Drug & supplement interaction

Bacillus Coagulans + Pretomanid

Pretomanid brand name: Pretomanid.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Bacillus Coagulans has a moderate interaction with Pretomanid. 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 Pretomanid

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

Moderate

ANTIBIOTIC DRUGS

Why this applies to Pretomanid

Pretomanid 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 good news first: this interaction goes one direction only, and it doesn't affect how well your TB treatment works. Pretomanid (taken together with bedaquiline and linezolid) is a powerful antibacterial drug, and like other antibiotics, it can kill off some of the live probiotic organisms in your Bacillus coagulans before they get a chance to do their job in your gut.

So the concern is about the probiotic losing some of its punch, not about your medication. To get the most out of both, simply space them apart by at least two hours. Keep in mind this is based on lab reasoning rather than human studies, so it's a sensible precaution, not an emergency. Always check with your pharmacist or TB care team before adding any supplement during treatment.

Contact Dr. Brian directly if you have additional questions on this interaction

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 Pretomanid one above is one of them. If you take anything else, check it against the full list below.

Moderate 181 No known interaction 2,649 (incl. Pretomanid)
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 Pretomanid

This page covers Bacillus Coagulans only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pretomanid page lists 143 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), Beer (major) and Cesium (major).

By severity: 10 major · 122 moderate · 11 minor.

From our pharmacist’s overview on the Pretomanid page

“Pretomanid is reserved for highly drug-resistant tuberculosis, and it can stress the liver and lengthen the heart's QT interval, so the supplements on this page deserve genuine care. Ten of the 143 ingredients on file carry a major rating, and nearly all of those either compound the liver risk (alcohol in beer or wine is the plainest e…”

Reviewed by 2 · Jul 18, 2026

Open the Pretomanid 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 Pretomanid 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 Pretomanid 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 10%

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

29 days ago today
Medication Pretomanid
Steady interest

#2,518 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 Pretomanid

What Is Pretomanid Used For?

Brand name: Pretomanid

Pretomanid Tablet is used only as part of a three-drug combination regimen with bedaquiline and linezolid. It is approved for adults with pulmonary (lung) tuberculosis (TB) that has become resistant to multiple standard TB drugs — specifically those resistant to isoniazid, rifamycins, a fluoroquinolone, and a second-line injectable antibiotic.

It is also approved for adults with TB resistant to both isoniazid and rifampin who cannot tolerate standard therapy or whose TB has not responded to it. This approval is based on limited clinical data, and pretomanid is intended for a specific, narrow patient population only.

See full Pretomanid 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
181 Moderate 2,648 No 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

We also checked Bacillus Coagulans against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,648 medications checked with no known interaction — see the full Bacillus Coagulans list.

See the full Bacillus Coagulans interactions page
See every supplement checked against Pretomanid, ranked by severity
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

Keep exploring
Bacillus Coagulans monograph › Uses, safety, and every drug interaction in one place Pretomanid supplement interactions › Every supplement checked against Pretomanid, ranked by severity Pretomanid drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Bacillus Coagulans and Pretomanid Together: Common Questions

Can you take Bacillus Coagulans with Pretomanid?
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 Pretomanid 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

Still Have a Question About Pretomanid and Bacillus Coagulans?

Our pharmacists answer your medication & supplement questions — free.

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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.