The Health Benefits of Serrapeptase

This silkworm enzyme believed to reduce pain and inflammation

Silkworms on leaves

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Serrapeptase is an enzyme derived from an intestinal bacteria of silkworm (called Serratia E-15), which the moth uses to dissolve the cocoon. Serrapeptase was first isolated by scientists in Japan in the 1960s and soon after became a bestselling drug there, later finding its way onto drugstore shelves in Europe and North America as a dietary supplement.

Serrapeptase is believed to exert anti-inflammatory effects to reduce pain and swelling, mostly of the upper respiratory tract, It is also widely used to relieve pain following minor surgery, although recent doubts about its efficacy led its manufacturer, Takeda Pharmaceutical, to voluntarily withdraw the drug (brand name Danzan) in 2011.

Despite the recall, there are plenty of manufacturers who still produce serrapeptase and point to its efficacy in clinical studies.

Also Known As

  • Butterfly extract
  • Serratiopeptidase
  • Silkworm enzyme

Health Benefits

Proponents of alternative medicine claim that serrapeptase can help treat a wide range of medical conditions. Chief among these is the reduction of pain and inflammation following oral surgery and the treatment of chronic upper respiratory symptoms, including bronchitis, sinusitis, laryngitis, and pharyngitis (sore throat).

As can happen with alternative drugs, claims of health benefits will often extend beyond its often intended use and sudden encompass an almost encyclopedic range of medical conditions.

With serrapeptase, proponents claim the enzyme can dissolve blood clots, alleviate symptoms of arthritis, prevent atherosclerosis ("hardening of the arteries"), and treat diabetes, asthma, inflammatory bowel disease (IBD), leg ulcers, and fibrotic breast disease. To date, there is no evidence that it can treat any of these conditions.

That is not to say there is no benefit to serrapeptase use. However, the current body of research is often poorly designed or too small to be statistically relevant. Here are a few studies that provide some of the more compelling pieces of evidence in support of serrapeptase use.

Oral Surgery

A small study published in the International Journal of Oral and Maxillofacial Surgery suggests that serrapeptase may help alleviate pain and swelling resulting from dental surgery. The study involved 24 healthy people, all of whom underwent the surgical removal of impacted molars. Half were given a 1,000 milligrams of Tylenol (acetaminophen) plus 5 milligrams of serrapeptase, while the other hand received the same amount of Tylenol with a placebo.

According to the researchers, in the seven days following surgery, the group provided serrapeptase had less cheek swelling (as measured by calipers) and pain intensity (as measured by numeric scores) than those given the placebo.

Despite the promising results, the conclusions were limited by the size of the study and the highly subjective nature of the pain measurements.

Upper Respiratory Symptoms

Serrapeptase has long been touted for its ability to alleviates throat pain, hoarseness, and sinus congestion associated with upper respiratory infections and illnesses.

According to a 2017 review published in the Asian Journal of Pharmacological Science, serrapeptase exerts effects similar to cyclooxygenase-1 (COX-1) and cyclooxygenase-1 (COX-2) inhibitor drugs like Aleve (naproxen) and Celebrex (celecoxib). In addition to alleviating inflammation, serrapeptase also appears to break down exudates (fluids that seep out of tissue as a result of inflammation).

By exerting anti-inflammatory, anti-exudate, and analgesic (pain-relieving) properties, serrapeptase could very well alleviate common upper respiratory tract symptoms. However, there is little qualitative evidence to date of such benefits.

Of the available research, a 2003 study in the journal Respiralogy reported that four weeks of treatment with serrapeptase, given at a dose of 30 milligrams daily, reduced the amount and thickness of mucus coughed up by people with chronic bronchitis.

Despite flaws in the study design, the findings were significant enough to suggest that serrapeptase may play an important role in mucus clearance in people with chronic obstructive pulmonary disease (COPD) and other respiratory diseases.

Possible Side Effects

While serrapeptase has been used for up to four weeks in clinical research, little is known about its long-term safety. Common side effects tend to be mild but may include:

  • Nausea
  • Stomach ache
  • Muscle and joint pain
  • Cough
  • Rash

Although it is said to alleviate upper respiratory symptoms, serrapeptase has been known to cause pneumonitis (lung inflammation) in some. The condition appears triggered by a sudden drop in white blood cells called eosinophils and occurs mostly in elderly adults.

A 2016 report in the Journal of Clinical and Diagnostic Research also suggests that serrapeptase may increase the size of an abscess, in part by breaking down exudates in surrounding tissues.

Serrapeptase should not be used if you have an abscess of any sort, including an abscessed tooth. Doing so may facilitate the further spread of infection.

The safety of serrapeptase in pregnant women, nursing mothers, and children has not been established. Given the potential harms and uncertain benefits, it may be best to avoid serrapeptase in these groups.


Serrapeptase may interfere with blood clotting and should be avoided if you are taking blood thinners like Coumadin (warfarin) or Plavix (clopidogrel). Taking them together may cause easy bruising or bleeding.

For this same reason, you should stop using serrapeptase two weeks before a scheduled surgery to avoid excessive bleeding.

Dosage and Preparation

There are no guidelines for the appropriate use of serrapeptase. Doses of up to 30 milligrams (mg) daily have been used safely in short-term studies.

Serrapeptase supplements are readily sourced online and in certain health food and nutritional supplement stores. Most are sold as capsules, gelcaps, or enteric-coated tablets with doses ranging from 34 mg (20,000 international units, or IU) to 500 mg (300,000 IU).

As a general rule, it is best to avoid high-dose formulations. Not only are they more costly, but there is no evidence that higher doses are any more effective than lower doses.

As a rule of thumb, it is always best to use the smallest dose possible and to never exceed the recommended dose on the product label. If side effects persist or worsen, stop taking the drug and advise your doctor.

To avoid stomach upset, take the supplement with food or choose an enteric-coated tablet that dissolves lower down in the intestinal tract. This can also help slow the breakdown and deactivation of serrapeptase by stomach acids.

What to Look For

Dietary supplements are not strictly regulated in the United States. To ensure the highest quality, opt for brands that have been tested for by an independent certifying body like the U.S. Pharmacopeia (USP), NSF International, or ConsumerLab.

If you are strictly vegetarian or vegan, double-check that gelcaps are made of a vegetable-based gelatins rather than animal-derived bovine or porcine gelatin.

Serrapeptase can be stored safely at room temperature. You should discard any supplement that has expired or shows signs of spoilage or deterioration (including changes in color, texture, or smell).

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Article Sources
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  1. Bhagat S, Agarwal M, Roy V. Serratiopeptidase: a systematic review of the existing evidence. Int J Surg. 2013;11(3):209-17. doi:10.1016/j.ijsu.2013.01.010.

  2. Health Science Authority. HSA Updates on the Phasing-Out of Serratiopeptidase-Containing Preparations as Medicinal Products.Singapore: November 29, 2011.

Additional Reading
  • Al-Khateeb TH, Nusair Y. Effect of the proteolytic enzyme serrapeptase on swelling, pain, and trismus after surgical extraction of mandibular third molars. Int J Oral Maxillofac Surg. 2008 Mar;37(3):264-8. doI:10.1016/j.ijom.2007.11.011.

  • Nakamura S, Hashimoto Y, Mikami M, et al. Effect of the proteolytic enzyme serrapeptase in patients with chronic airway disease. Respirology. 2003 Sep;8(3):316-20.

  • Rajaram P, Bhattacharjee A, Ticku S. Serratiopeptidase – A Cause for Spread of Infection. J Clin Diagn Res. 2016 Aug;10(8):ZD31-ZD32. doi:10.7860/JCDR/2016/21388.8302.

  • Tiwari, M. The role of serratiopeptidase in the resolution of inflammation. Asian J Pharma Sci. 2017 May;12(3):209-15. doi:10.1016/j.ajps.2017.01.003.