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Patients should always consult their physicians before taking Boluoke® while on any prescriptions. Boluoke® has been shown not to significantly affect PT and aPTT (thus it does not affect INR). However, physicians and patients should be aware that other lumbrokinase products may significantly affect PT and/or aPTT.
Can the content of Boluoke® capsules be emptied out and taken without the capsules?
The capsules used in Boluoke® are acid-resistant capsules. They are designed to resist stomach acid and dissolve in the small intestines, because lumbrokinase may be inactivated by stomach acid. Preliminary coagulation tests using Sonoclot® machine (manufactured by Sienco, Inc.) indicate that Boluoke® is still effective when taken without the capsules on an empty stomach. However, it is highly recommended that the patients take Boluoke® in its original capsulated format whenever possible.
How long before surgery should patient stop taking Boluoke®?
The conservative approach is to stop Boluoke® 1 week prior to surgery. The patient may resume taking Boluoke® 15 days after surgery if there is no complication, or earlier if the physician deems appropriate.
Can Boluoke® be safely taken with anti-platelet agents?
Please consult a doctor before taking Boluoke® if you are on any prescription medications. Because Boluoke® can affect platelet aggregation (Zhang GP, Qian RZ, et al. 1998), it should be used cautiously with strong anti-platelets like Plavix or Ticlid and only under the supervision of a physician.
Can Boluoke® be safely taken with aspirin?
Please consult a doctor before taking Boluoke® if you are on any prescription medications. Boluoke® can affect platelet aggregation (Zhang GP, Qian RZ, et al. 1998), so patients should consult with their physicians before taking Boluoke® with aspirin or other NSAIDs.
Can Boluoke® be used on pregnant women?
Please consult a doctor before taking Boluoke® if you are pregnant or breastfeeding. Teratogenicity studies of Boluoke® on animals showed no effect on pregnancy weight, fetal growth, abortion rate, still birth rate, and fetal resorption rate in mice compared to the placebo group. There was also no birth defect detected. However, pregnant patients should not take Boluoke® unless it is done under a physician’s approval and supervision.
What are the contra-indications for taking Boluoke®?
Contra-indications for Boluoke® are: allergy to lumbrokinase or earthworm; recent surgery; pre-surgery; lumbar puncture or arterial puncture; trauma; high risk aneurysm; active internal bleeding or GI ulceration; any other bleeding disorders/tendencies. People who are taking any prescription medications should consult their physicians before taking Boluoke®.
Does Boluoke® have any side effects?
The earthworm has been used in Traditional Chinese Medicine for a few thousand years, and is considered to be one of the safest ingredients in the traditional pharmacopoeias. In one of the largest clinic trial of Boluoke® involving 16 hospitals and 1560 patients in China, the overall adverse reaction rate was 1.92% (30 cases). 0.58% had skin itching, 0.19% had skin rash, and 1.15% had nausea or diarrhea; no hemorrhage or major side effect was reported.
Can Boluoke® be taken with other enzyme products?
There is a theoretical possibility that Boluoke® may be cleaved and rendered ineffective by other proteolytic enzymes, so we currently do not recommend taking Boluoke® with another proteolytic enzyme product. If you do have to take another proteolytic enzyme product, please take Boluoke® on an empty stomach first, and then take the other enzyme product 30 minutes later.
What is the suggested protocol for taking Boluoke®?
The suggested dosage is 1-2 capsules one to three times daily on an empty stomach, or as directed by a health care practitioner.
How is Boluoke® different from other products that contain lumbrokinase?
Boluoke® is the only lumbrokinase that has been through various clinical trials in China and has an excellent clinical safety and efficacy profile since 1992 (over 30 years). Its enzymatic strength is standardized to no less than 12,000 lumbrokinase units per milligram (often much higher) and no less than 1.6 million tPA units per capsule (tested by independent lab in Canada). Other lumbrokinase products often are citing Boluoke®’s credentials and research, and may not be held to as vigorous quality control measures as Boluoke®. On the raw material market, the price of lumbrokinase can vary by up to 15 folds, and the enzymatic strengths of various lumbrokinase also differ greatly. In addition, lumbrokinase is a preparation containing multiple enzyme fractions, and the extraction and purification method determines the composition of the various enzyme fractions. Thus different extraction method will produce different sub-fractions of lumbrokinase. This is the reason why Boluoke® does not significantly change prothrombin time (PT) or activated partial thromboplastin time (aPTT), while other lumbrokinase sources may significantly alter PT or aPTT as shown in some studies (Jin L, Jin H, Zhang G, Xu G. 2000).
* The statements above have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.
