Drug & supplement interaction

Bacillus Coagulans + Lefamulin Acetate

Lefamulin Acetate brand name: Xenleta.

Moderate Interaction
The bottom line Moderate

Bacillus Coagulans has a moderate interaction with Lefamulin Acetate. Theoretically, taking antibiotics with Bacillus coagulans might decrease the effectiveness of B.

Read the full interaction report
SeverityModerate
LikelihoodProbable
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Bacillus Coagulans and Lefamulin Acetate

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTIBIOTIC DRUGS

Why this applies to Lefamulin Acetate

Lefamulin Acetate falls under ANTIBIOTIC DRUGS — the group Bacillus Coagulans interacts with.

Theoretically, taking antibiotics with Bacillus coagulans might decrease the effectiveness of B. coagulans.
B. coagulans preparations usually contain live and active organisms. Therefore, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and B. coagulans preparations by at least two hours.
Severity Moderate Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: this interaction runs in one direction. Lefamulin is an antibiotic, and Bacillus coagulans is a live probiotic. An antibiotic doesn't know the difference between bad bacteria and the friendly bacteria in your supplement, so taking them at the same time can kill off a good chunk of those probiotic organisms before they ever get to work. In short, the lefamulin may make your probiotic less helpful, not the other way around.

The good news is your lefamulin will still fight the pneumonia just fine, so its effectiveness and side effects (like nausea or diarrhea) aren't changed by the probiotic. To get the most out of your Bacillus coagulans, just space them apart by at least two hours. This advice is based mainly on lab reasoning, so check with your pharmacist if you'd like to confirm the timing.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Bacillus Coagulans Also Interacts With Other Medications

Bacillus Coagulans has 181 moderate known drug interactions in our database — the Lefamulin Acetate one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Bacillus Coagulans

Covers the 2,830 medications we’ve checked against Bacillus Coagulans. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Lefamulin Acetate

This page covers Bacillus Coagulans only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Lefamulin Acetate page lists 178 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 8 major · 130 moderate · 40 minor.

From our pharmacist’s overview on the Lefamulin Acetate page

“Before adding any supplement to lefamulin acetate (Xenleta), a short-course antibiotic for pneumonia, look hard at the eight major-rated entries among its 178 documented interactions. They cluster around two dangers: ingredients that change how much lefamulin reaches your blood, and ingredients that can stretch the heart's rhythm on to…”

Reviewed by 2 · Jul 18, 2026

Open the Lefamulin Acetate interaction page

One more smart check

Taking Bacillus Coagulans as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,895 real supplement products containing Bacillus Coagulans, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bacillus Coagulans. Your product may carry other ingredients that interact with Lefamulin Acetate too, on top of Bacillus Coagulans — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Bacillus Coagulans and Lefamulin Acetate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Bacillus Coagulans
Top 25%

#147 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Lefamulin Acetate
Top 25%

#599 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Bacillus Coagulans

What is Bacillus Coagulans?

Bacillus Coagulans
  • Constipation
  • Irritable bowel syndrome (IBS)
  • Diarrhea
  • General digestive health
  • Immune support
  • Bloating and gas

Bacillus coagulans is a spore-forming probiotic that survives stomach acid well and may help with some digestive problems such as IBS, constipation, and certain types of diarrhea. The evidence is promising but still limited, and quality and strains vary between products. It is generally well tolerated in healthy people, but people with weak immune systems and those who are pregnant or breastfeeding should talk to a doctor first.

Read the full Bacillus Coagulans monograph & all interactions
Medication

About Lefamulin Injection

What Is Lefamulin Injection Used For?

Brand name: Xenleta

Xenleta Injection is approved for treating community-acquired bacterial pneumonia (CABP) — a type of lung infection caught outside of a hospital — in adults. It targets specific bacteria known to cause this infection, including Streptococcus pneumoniae, Staphylococcus aureus (methicillin-susceptible strains), Haemophilus influenzae, Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydophila pneumoniae.

Xenleta Injection is given intravenously (by IV infusion) and is only intended for bacterial infections — it will not work against viral illnesses like the flu or COVID-19.

See full Lefamulin Injection drug information
Keep checking

Other Drugs & Bacillus Coagulans

Browse every other medication we’ve checked against Bacillus Coagulans — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
181Moderate
0Minor
2,648No known interaction
Moderate

181 interactions

Showing 60 of 181 moderate interactions — see all 181 on the Bacillus Coagulans page.

No interaction 2,648 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Bacillus Coagulans and Lefamulin Acetate Together: Common Questions

Can you take Bacillus Coagulans with Lefamulin Acetate?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Bacillus Coagulans and Lefamulin Acetate interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.