Serrapeptase

Serratiopeptidase · Serratia peptidase

Snapshot

Indications	Contraindications
Trismus after molar surgery¹ Post-sinus surgery swelling² Ear, nose, and throat inflammation³ Breast engorgement^{4, 5}	Stomach ulcer⁶ Pregnancy⁷ Soy or milk allergy⁷

Serrapeptase (also called serratiopeptidase) is a proteolytic enzyme with anti-inflammatory, anti-edemic, and fibrinolytic activity^{3, 8}. That activity drives its use for swelling and trismus after surgical removal of impacted molars, swelling after sinus surgery, ear, nose, and throat inflammation³, and breast engorgement during lactation. It is also promoted as a cardiovascular health supplement, a use the evidence does not support⁸.

The evidence is mixed. A meta-analysis found better trismus than with corticosteroids and no difference in swelling, while a placebo-controlled impaction trial found no significant analgesic or anti-inflammatory action. Older placebo-controlled trials reported less swelling after sinus surgery and faster symptom regression in ear, nose, and throat disorders, but a systematic review found the evidence insufficient. In women after liposuction for lipedema, a 2026 retrospective cohort found no difference in tissue stiffness or fibrosis with supplementation⁹. US labels list serrapeptase in 555 products, and the sampled products were all capsules; see Form comparison.

Health Canada lists practitioner consultation before use with anticoagulant or anti-inflammatory medication, gastrointestinal ulcer, or planned surgery⁶. US product labels most often warn about blood-thinning medication⁷.

Last updated October 16, 2026. Read how we make monographs.

In the full monograph

40 sources, 24 studies

When to useThe situations practitioners use it for, each with the reason and the study behind it.
SafetyWho should avoid it, who needs extra care, and the side effects reported in studies.
InteractionsThe medicines and supplements it interacts with, the effect of each, and what labeling says to watch.
Protocol notesThe doses used in studies, how and when they were taken, and how the forms on the market compare.
How it worksWhat it is and how it works in the body, in plain terms.
Published studiesThe studies behind each use, popular claims checked against them, and trials still under way.
Word of mouthWhat patients and practitioners report online, kept separate from the clinical evidence.
Clinical perspectiveA closing read of where the evidence is solid, where it is thin, and what has not been studied.

Snapshot

In the full monograph

Sources