Degenerative Disease is a chronic disease caused by decline of the organ function due to the aging process. Currently, degenerative diseases have shifted patterns so that the disease has its own problem segmentation for each country around the world.

    One type of degenerative disease attract be attention of many parties today is the cardiovascular disease. According to data provided by the World Health Organization (WHO) in 2012 showed 17.5 million people worldwide died caused by cardiovascular disease or about 31% of 56.5 million deaths in worldwide. More than three-quarters of deaths in the world are caused by cardiovascular diseases that generally occur in developing countries like Indonesia.

shutterstock_336595781  Cardiovascular disease is a disease caused by disruption of the heart and blood vessels. Fatty deposits (atheroma or plaque) are a major cause of cardiovascular disease. The process of formation of atheroma occurs gradually in various branches of blood vessels. This process is referred to  Atherosclerosis. Atherosclerosis can occur in arteries of brain, heart, kidneys, and the other organs. When it occur of heart arteries, it will cause heart attack or Coronary Heart Disease (CHD), if it occur in the brain arteries, it will cause a stroke. According to Dr. dr. Robert Arjuna. FEAS in Roberto News 603 on November 6th 2017, stroke is one of the killer disease in Indonesia. Stroke can occur when the blood supply that carries oxygen and nutrients to the brain is lost due to blockage or rupture of blood vessels causing damage to the brain, and can cause the death.

   Atheroma scattered in the blood vessels contain a number of fatty materials, especially cholesterol, smooth muscle cells and connective tissue cells. Atheroma in the blood vessels can develop into a larger size. In the next condition, atheroma  become brittle and may break. A broken of atheroma will trigger the formation of blood clot (thrombus).

   Thrombus is an abnormal blood clot in the arterial and venous blood vessels that can cause a disease known as thrombosis. Structurally, thrombus is a cellular mass joined by  fibrin network. Based on the Triad of Virchow’s theory, there are three pathophysiology factors of thrombosis, that is: abnormalities of blood vessel walls, changes in blood flow and changes of clot blood potency

   Thrombosis is a process of excessive coagulation in the blood vessels so that inhibit the blood flow . Generally, thrombosis is divided into two parts:

  1. Thrombosis which occur in the vein, known as Venous Thromboembolism (VTE)
  2. Thrombosis which occur in the arteries, known as Arterial Thromboembolism (AT).  This condition is associated with atherosclerosis or blockage of blood vessels in the heart.

The risk factor for the incindence of thrombosis is

  1. Genetic
  2. Age
  3. Trauma or Injury
  4. History of cardiovascular diseases such as hypertension, diabetes, cancer.
  5. Smoking
  6. Pregnancy, use birth control pills, and hormone replacement therapy
  7. Obesity
  8. Cholesterol

  For the thrombotic conditions, treatment with pharmacological therapy has been widely used, one of that use the fibrinolytic agents (thrombolytics). In general, fibrinolytic worked by activator plasminogen to plasmin’s form which will degrade fibrin and then break down the thrombus.

  Nattokinase is present as one of the supplement  has been widely used  for the prevention of thrombosis. Nattokinase is an enzyme extracted from Japanese food that is natto soybean. The soybeans are then fermented with Bacillus subtilis bacteria. Nattokinase has been used by Japanese people for almost hundreds years and was believed to have an effect for the health. Efficacy of nattokinase  is proved by Dr. Hiroyuki Sumi in 1980. His study discover that nattokinase has a fibrinolytic effect by reducing thrombus levels in the blood vessels and works by degrading fibrin yarns and affecting for plasminogen activity so that thrombus can be broken down.

 The health of the blood vessels has a role important plays in the occurrence of thrombosis and can be achieved with help of the antioxidants and then can to prevent the bad effects of free radicals. Based on some studies, free radicals can trigger atherosclerosis. Free radicals oxidize LDL (Low Density Lipoprotein) chemically, so LDL can’t to recognize the receptors. The oxidized LDL will settle in the blood vessels to block blood flow.

  Antioxidants are compounds that can neutralize free radicals. Based on the source, antioxidants are divided into two types of endogenous antioxidants and exogenous antioxidants. Endogenous antioxidants are antioxidants produced in the body. The antioxidant production will decrease with increase of age, history of disease, and high concentration of free radical in the body. Therefore, it is necessary to supply of antioxidants from outside the body which called as antioxidant exogenous.

  Coenzyme Q10 (Co Q10) is an endogenous antioxidant needed for basic cell function in generating the energy required for cell growth and maintenance. Coenzyme Q10 also has effectiveness for cell wall stabilization, mitochondrial stabilization, enhancing immune system, nerve protection, and protection of heart muscle. In addition to production in the body, coenzym Q10 can also be obtained from food sources such as grains, fish oil and supplements containing coenzym Q10. Therefore, to maximize the effectiveness necessary to supply of coenzym Q10 from outside the body.

MAXTOTEN (3)PT SIMEX PHARMACEUTICAL as one of the pharmaceutical companies in Indonesia presenting MAXTOTEN, as one of the supplements that can be used to help reduce the risk of thrombosis, heart disease, stroke and other cardiovascular diseases as a result of the blockage of atheroma in the blood vessels. MAXTOTEN contains 100 mg of nattokinase and 30 mg  of coenzyme Q10 which has a synergistic effect in the health care of blood vessels. Several studies have shown that nattokinase help to destruction of thrombus so that plaque in blood vessels can be reduced, and the coenzyme Q10 as an antioxidant, can help to repair blood vessel damage, maintain elasticity of blood vessels and help ensure functioning of blood vessels is well and as protection for heart muscle. In addition, the presence of coenzym Q10 in MAXTOTEN will increase the amount and effectiveness as antioxidants in blood vessels. In conclusion, MAXTOTEN contains a synergistic and safe combination of active ingredients, and is an excellent choice for prevention and helps reduce the risk of heart disease and stroke due to blockage in the blood vessels.


1.    Handajani A., et al.2010. Faktor-faktor yang berhubungan dengan pola kematian pada penyakit degeneratif di Indonesia. Buletin Penelitian Sistem Kesehatan. Surabaya. Vol 13 (1): 42-53.

2.   Kementerian Kesehatan Republik Indonesia. 2017. Penyakit Jantung Penyebab Kematian Tertinggi, Kemenkes Ingatkan Cerdik. Jakarta.


4.      Ariens RAS., et al. 2013. Fibrin(ogen) and thrombotic disease. Journal of Thrombosis and Haemostasis.Vol 11 (1): 294-305.

5.      Makin A., et al. 2002. Peripheral Vascular Disease and Virchow’s Triad for Thrombogenesis; 95: 199 – 210.

6.   Meruvu H., et al. 2011. Nattokinase: A Review on Fibrinolytic Enzyme. International Journal of Chemical, Environment, and  Pharmaceutical Research; vol 2 (1): 61-66.

7.      Kapoor P., et al. 2013. Coenzym Q10- A Novel Molecule. Vol 14(1): 37-45.


  1. Dhany

    Mohon info harga maxtoten?.. Isi nya berapa?… Kandungan nattokinase nya berapa gram?.. trims..

    • PT. Simex Pharmaceutical Indonesia

      Halo Bpk Dhany,

      Komposisi MAXTOTEN mengandung Nattokinase 100 mg & Coenzyme Q10 30 mg. Per box berisi 30 kaplet salut selaput. Mengenai harga, mohon informasikan kepada kami dimana lokasi Bapak tinggal, lalu akan kami informasikan ketersediaannya di apotek terdekat. Terima kasih.

      Salam Sehat,
      Product Department
      PT. Simex Pharmaceutical Indonesia


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