Common conditions associated with pain and inflammation include arthritis, trauma, surgical wounds and fibromyalgia. Serratiopeptidase acts as an anti-inflammatory agent to pacify mild to moderate pain and inflammation. The clinical research on the efficacy of serratiopeptidase has been conducted at the King Abdullah University Hospital in Jordan. Among the 17 clinical studies identified, 5 were randomized controlled trials published in English and with a low risk of bias are summarized in the following sections.12, 13, 14, 15, 16. Three randomized, double-blind clinical trials evaluated serrapeptase for relief of pain and swelling after extraction of impacted third molars.12, 13, 22 Although 1 study suggested that adding serrapeptase to acetaminophen may have some benefit over acetaminophen alone, 2 studies have suggested that serrapeptase is ineffective. Medically reviewed by Drugs.com. This case was successfully managed in M.A. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. Facial Swelling After Sinus Surgery-Serrapeptase may reduce facial swelling after some types of sinus surgery but evidence is lacking to support the use of serrapeptase for reducing swelling after dental surgery or soft tissue injuries. Two randomized controlled trials reported no reduction in swelling caused by sprained ankles, and results of studies evaluating use for pain and swelling after dental surgery are conflicting. The Journal of Maxillofacial and Oral Surgery (3) compared serrapeptase to other drugs after the removal of wisdom teeth. In a scalded rat model of acute inflammation, serrapeptase inhibited activation of fibrinolysis; this activity was related to the enzyme's proteolytic activity.17 In a study evaluating carrageenan-induced paw edema for acute inflammation and cotton pellet–induced granuloma for subacute inflammation, serrapeptase demonstrated dose-dependent anti-inflammatory activity that was synergistic with aspirin.18 In a study evaluating formalin-induced paw edema, serrapeptase demonstrated dose-dependent inhibition of acute and chronic inflammation that was comparable with that of diclofenac.19 A final study evaluating carrageenan-induced paw edema found that a low dose of diclofenac reduced edema formation, but serrapeptase did not reduce edema and did not demonstrate a synergistic effect with diclofenac.5. Serratiopeptidase is a proteolytic enzyme prescribed in various specialities like surgery, orthopaedics, otorhinolaryngology, gynaecology and dentistry for its anti-inflammatory, anti-edemic and analgesic effects. Case Report “ Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Serratiopeptidase is a proteolytic enzyme obtained from the silkworm. In both studies, there was no difference between serrapeptase and placebo for the primary end point, the change rate in the injured ankle joint sectional area on computed tomography scan. There is no pain prevention benefit associated with the medication. Required fields are marked *. I know that in America, vets use injections of collagenase to dissolve lipomas from within, but that this can sometimes damage healthy tissues. In 1968, serrapeptase was introduced to the Japanese pharmaceutical market with a broad range of indications, including use as an anti-inflammatory agent for swelling due to surgery or trauma and for the treatment of chronic sinusitis and breast engorgement; as a mucolytic agent in patients with bronchitis, asthma, and tuberculosis, and for the clearing of bronchial secretions after surgery.3 In 2011, the manufacturer voluntarily recalled serrapeptase from the Japanese market after postmarketing clinical trials found it ineffective for anti-inflammatory use.3 In India, serrapeptase is marketed alone or in combination with a nonsteroidal anti-inflammatory drug (NSAID), including diclofenac and aceclofenac.4 In 2014, serrapeptase was licensed as a natural health product in Canada.5. Preliminary studies describe the development of topical products that pair serrapeptase with either ciprofloxacin or tetracycline for the management of periodontal disease.31, 32 An additional study describes the development of a wound-healing formulation that incorporates metronidazole and serrapeptase into alginate-based microspheres.33 Although serrapeptase has been promoted to prevent atherosclerosis, evidence to support use is only anecdotal.2, GI absorption of large proteins such as serrapeptase may be impeded by a number of factors, including hydrophilicity, large molecular weight, chemical instability, nonspecific binding to biologic surfaces, and metabolism by intestinal enzymes.34 Some oral formulations of serrapeptase have an enteric coating intended to protect it from degradation in the stomach and enable dissolution in the more alkaline environment of the small intestines.2 Although a study in rats reported GI absorption of serrapeptase into the systemic circulation in an active form, studies evaluating GI absorption in humans are lacking.35 A Canadian natural health product monograph notes that enteric-coated products are the only acceptable formulation of serrapeptase.5, A serrapeptase dose of 5 to 10 mg is equivalent to 10,000 to 20,000 serrapeptase units.9 For use as a natural health product in Canada, the maximum dose of serrapeptase is 60 mg/day (120,000 serrapeptase units/day).5 To reduce swelling and pain, the dose is 15 to 60 mg/day (30,000 to 120,000 serrapeptase units/day); a health professional should be consulted for use of longer than 1 week. But they did experience less pain. As in this case, serratiopeptidase was used for the patient who had a buccal space abscess. A double-blind trial randomized 193 patients with acute or chronic ear, nose, and throat (ENT) disorders to receive 7 or 8 days of therapy with placebo or serrapeptase 10 mg 3 times daily after meals.15 Outcomes, evaluated in only 140 patients who completed the study, included pain, quantity of secretions, purulence of secretions, difficulty swallowing, nasal obstruction, nasal dysphonia, anosmia, and temperature. Synopses provide limited information regarding these unpublished multicenter, double-blind, parallel-group trials in which patients were randomized to receive serrapeptase 10 mg 3 times daily after meals or placebo for 1 week.20, 21 The first study, completed in 2002, enrolled 301 patients. University Hospital in Jordan, Ginkgo Biloba, garlic, echinacea is also as! 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