Supplement · graded by use, two uses
Serrapeptase (Serratiopeptidase)
Systemic inflammation, cardiovascular or longevity use.
Grade D, not yet tested: no human randomized trial has been run. This D records missing trials, not a finding that it does not work. How to read a grade →
Serrapeptase is an enzyme first found in silkworms. It is sold to clear swelling and to protect the heart and blood vessels. Five small studies looked at swelling after mouth or sinus surgery, with mixed results. No study has tested it for whole-body swelling, heart health or long life.
The D belongs to one of the two uses graded on this record. The other one carries its own letter.
As studied, and the trials
Four small randomized placebo-controlled trials found less swelling (Tachibana 1984, n=174; Al-Khateeb 2008, n=24; Tamimi 2021, n=133; Kee 1989, breast engorgement, n=70) and one found no effect (Chopra 2009, n=150). Pain results are split: Al-Khateeb and Kee found less, Tamimi and Chopra did not. A 2013 systematic review A review that searches for every study on a question using a method set in advance, then assesses them together. (Bhagat, PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 23380245) rates the trials small and poorly designed. Small, mixed, short-term human trials are C.
As studied, and the trials
No randomized trial has tested serrapeptase for any systemic, cardiovascular or longevity outcome. The eleven randomized trials of the enzyme all address short-term surgical and ENT swelling. The 2013 systematic review (PMID 23380245) found the evidence insufficient to support use as a health supplement and noted that long-term safety data are lacking.
Read the grade that matches your goal. How EBL grades by use →
- Dose studied
- 30 mg/day (10 mg TID)
- Form graded
- Enteric-coated serrapeptase
- Evidence behind the D
- PMID 23380245 →
A letter describes the human evidence, not the product, the manufacturer, or the ingredient's worth.
See the full evidence record →No human randomized trial has tested this at the dose and form graded, so there is nothing for a higher letter to rest on. A Route 1 Grade D records the absence of trials. It is not a finding against the compound, and it is not a finding that the compound is safe, because neither has been established. It may turn out to work once someone tests it. The grade moves when a qualifying human trial reports.
Systemic inflammation, cardiovascular or longevity use: untested (D). Swelling after oral or sinus surgery (C).
How this letter has changed · latest: October 2026 · Corrected
The record's title said Grade D, no human randomized trial, while its own citation was a randomized trial of swelling after dental surgery. Five randomized placebo-controlled trials exist: four found less postoperative swelling (Tachibana 1984, Al-Khateeb 2008, Tamimi 2021, Kee 1989) and one found no effect (Chopra 2009), and a 2013 systematic review rates them small and poorly designed. The record now grades two uses. Swelling after oral or sinus surgery is C: small, mixed, short-term trials. Systemic, cardiovascular and longevity use stays D on Route 1, because no trial has tested it, which is the use the enzyme is sold for. The headline letter stays D.PMID 6366808 PMID 18272344 PMID 33653320 PMID 2688125 PMID 19168326 PMID 23380245
Every change to a letter on this site is dated and published. The full evidence log →
Commercial disclosure
EBL earns no commission on any supplement it grades, and there is no dispensary link on this page to earn one from. Grades are assigned by published rubric before any commercial relationship exists and are never influenced by one. Full disclosure.
No dispensary link. EBL’s practitioner dispensary does not carry this item, so there is nothing to link to. Its absence is not a judgment beyond the letter above.
No dose is published here. This record carries no authored dose, because the cited trials do not converge on a single figure. Each trial cited on this page states the dose it used, and EBL has not turned those into a recommendation.
Standardized extracts/forms were used in the cited trials; product quality varies.
In the cited dental surgery trial, 10 mg was taken three times daily after the operation (PMID 33653320). The report does not tie the doses to meals or times of day.
Checked against the full published report. What the cited trials did, not a schedule. Every supplement, by trial timing →
Raised bleeding risk. Separation from surgery is the usual clinical margin.
Anticoagulants and antiplatelets, on the proteolytic and fibrinolytic activity. This is a mechanistic caution: the human evidence base for serrapeptase is thin in every direction, including this one, and no trial has measured the interaction.
Mechanism-based, no human interaction study located. The drug interactions described for Serrapeptase (Serratiopeptidase) are mechanism-based. A PubMed search for human interaction, pharmacokinetic or co-administration studies pairing it with anticoagulant, antiplatelet returned no results in August 2026. The caution stands on pharmacology, not on a trial, and is labeled as such. Basis: pharmacological mechanism, not a human study. Searched PubMed in August 2026: 2 queries, 0 human results.
No validated human outcome to track for the uses it is sold for. In the surgical trials the measured outcome was cheek swelling by caliper or tape over the first postoperative week.
Primary evidenceSix papers, each linked to its PubMed record.
Graded by use. Postoperative swelling: Tachibana et al. (Pharmatherapeutica, 1984; PMID 6366808): double-blind placebo-controlled trial, 174 patients after Caldwell-Luc sinus surgery; buccal swelling less at every postoperative time point. Al-Khateeb and Nusair (Int J Oral Maxillofac Surg, 2008; PMID 18272344): randomized double-blind crossover A trial design in which each participant receives both the treatment and the comparison, one after the other, and serves as their own control. trial, 24 patients, third molar surgery; cheek swelling and pain less on days 2, 3 and 7, mouth opening not different. Tamimi et al. (BMC Oral Health, 2021; PMID 33653320): randomized controlled trial People are assigned to the treatment or a comparison by chance, so the groups differ only in what they received. It is the design that can show cause and effect., 133 patients, third molar surgery; swelling and trismus improved, pain not different. Kee et al. (Singapore Med J, 1989; PMID 2688125): randomized double-blind trial, 70 women with breast engorgement; pain, swelling and induration improved against placebo An inactive substitute made to look like the real treatment, so participants cannot tell which one they received.. Chopra et al. (Int J Oral Maxillofac Surg, 2009; PMID 19168326): randomized five-arm trial, 150 patients, third molar surgery; serratiopeptidase showed no significant analgesic or anti-inflammatory effect. Bhagat et al. (Int J Surg, 2013; PMID 23380245): systematic review; the trials are few, small and of poor methodology, and the evidence is insufficient to support use as an analgesic or health supplement. Grade C for postoperative swelling: four positive and one null small trials. Grade D, Route 1, for systemic inflammation, cardiovascular and longevity use: no randomized trial has tested any of them.
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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. The grade on this page describes the strength of published human trial evidence in the populations studied. It is not a recommendation for any individual and is not medical advice. Starting, stopping or changing any supplement or medication is a decision for your physician.
Who responds: this record's trial reading reports no subgroup that identifies who responds.
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