Serratiopeptidase (Macozac)

Clinical Summary

Serratiopeptidase is a proteolytic enzyme derived from the bacteria Serratia E15. It is widely prescribed in India and parts of Europe/Asia as an anti-inflammatory and mucolytic agent, though evidence of efficacy is limited and it is not approved by FDA/EMA for therapeutic use.

Documented on handwritten prescription as "Macozac" — likely brand name containing serratiopeptidase.

Newly documented from handwritten prescription dated 2026-05-04. Dose: 100 mg (frequency unclear from Rx).

Dosing History

This medication was NOT previously documented in any ingested raw source. Indication, date of initiation, and dosing frequency are unknown.

Indication (PRESUMED)

Indication is unclear from available documentation. Common uses in India:
1. Anti-inflammatory: Post-surgical edema, traumatic inflammation
2. Mucolytic: Respiratory infections, sinusitis (thins mucus)
3. Analgesic adjunct: May be combined with NSAIDs/analgesics

Possible reasons for Ishamma:
- Post-procedure inflammation (dental, minor trauma)?
- Respiratory symptoms (not documented)?
- Musculoskeletal inflammation (not documented)?

Unclear why this is prescribed in the context of AML + diabetes.

Pharmacology

• Drug class: Proteolytic enzyme (fibrinolytic, anti-inflammatory, mucolytic)
• Mechanism: Hydrolyzes bradykinin, histamine, serotonin (proposed anti-inflammatory effect); breaks down fibrin and mucus (proposed fibrinolytic/mucolytic effect)
• Evidence base: Limited high-quality evidence; widely used in India/Japan/Europe but not FDA-approved

Monitoring

No specific monitoring required.

Drug Interactions

• Anticoagulants / antiplatelets: Theoretical increased bleeding risk (serratiopeptidase has fibrinolytic activity)
• Antibiotics: May enhance antibiotic tissue penetration (theoretical; limited evidence)

[!info] Theoretical Bleeding Risk
Serratiopeptidase has fibrinolytic activity. While Ishamma's platelets are now normal (213K as of May 4), during thrombocytopenic periods (nadir 45K), concurrent use of a fibrinolytic agent could theoretically increase bleeding risk. No documented bleeding events.

Adverse Effects

• Generally well-tolerated
• GI upset (nausea, anorexia)
• Skin reactions (rare)
• Bleeding (theoretical, rarely reported)

Evidence and Regulatory Status

• Not FDA-approved for any indication
• Not EMA-approved
• Widely prescribed in India, Japan, Europe
• Cochrane reviews: insufficient evidence for most indications
• ICMR (India): questioned evidence base in 2011

Related

• Indication unclear — no documented inflammation, respiratory symptoms, or post-procedure state in available sources

Medication page created during ingest of 2026-05-04 handwritten prescription. Indication unclear.