Serratiopeptidase Safety in Lactation

Introduction to Safe Alternatives

The American College of Chest Physicians and other major medical societies recommend avoiding serratiopeptidase during lactation due to insufficient safety data, and suggest using well-established alternatives like ibuprofen, diclofenac, or paracetamol instead 1, 2, 3, 4, 5, 6, 7

Ibuprofen has been used extensively for postpartum pain and during lactation and is considered safe during breastfeeding, with a low risk of adverse effects on breastfed infants 1, 2
Diclofenac has been used extensively during lactation with only small amounts detected in breast milk, making it safe for breastfeeding, according to the Association of Anaesthetists 1, 2
Paracetamol (acetaminophen) transfers to breast milk in amounts significantly less than the pediatric therapeutic dose, and is considered compatible with breastfeeding by the American College of Chest Physicians 1, 2

If serratiopeptidase is being used for anti-inflammatory or analgesic purposes, the American College of Chest Physicians recommends substituting with ibuprofen (first choice) or diclofenac (second choice) 1, 2
The Association of Anaesthetists suggests using the lowest effective dose of the alternative NSAID for the shortest duration necessary, and combining with paracetamol for multimodal analgesia to minimize total NSAID exposure 1, 2

NSAIDs like ibuprofen and diclofenac have extensive pharmacokinetic profiles during lactation showing minimal infant exposure, according to the American College of Chest Physicians 1, 2, 8
The American College of Chest Physicians notes that well-studied lactation-compatible drugs have established milk:plasma ratios, oral bioavailability data, and relative infant dose calculations, which are lacking for serratiopeptidase 8