Serrapeptase is an enzyme widely used to treat pain and inflammation. It also has a range of other potential health benefits like lowering heart disease risk, reducing excess mucus, and even boosting sperm count. However, clinical and animal studies on serrapeptase are limited. Read on to see if serrapeptase is right for you.

What Is Serrapeptase?

Serrapeptase, otherwise known as serratiopeptidase, is a proteolytic enzyme, meaning it is used by the body to break down proteins into amino acids [R, R].

It was first isolated from gut bacteria (Serratia E15) of silkworms, which use this enzyme to break down their cocoon walls [R].

A study comparing the anti-inflammatory effects of different enzymes found that serrapeptase was the most effective in reducing inflammation [R, R].

As a result, serrapeptase is commonly used as an anti-inflammatory drug/supplement [R, R].

Another class of anti-inflammatory drugs called nonsteroidal anti-inflammatory drugs (NSAIDs) is used more often, but they have many side effects. Therefore, alternatives like serrapeptase that have fewer side effects are becoming more popular [R].

After digestion, serrapeptase reaches the bloodstream in its active form [R].

Health Benefits of Serrapeptase

1) Serrapeptase Reduces Inflammation and Swelling

Dead cells and tissues (cellular debris) cause inflammation by overstimulating the immune system. Serrapeptase promotes the breakdown of this debris and dilutes injury made fluids, which helps drain harmful substances from the inflammatory site [R].

It also inactivates toxins that cause swelling and pain [R].

Serrapeptase reduces swelling by decreasing fluid buildup in the tissues and increasing fluid drainage [R].

In a study (DB-RCT) of 174 patients undergoing a Caldwell-Luc antrectomy, serrapeptase reduced swelling in the cheek after surgery [R].

Other studies (DB-RCT of 24 patients and RT of 66 patients) found that serrapeptase decreased swelling in the jaw and ankle by 15% following operations [R, R].

It also reduced swelling in the upper and lower limbs in a study (RCT) of 50 patients [R].

Serrapeptase works best in breaking down cyclooxygenase, an enzyme responsible for producing different inflammatory molecules after injury or infection (e.g., interleukins, prostaglandins, and thromboxane) [R].

Because of this, serrapeptase can reduce inflammation due to [R]:

  • Arthritis
  • Trauma
  • Infections in the sinuses (sinusitis)
  • Infections in the lungs (bronchitis)
  • Carpal tunnel syndrome

However, in a study (DB-RCT) of 150 patients who underwent dental operations, serrapeptase did not show any significant anti-inflammatory effects [R].

2) Serrapeptase Reduces Pain

Serrapeptase reduced pain in a study (DB-RCT) of 24 postoperative patients [R].

Similarly, serrapeptase decreased pain by 64% and nighttime cramps by 53% in a study (RCT) of 40 patients with inflammatory venous disease [R].

It also mildly reduced pain in a study (RCT) of 50 patients suffering from injuries to their legs and arms [R].

This enzyme reduces pain by preventing the release of amines, some of which cause pain (e.g. bradykinin) [R].

Serrapeptase is most effective in reducing pain in localized areas of inflammation like the ears, nose, or throat [R].

However, in a study (DB-RCT) of 150 postoperative patients, serrapeptase did not show any significant pain relieving effects and fared worse than drugs like ibuprofen and betamethasone [R].

3) Serrapeptase Reduces Mucus and Other Secretions

Serrapeptase reduces the viscosity (the resistance to flow) of many secretions such as mucus. This allows the body to remove excretions more efficiently, speeding up tissue repair [R, R].

In a study (RCT) of 29 patients suffering from difficulty breathing due to blocked airways (chronic airway disease), serrapeptase significantly reduced mucus clearance. The amount of sputum (mucus and saliva), cough frequency, and amount of phlegm also decreased after serrapeptase treatment [R].

This enzyme also reduced the number of neutrophils in the sputum. In many lung diseases, increased neutrophils are correlated with thicker sputum and inflammation [R, R].

Another study (DB-RCT) of 193 patients with ear, nose, and throat conditions discovered that serrapeptase reduced nasal secretions, difficulty swallowing, and obstructions in the nose [R].

4) Serrapeptase Removes Blood Clots and Plaques

Serrapeptase can break down fibrin, a blood clotting molecule, in dead tissue without damaging the surrounding healthy tissue. This helps remove blood clots and plaques. It allows for better antibiotic treatment as the antibiotics are able to further penetrate into the tissue [R].

Biofilms, which can be made of fibrin, grow on devices to cause infection and protect bacteria from dying. Serrapeptase can break down biofilms made of fibrin [R].

Fibrin is also responsible for creating scar tissue, which can be painful and unsightly. By breaking down fibrin, serrapeptase can reduce excess scar tissue formation, thereby reducing pain in the patient [R, R, R].

On the contrary, serrapeptase reduced the abnormal breakdown of fibrin caused by scalding in rats. Improper fibrinolysis can lead to extra bleeding, inflammation, shock, and poor immune responses [R].

5) Serrapeptase May Help with Alzheimer’s Disease

In rats, serrapeptase increased the levels of both BDNF and IGF-1, both of which protect brain cells [R].

Additionally, serrapeptase decreased the activity of pro-inflammatory TGF-β and IL-6, both of which are normally high in Alzheimer’s patients [R].

Amyloid-β plaques are a common feature of Alzheimer’s. Levels of acetylcholinesterase, which causes the formation of these plaques, decreased with serrapeptase intake [R].

Serrapeptase can also break down amyloid plaques, as seen in zebrafish [R].

6) Serrapeptase May Reduce the Risk of Stroke

Serrapeptase dissolves dead and damaged tissue without harming healthy tissue. By doing this, serrapeptase can remove deposits or clots of fat, cholesterol, cellular waste, calcium, and fibrin that can build up in arteries [R, R].

Removing these deposits can decrease blood thickness and lower the risk of stroke [R].

7) Serrapeptase Treats Breast Engorgement

Serrapeptase treatment can improve breast engorgement or painful overfilling of the breasts with milk. In a study (DB-RCT) of 70 patients, serrapeptase reduced breast pain, swelling, and hardness in 86% of patients [R].

Although not stated in the literature, serrapeptase may be transferred through breast milk. Please consult with a doctor before taking serrapeptase when breastfeeding.

8) Serrapeptase Treats Superficial Thrombophlebitis

Serrapeptase showed improvement in 65% of patients with superficial thrombophlebitis (pain and inflammation caused by a blood clot in the vein) in a 40-patient study (RCT). Many symptoms of superficial thrombophlebitis such as pain, inflammation, and skin decay decreased after serrapeptase treatment [R].

9) Serrapeptase Enhances Antimicrobial Treatments

As mentioned above, serrapeptase decreases biofilm formation [R].

Combining antibiotics and serrapeptase increases the concentrations of antibiotics in tissues. This is because serrapeptase dissolves dead tissue, allowing antibiotics to penetrate deeper into tissues. Not only does this enhance the effectiveness of antibiotic treatment, but is also safer for patients due to lower drug use [R, R].

10) Serrapeptase May Treat Peri-implantitis

Peri-implantitis is inflammation of the soft and hard tissue of dental implants. Patients that received serrapeptase healed faster and had lower implant failure rates than patients receiving placebo or nonsteroidal anti-inflammatory drugs [R].

11) Serrapeptase May Treat Carpal Tunnel Syndrome

In a study, 13 of 20 patients with carpal tunnel syndrome showed significant clinical improvement after serrapeptase treatment. However, the condition recurred in four of the 13 patients [R].

12) Serrapeptase Reduces Red Patches on the Skin

Serrapeptase reduced red patches on the skin (erythema) by 58% in a study (RCT) of 40 patients with inflammatory venous disease [R].

13) Serrapeptase May Increase Sperm Count

In a study of infertile 50 male patients with accessory gland infections, a combination of quinolones and serrapeptase increased sperm count in 22 of the patients. Because serrapeptase enhances the activity of antibiotics like quinolone in fighting infections, it may partly account for this increase in sperm count [R].


Although there is popular opinion supporting the use of serrapeptase for these diseases, there is no scientific evidence backing its use in:

  • Fibroids (noncancerous growths in women’s uteri)
  • Bartholin cyst (swelling of the Bartholin gland)
  • Cancer
  • Endometriosis (abnormal external uterine tissue growth)

Serrapeptase Dosage

Serrapeptase is effective in different doses. Doses as small as 5 mg were enough to reduce swelling and pain after tooth surgery [R].

Most clinical studies use serrapeptase in doses ranging from 10 to 60 mg/day [R].

Sometimes serrapeptase is dissolved in a salt solution (at a concentration ranging from 0.005-0.5mg/mL) and given along with antibiotics [R, R].

Serrapeptase has also been developed as a gel or ointment for use over the skin. These forms are better for localized treatments and produce fewer side effects [R].

Serrapeptase has to be taken on an empty stomach or 2 hours after eating. Food should not be consumed for the next 30 minutes after taking serrapeptase [R].

There have been no dosage studies in humans to this day. Studies for the minimum concentration needed to produce therapeutic effects in humans have not been conducted. However, drug companies recommend at least 15 to 30 mg/day. You should consult a doctor for more information on correct dosing [R, R].

Side Effects of Serrapeptase

Serrapeptase with diclofenac, an anti-inflammatory drug, can induce Stevens-Johnson syndrome, leading to blisters all over the body [R].

Serrapeptase, when taken orally, can cause anorexia, nausea, and disturbances in the gut [R].

Other common side effects include [R]:

  • Skin inflammation
  • Bulls-eye shaped lesions of the skin
  • Muscle ache
  • Joint pains
  • Pneumonia
  • Blood clot abnormalities

Limitations and Caveats

Despite its wide usage as a drug and supplement, clinical studies proving serrapeptase’s effectiveness in treating pain and inflammation are limited and larger, better-designed, placebo-controlled trials are needed. In addition, research on the side effects and long-term safety of this enzyme is lacking [R].

Serrapeptase Dangers

Although rare, cases were reported when serrapeptase caused pneumonia. There are cases of a 69-year-old man with a common cold, an 84-year-old man with recurrent bladder infections, and a 32-year-old woman that took serrapeptase for treatment and saw worsening of symptoms and development of pneumonia. Stopping treatment reduced pneumonia symptoms [R, R, R].

Combining serrapeptase with drugs such as warfarin, clopidogrel, and aspirin or natural substances such as garlic, fish oil, and turmeric can increase the risks of bleeding and bruising [R].

Synergies with Serrapeptase

Serrapeptase inhibits biofilm production, which is a coating that many bacteria produce to protect themselves from antibiotics. It enhances the effects of many antibiotics such as ampicillin, cyclacillin, cephalexin, minocycline, and cefotiam [R, R].

5.6% of rats saw continued infection when combining serrapeptase with antibiotics while 37.5% of rats saw continued infection with only antibiotics [R].

Serrapeptase is more efficient when used with zinc or manganese [R, R].

A study of 18 lung-cancer patients found that serrapeptase with cefotiam, an antibiotic, increased lung cefotiam levels compared to the blood by 44%. This is especially useful for patients needing lung surgery [R].

Contraindications of Serrapeptase

Patients with abscesses, especially in the cheek area, should avoid serrapeptase. The drug can cause painful swelling in the abscess area [R].

Serrapeptase vs. Nattokinase

Both serrapeptase and nattokinase are proteolytic enzymes, meaning they both break down proteins. They are also both serine proteases. In rats, both serrapeptase and nattokinase reduced Alzheimer’s symptoms and levels of inflammatory molecules that are high in Alzheimer’s patients [R].

One study in zebrafish found that serrapeptase was more effective than nattokinase in breaking down amyloid plaques [R].

Combinations of serrapeptase and nattokinase can break down biofilms, which commonly prolong infection [R].

Serrapeptase Reviews

1 to 2 capsules of serrapeptase for healthy maintenance and up to 4 to 6 capsules a day for therapeutic action are recommended. Reviews of serrapeptase are fairly mixed with some people for the drug and others against.

People have said that serrapeptase has helped them with both inflammation and pain, but they did mention that other drugs like FlexoPlex seemed to work better for reducing pain.

One person with bad knees said he used to have to stretch for up to 20 minutes in the mornings but no longer has to due to taking serrapeptase.

One review noted that the serrapeptase was making him and his friend tired and was giving them headaches. His friend ended up developing pneumonia as well. Stopping serrapeptase helped ease the symptoms.

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