Lumbrokinase (Earthworm)
Also called lumbrokinase, earthworm enzyme, earthworm fibrinolytic enzyme, Lumbricus rubellus enzyme, DLBS1033.
Best grade D across 4 graded outcomes Other Last checked
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The short answer
From 8 sourcesLumbrokinase is a clot-dissolving enzyme from earthworms, studied mainly as an add-on to hospital stroke care. A meta-analysis of 35 trials reported better disability scores without a significant rise in bleeding, but its authors call the evidence limited. Its label says it is contraindicated in any condition associated with bleeding.
Quick pick
From a partner brand · paid link
NutriCology (Allergy Research Group) Lumbrokinase, 60 caps
from HerbsPro
Label: Label: 2 capsules give 600,000 IU of lumbrokinase. The label says it is contraindicated in any condition associated with bleeding and calls for medical supervision with anticoagulant drugs.
The label says it is contraindicated in any condition associated with bleeding and calls for medical supervision with anticoagulant drugs.
Best for trying one bottle: $97.69 one-time (checked Oct 15, 2026).
Every graded outcome on this page
4 rows · line = participantsKey facts
- What it is
- Proteolytic enzymes from the earthworm Lumbricus rubellus; labels state activity in IU (600,000 IU per 2 capsules)1
- Stroke trials (meta-analysis of 35 RCTs)
- Added to supportive care: Barthel Index +15.17 and NIHSS -2.01 points2
- Bleeding in stroke trials
- GI bleeding odds ratio 1.42 (95% CI 0.55 to 3.67), not a significant rise2
- Healthy adults (20, 14 days)
- No differences from placebo in clotting tests, blood counts, liver or kidney tests; no bleeding signs5
- Label warning
- Contraindicated in any condition associated with bleeding; medical supervision with anticoagulant drugs1
What it is
Lumbrokinase is a group of fibrin-dissolving enzymes extracted from the earthworm Lumbricus rubellus, sold in acid-resistant capsules.
Forms
Form
| Form | Elemental % | Absorption (human data) | GI tolerance | Studied for |
|---|---|---|---|---|
| Lumbrokinase in enteric-coated or delayed-release capsules | Varies1Not applicable; labels give enzyme activity in IU (600,000 IU per 2 capsules) | A healthy-volunteer study of DLBS1033 (490 mg three times a day) could not detect activity after a single dose; at steady state after 3 days its biological half-life was 8.6 hours. The maker describes acid-resistant capsules to protect the enzymes from stomach acid.81 | No bleeding signs vs placebo over 14 days in 20 healthy adults; across stroke trials, GI bleeding (OR 1.42) and GI discomfort (OR 1.00) did not rise significantly.52 | Ischemic stroke (as an add-on to hospital care, including with aspirin), safety and half-life in healthy adults |
What the human research says
Human trials only, one row per outcome. The form line shows what each trial actually tested. Grades follow our evidence-grading policy.
Trial map
4 graded outcomes, largest study first4 graded outcomes: 3 improved, 1 no effect. The largest, a 2013 randomized trial of 310 people on vascular events over 1 year after ischemic stroke, found an improvement.
1Vascular events over 1 year after ischemic stroke
Improved · Grade D · RCT, 310 people, 2013
Hospitalized ischemic stroke patients (192 lumbrokinase, 118 control), all on standard stroke treatment
Dose, result and source| Outcome | Found | People | Study | Who was studied |
|---|---|---|---|---|
| Vascular events over 1 year after ischemic stroke | Improved | 310 | Grade D · RCT, 2013 | Hospitalized ischemic stroke patients (192 lumbrokinase, 118 control), all on standard stroke treatment |
| Stroke disability scores (NIHSS, Barthel Index) at 30 days | Improved | 180 | Grade D · RCT, 2021 | Adults with acute ischemic stroke at an Indonesian referral centre, all on aspirin 100 mg, atorvastatin and vitamin B12 |
| Stroke scores and clotting markers in cerebral infarction | Improved | 51 | Grade D · RCT, 2000 | Patients with cerebral infarction (31 lumbrokinase, 20 control) |
| Bleeding and laboratory safety in healthy adults | No effect | 20 | No-effect grade · Crossover RCT, 2016 | Healthy adults (19 completed both periods) |
Every graded row
4 rowsShowing 4 of 4 outcomes. Human trials only.
DGrade DVascular events over 1 year after ischemic strokeStrokeFewer vascular eventsRCT
n 310 · 2013
Improved Total vascular events were 2.08% vs 6.78% and cerebral vascular events 1.04% vs 5.93% (P < 0.05); fibrinogen, carotid wall thickness and plaque measures also favored lumbrokinase.
- Design
- RCT, n = 310, 2013
- Population
- Hospitalized ischemic stroke patients (192 lumbrokinase, 118 control), all on standard stroke treatment
- Form
- Enteric-coated lumbrokinase capsules
- Dose
- Oral capsules (dose not stated in the abstract)
- Duration
- 12 months
- Source
- Reference 3 · PubMed 24229674 (opens PubMed)
DGrade DStroke disability scores (NIHSS, Barthel Index) at 30 daysStrokeBetter NIHSS and Barthel scoresRCT
n 180 · 2021
Improved NIHSS improved more with DLBS1033 at discharge (−5.57 vs −3.64) and day 30 (−6.62 vs −5.14), as did Barthel Index scores; good functional outcome (mRS <2) at day 30 did not differ significantly (86.7% vs 80%). No clinically significant product-related adverse events.
- Design
- RCT, n = 180, 2021
- Population
- Adults with acute ischemic stroke at an Indonesian referral centre, all on aspirin 100 mg, atorvastatin and vitamin B12
- Form
- Lumbrokinase DLBS1033
- Dose
- Three times daily (amount not stated in the abstract)
- Duration
- 30 days
- Source
- Reference 7 · PubMed 33927846 (opens PubMed)
DGrade DStroke scores and clotting markers in cerebral infarctionStrokeClotting markers shiftedRCT
n 51 · 2000
Improved Stroke scores fell in both groups, more with lumbrokinase; KPTT lengthened, t-PA activity and D-dimer rose and fibrinogen fell, while PT and PAI did not change.
- Design
- RCT, n = 51, 2000
- Population
- Patients with cerebral infarction (31 lumbrokinase, 20 control)
- Form
- Lumbrokinase (route and dose not stated in the abstract)
- Dose
- Not stated in the abstract
- Duration
- Not stated in the abstract
- Source
- Reference 4 · PubMed 11321442 (opens PubMed)
∅No effectBleeding and laboratory safety in healthy adultsSafetyNo change in bleeding testsCrossover RCT
n 20 · 2016
No effect Clotting tests, blood counts, liver and kidney function, lipids, glucose, urine, stool occult blood and ECG did not differ from placebo; there were no bleeding signs or allergic reactions.
- Design
- Crossover RCT, n = 20, 2016
- Population
- Healthy adults (19 completed both periods)
- Form
- Lumbrokinase DLBS1033
- Dose
- 490 mg three times a day
- Duration
- 14 days per period, 2-week washout
- Source
- Reference 5 · PubMed 27011386 (opens PubMed)
What the numbers add up to
Each point is worked out from the data and the sources numbered on this page, with the arithmetic shown under it. It adds no new data and is not medical advice.
Hospital add-on, not a stand-alone supplement
Safety data are short
The only placebo-controlled safety trial ran 14 days in 20 healthy adults, and it tested one product, DLBS1033, made by the authors' company.5
Studied doses
Doses used in research, shown against the official limits. They describe the studies, not a recommendation for you.
Studied doses in research, not advice. These are amounts used in research, not personal advice. Your clinician or pharmacist can say what fits you.
Doses studied in human trials
Interactions and safety
Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.
What Lumbrokinase meets
2 cited rowsMedicines 2
Supplements and foods 0
No supplement rows in our sources.
- Drug label or FDA notice
- Measured in a human study
Choose a medicine or supplement above to read its cited rows here.
Also cited:
Anticoagulants (blood thinners)
Drug labelDrug label or FDA notice
Anticoagulants (blood thinners), for example warfarin, heparin, apixaban: The maker's label says to use lumbrokinase only under medical supervision if you take anticoagulant drugs.
Source 1, NutriCology / Allergy Research Group (2024)
Antiplatelet drugs
RCTMeasured in a human study
Antiplatelet drugs, for example aspirin, clopidogrel: DLBS1033 is described as inhibiting platelet aggregation. In a 180-patient stroke trial it was added to aspirin 100 mg with no clinically significant product-related adverse events, but combined bleeding risk has not been tested in larger or blinded trials.
Source 7, Stroke Res Treat (2021)
Interactions
2 agents| Agent | What the source says | Evidence |
|---|---|---|
| Medicines2 | ||
| Anticoagulants (blood thinners)e.g. warfarin, heparin, apixaban | The maker's label says to use lumbrokinase only under medical supervision if you take anticoagulant drugs.1 | Drug label |
| Antiplatelet drugse.g. aspirin, clopidogrel | DLBS1033 is described as inhibiting platelet aggregation. In a 180-patient stroke trial it was added to aspirin 100 mg with no clinically significant product-related adverse events, but combined bleeding risk has not been tested in larger or blinded trials.7 | RCT |
Check with what you take
Kept on this device onlyAdd what you take. We list every interaction our evidence profiles cite between Lumbrokinase and your picks, and between your picks.
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Add a supplement or medicine you take to check it against Lumbrokinase.
Starting from one medicine? The interaction checker rates how serious each pair is, on a curated list of 19 entries for 11 medicines. This cabinet has no severity rating: it lists every interaction row our supplement pages cite.
Who should be careful
4 groups- Bleeding disorders
- The product label says lumbrokinase is contraindicated in any condition associated with bleeding.1
- Blood thinners
- The label calls for medical supervision if you take anticoagulant drugs. Stroke trials combined lumbrokinase with aspirin under hospital care; its effect on bleeding with antiplatelet drugs outside hospital has not been studied.17
- Medicines and surgery
- NCCIH advises that supplements may interact with medications or pose risks before surgery, and to tell your health care providers about everything you use.6
- Pregnancy, breastfeeding and children
- No lumbrokinase data in pregnancy, breastfeeding or children were found in the sources cited here, and NCCIH notes that many dietary supplements have not been tested in pregnant women, nursing mothers or children.6
How to read the label
What to check on the Supplement Facts panel.
How to read the label
1 checksCompare IU, not milligrams
The maker lists 600,000 IU per 2 capsules and notes the capsule weight changed from 40 mg to 32 mg without changing enzyme activity.1
Where to buy Lumbrokinase (Earthworm)
Products from brands we partner with that contain Lumbrokinase (Earthworm). Check the amount per serving against the doses studied above, and the label for other ingredients.
Lumbrokinase (Earthworm) products from partner brands
1 product Paid links · we earn a commission- Quick pickHerbsProNutriCology (Allergy Research Group) Lumbrokinase, 60 caps
Label: 2 capsules give 600,000 IU of lumbrokinase. The label says it is contraindicated in any condition associated with bleeding and calls for medical supervision with anticoagulant drugs
$97.69one-timeChecked Oct 15, 2026
Frequently asked questions
Short answers to common questions; the numbers link to the sources below.
Common questions
7 answersDoes lumbrokinase help after a stroke?
Does lumbrokinase cause bleeding?
How much lumbrokinase was studied?
How long does lumbrokinase stay active?
In healthy volunteers, DLBS1033 activity could not be measured after a single dose, but at steady state after 3 days of 490 mg three times a day its biological half-life was 8.6 hours.8
Can lumbrokinase be combined with blood thinners?
The maker's label says to use it only under medical supervision if you take anticoagulant drugs.1
What is lumbrokinase?
A group of fibrin-dissolving enzymes extracted from the earthworm Lumbricus rubellus, sold in acid-resistant capsules with activity stated in IU.1
Was lumbrokinase combined with aspirin in trials?
Yes. In a 180-patient open-label stroke trial, DLBS1033 three times a day was added to aspirin 100 mg and atorvastatin; disability scores improved more than with standard care alone, with no clinically significant product-related adverse events. Larger blinded data on combined bleeding risk are lacking.7
Sources
8 sources: trial abstracts, NIH fact sheets and reference databases. Numbers in the text link here.
Sources cited on this page
8 sources- 1Lumbrokinase: Circulatory System Support (product information sheet and label)Label NutriCology / Allergy Research Group, 2024 · nutricology.com
- 2Therapeutic Potential of Lumbrokinase in Acute Ischemic Stroke: A Meta-Analysis of Efficacy and Safety.Meta-analysis Ther Clin Risk Manag, 2025 · PMID 40933244
- 3Oral fibrinogen-depleting agent lumbrokinase for secondary ischemic stroke prevention: results from a multicenter, randomized, parallel-group and controlled clinical trial.RCT Chin Med J (Engl), 2013 · PMID 24229674
- 4Changes in coagulation and tissue plasminogen activator after the treatment of cerebral infarction with lumbrokinase.RCT Clin Hemorheol Microcirc, 2000 · PMID 11321442
- 5The Safety and Tolerability of Lumbrokinase DLBS1033 in Healthy Adult Subjects.Crossover RCT Drug Res (Stuttg), 2016 · PMID 27011386
- 6Using Dietary Supplements WiselyFact sheet National Center for Complementary and Integrative Health (NCCIH), 2019 · nccih.nih.gov
- 7Effect of DLBS1033 on Functional Outcomes for Patients with Acute Ischemic Stroke: A Randomized Controlled Trial.RCT Stroke Res Treat, 2021 · PMID 33927846
- 8A Clinical Trial on Biological Half Life of Bioactive Protein from Lumbricus rubellus, DLBS1033 in Healthy Volunteers.PK study Acta Med Indones, 2018 · PMID 30333270
What changed
Every dated change to this page: what changed, who made it and why.
Change log
2 entries| Date | Change | Who and why |
|---|---|---|
| evidence, forms, studied doses, interactions, who should avoid, FAQ | Added a 2021 open-label DLBS1033 stroke trial with aspirin (PMID 33927846) as an evidence row and a 2018 half-life study (PMID 30333270); added an antiplatelet-drug interaction; clarified pregnancy, breastfeeding and blood-thinner notes; FAQ now 7. PubMed search (2016–2026) found no newer randomized human trials or meta-analyses beyond the 2025 meta-analysis already cited. Every new PMID checked with NCBI esummary and its abstract. | Writer: Kymata Health EditorialTrigger: A–Z page audit |
| all | Initial editorial evidence review. Every PMID checked against NCBI E-utilities esummary (title, year, journal; none retracted) and each cited abstract read; numbers taken from the abstracts (meta-analysis bleeding ORs and 'no funding' statement checked in the PMC full text). The 2025 meta-analysis has no evidence row because neither its abstract nor full text gives a pooled participant count; it is cited in key facts, forms and FAQ. Funding and conflicts: DLBS1033 safety trial authors work for its maker, Dexa Medica; other abstracts name no funder. Safety from the NutriCology/Allergy Research Group label (contraindicated in bleeding conditions; supervision with anticoagulants) plus NCCIH general guidance. Where to buy: NutriCology Lumbrokinase (checked 2026-10-15). | Writer: Kymata Health EditorialTrigger: new page |
Supplement & Nutrient Encyclopedia. Educational information only; it is not medical advice and does not replace a clinician. Dietary supplements are not intended to diagnose, treat, cure or prevent any disease. Statements about supplements have not been evaluated by the FDA.