Can You Take Nattokinase With Gabapentin?

Hello, and thanks for checking with us here at HelloPharmacist before combining these two!

There is no known interaction between gabapentin and nattokinase, and based on how each one works in the body, a problem between them isn't expected. 

Why Gabapentin Rarely Interacts With Supplements

Gabapentin is used for nerve pain, seizures, and several other conditions, and one of its nicer features from a pharmacist's perspective is how cleanly it moves through the body. It is not broken down by the liver in any meaningful way and instead leaves the body unchanged through the kidneys.

Laboratory studies looking at the major liver enzymes that handle most drug and supplement interactions found essentially no effect from gabapentin, which is a big part of why its list of clinically important interactions is so short.

The interactions it does have are mostly practical ones, such as antacids containing aluminum and magnesium reducing its absorption when taken at the same time, and additive drowsiness when it's combined with opioids, alcohol, or other sedating medications. Nattokinase doesn't fall into any of those categories, so there's no obvious pathway for the two to interfere with each other.

Nattokinase and Its Effect on Blood Clotting

Nattokinase is an enzyme extracted from natto, a traditional Japanese food made from fermented soybeans, and it's most often taken for cardiovascular support. Its main claim to fame is a fibrinolytic effect, meaning it may help break down the protein mesh (fibrin) that holds blood clots together. That's exactly why people take it, but it's also the source of its main safety consideration: nattokinase may mildly thin the blood.

Gabapentin has no effect on blood clotting, so this isn't a concern between these two specifically. Where it matters is if you also take an anticoagulant or antiplatelet medication such as warfarin, apixaban, clopidogrel, or even daily aspirin, or if you have a bleeding disorder or an upcoming surgery or procedure.

In those situations, nattokinase could theoretically add to the bleeding risk and should be discussed with your doctor or pharmacist first. You can read more on our nattokinase interactions and safety page, which I've linked at the end of this answer.

A Few Practical Points

You don't need to separate the doses of these two for interaction reasons, so take each as you normally would.

Since supplement-drug combinations like this one haven't been formally studied, it's still smart to let your pharmacist and doctor know nattokinase is part of your routine, especially if your medication list ever changes or you're scheduled for a procedure.

Final Words

Overall, gabapentin and nattokinase aren't known or expected to interact, and most people can take them together without an issue. The key point to remember is nattokinase's mild blood-thinning potential.

Thanks again for reaching out, and feel free to follow up if anything else comes up!

We have more detail in this related resource:

• Nattokinase drug interactions and safety information.