Q: Does lumbrokinase cross the placental barrier? Martin G., MD, DC (Jeannette, PA)
A: We do not know if lumbrokinase crosses the placental barrier; most likely not. The studies in pregnant mice showed that lumbrokinase group had no significant difference in pregnancy weight, fetal growth, abortion rate, still birth rate, or fetal resorption rate vs the control group. There were also no birth defects observed. Thus, lumbrokinase is considered fairly safe during pregnancy.
Q: We have a female patient with rectal cancer. She has been taking Neprinol and Wobenzym N this past year. Her platelets have gone over 500 and we are adding Boluoke® (1 capsule twice daily) to her regimen. She takes the Neprinol and Wobenzyme-N together at 6:00 AM and again at 10:00 PM.The question is, when can she take the Boluoke®? At the same time as the other enzymes or does it have to be taken at a different time. Please advise. Cary S., RPh (Sarasota, FL)
A: Ideally, she should take Boluoke® away from other proteolytic enzymes, either 30 minutes before or 1.5 hours after. However, this is just theoretically. Cancer patients often have many medications/supplements to take. Thus, it is still better to take the suggested daily Boluoke® dosage rather than missing them, even though the timing isn’t perfect. So taking Boluoke® with other enzymes is ok. Cancer patients often are very hypercoagulable (esp. in mid to late stages), and often they’ll need to take a high dose of Boluoke® (e.g. 2 cap tid). Sometimes we would also suggest that patients take anticoagulants (e.g. Xeralto®) to help manage severe hypercoagulation. Ideally the patient should get monthly testing of the coagulation profile, including Prothrombin Fragment 1+2, Thrombin/Antithrombin Complex, and Alpha-2-Antiplasmin. If cost is an issue, then cheaper markers may also be useful if they are elevated, like fibrinogen, C-RP and ferritin.
Q: My doctor recommended Boluoke® over Coumadin. I believe he is wise in his recommendation but I would like to test for platelet condition. Do you have a suggestion? Is there a home self test I could use? J.Rice (Unknown)
A: Boluoke® is a fibrinolytic enzyme and not an anticoagulant. On the other hand, Coumadin is an anticoagulant and has no fibrinolytic activities. Thus, functionally Boluoke® and Coumadin are in different classifications, but they both have similar clinical applications — to reduce the risk of thromboembolism and to improve hypercoagulation.
Because they have different mechanisms, their effects also have to be tested differently. Coumadin’s effect can be assessed via INR testing. However, Boluoke®’s effect would have to be tested via Sonoclot® Analysis or a combination of tests including Prothrombin Fragment 1+2, Thrombin/Antithrombin Complex, Alpha-2-Antiplasmin, and Fibrinogen. At this point, we are not aware of any home tests that can assess the effects of Boluoke®. You should talk to your recommending doctor about testing if you have more questions.
