmacist know.
Does this product have fillers?
Yes, the capsule contains microcrystalline cellulose, dextrin, hypromellose, and L-leucine as inactive ingredients to hold it together and keep it stable.
Is nattokinase proven to work for heart health?
There isn't enough reliable evidence yet for us to rate it for cardiovascular disease, atherosclerosis, angina, or any of the other conditions it's marketed for. The science just isn't there yet.
Can I take nattokinase while pregnant?
No. There isn't enough safety data, so the evidence advises against it during pregnancy. Talk with your doctor about what's right for you.

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

Not sure if Nattokinase is safe with your meds?

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Ask a pharmacist

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.

Nattokinase label
Sources

Sources & How We Checked

Nattokinase'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.

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 9 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
  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.

See these in context on the Nattokinase monograph →

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

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