Drug & supplement interaction

Bacillus Subtilis + Amikacin

Amikacin brand names: Amikin, Arikayce.

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

Bacillus Subtilis has a moderate interaction with Amikacin. Theoretically, taking Bacillus subtilis with antibiotic drugs 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 Subtilis and Amikacin

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

Moderate

ANTIBIOTIC DRUGS

Why this applies to Amikacin

Amikacin falls under ANTIBIOTIC DRUGS — the group Bacillus Subtilis interacts with.

Theoretically, taking Bacillus subtilis with antibiotic drugs might decrease the effectiveness of B. subtilis.
Since B. subtilis preparations usually contain live and active organisms, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and B. subtilis preparations by at least 2 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 key thing to know: this interaction runs in one direction. Amikacin is a powerful antibiotic, and Bacillus subtilis is a live probiotic. If you take them at the same time, the antibiotic can kill off a good chunk of those beneficial bacteria before they ever get a chance to do their job. So it's the probiotic that loses out, not your amikacin treatment.

The good news is your amikacin will still work just fine, and you won't get extra side effects (like the kidney or hearing concerns aminoglycosides are known for) from this combo. It's not dangerous, it's just a matter of timing. This is a theoretical concern based on how the two work, so don't worry too much. If you want the probiotic to count, separating them by at least 2 hours helps. Check with your pharmacist if you're unsure.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.

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 Subtilis Also Interacts With Other Medications

Bacillus Subtilis has 181 moderate known drug interactions in our database — the Amikacin 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. Amikacin)
Taking anything else?

Check Another of Your Medications Against Bacillus Subtilis

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

Everything else you take

See Every Supplement That Interacts With Amikacin

This page covers Bacillus Subtilis only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amikacin page lists 52 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Siberian Cocklebur (major), Aristolochia (moderate) and Bacillus Coagulans (moderate).

By severity: 3 major · 38 moderate · 11 minor.

From our pharmacist’s overview on the Amikacin page

“The supplements that deserve genuine wariness with amikacin (Amikin, Arikayce) are the ones that touch the kidneys. Amikacin is a potent antibiotic that can strain kidney function on its own, so herbs like Siberian cocklebur and asarabacca (often contaminated with aristolochic acid, a known kidney toxin) should stay off the table durin…”

Reviewed by 2 · Jul 18, 2026

Open the Amikacin interaction page

One more smart check

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

We hold 786 real supplement products containing Bacillus Subtilis, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bacillus Subtilis. Your product may carry other ingredients that interact with Amikacin too, on top of Bacillus Subtilis — 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 Subtilis and Amikacin 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 Subtilis
Top 25%

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

29 days ago today
Medication Amikacin
Top 25%

#607 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 Subtilis

What is Bacillus Subtilis?

  • Digestive health and bloating
  • Diarrhea support
  • Immune support
  • Gut microbiome balance

Bacillus subtilis is a spore-forming probiotic bacterium found in soil and some fermented foods, and it is used mainly to support gut health and digestion. Early research is promising for certain digestive and immune uses, but evidence is still limited and not strong enough to make firm claims. Talk to a pharmacist or doctor before using it, especially if you have a weak immune system.

Read the full Bacillus Subtilis monograph & all interactions
Medication

About Amikacin Oral Inhalation

What Is Amikacin Oral Inhalation Used For?

Brand names: Amikin, Arikayce

Arikayce is approved for adults with refractory Mycobacterium avium complex (MAC) lung disease — a serious bacterial lung infection that has not responded to at least 6 consecutive months of a standard multidrug antibiotic regimen. It is used as part of a combination treatment plan, not on its own.

This approval is limited: Arikayce is intended only for adults who have few or no other treatment options. It is not recommended for patients whose MAC lung disease has not yet failed standard therapy.

See full Amikacin Oral Inhalation drug information
Keep checking

Other Drugs & Bacillus Subtilis

Browse every other medication we’ve checked against Bacillus Subtilis — 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 Subtilis page.

No interaction 2,648 drugs checked — show the list

We also checked Bacillus Subtilis 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 Subtilis list.

See the full Bacillus Subtilis interactions page
See every supplement checked against Amikacin, 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 Subtilis monograph › Uses, safety, and every drug interaction in one place Amikacin supplement interactions › Every supplement checked against Amikacin, ranked by severity Amikacin Oral Inhalation 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 Subtilis and Amikacin Together: Common Questions

Can you take Bacillus Subtilis with Amikacin?
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 Subtilis and Amikacin 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 Amikacin and Bacillus Subtilis?

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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.