Drug & supplement interaction

Bacillus Subtilis + Tofacitinib

Tofacitinib brand names: Xeljanz, Xeljanz XR.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Bacillus Subtilis and Tofacitinib in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Bacillus Subtilis and Tofacitinib

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Tofacitinib and Bacillus Subtilis in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Bacillus Subtilis safety at a glance

Bacillus Subtilis overall Use caution Generally well tolerated in healthy adults, but quality and safety can vary by product and strain.
Pregnancy Use caution There is not enough safety data, so it is best to avoid unless a doctor advises otherwise.
Breastfeeding Use caution Limited safety information exists, so check with your doctor before use.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Tofacitinib and Bacillus Subtilis? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Tofacitinib

Interactions in our licensed database are recorded against drug classes, not just single drug names. Tofacitinib is filed under 4 classifications — including cytochrome p450 2c19 (cyp2c19) substrates, immunosuppressants, cytochrome p450 3a4 (cyp3a4) substrates. Bacillus Subtilis has documented interactions with 1 drug class — the most serious being antibiotic drugs (moderate) — and none of Tofacitinib’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Bacillus Subtilis Does Interact With Other Medications

Bacillus Subtilis has 182 moderate known drug interactions in our database — Tofacitinib isn’t one of them. If you take anything else, check it against the full list below.

Moderate 182 No known interaction 2,648 (incl. Tofacitinib)
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.

What to actually watch for

No Interaction Found — But Data Suggests Bacillus Subtilis and Tofacitinib May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • A higher chance of infection Worth acting on Additional detail

    Bacillus Subtilis

    “There are cases of Bacillus subtilis var. natto bacteremia and meningitis in patients with frequent consumption of natto, soybeans fermented with B. subtilis var. natto. A 70-year-old female recovered from bacteremia after this consumption was stopped and she was treated with vancomycin.”

    Bacillus Subtilis · Natural Medicines adverse-effect record, reported in diabetes.

    6 sources cited
    1. 110844. Kato A, Yoshifuji A, Komori K, et al. A case of Bacillus subtilis var. natto bacteremia caused by ingestion of natto during COVID-19 treatment in a maintenance hemodialysis patient with multiple myeloma. J Infect Chemother 2022;28(8):1212-1215. PubMed
    2. 110862. Tokano M, Tarumoto N, Imai K, et al. A case of bacterial meningitis caused by Bacillus subtilis var. natto. Intern Med. 2022. Epub ahead of print.
    3. 110834. Lampropoulos PK, Gkentzi D, Tzifas S, Dimitriou G. Neonatal sepsis due to Bacillus subtilis. Cureus 2021;13(9):e17692. PubMed
    4. 110837. La Jeon Y, Yang JJ, Kim MJ, et al. Combined Bacillus licheniformis and Bacillus subtilis infection in a patient with oesophageal perforation. J Med Microbiol 2012;61(Pt 12):1766-1769. PubMed
    5. 110840. Velasco E, Martins CA, Tabak D, Bouzas LF. "Bacillus subtilis" infection in a patient submitted to a bone marrow transplantation. Rev Paul Med 1992;110(3):116-7.
    6. 110838. Wallet F, Crunelle V, Roussel-Delvallez M, Fruchart A, Saunier P, Courcol RJ. Bacillus subtilis as a cause of cholangitis in polycystic kidney and liver disease. Am J Gastroenterol 1996;91(7):1477-8.

    Tofacitinib

    Listed in the ADVERSE REACTIONS section of the FDA label for Tofacitinib. Read the label on DailyMed ›

  • Headache reported in 7.3% of FDA reports for Tofacitinib Additional detail

    Bacillus Subtilis

    “Orally, one case of headache was reported in a clinical trial.”

    Bacillus Subtilis · Natural Medicines adverse-effect record, reported in cluster headache.

    1 source cited
    1. 110847. Lefevre M, Racedo SM, Denayrolles M, et al. Safety assessment of Bacillus subtilis CU1 for use as a probiotic in humans. Regul Toxicol Pharmacol 2017;83:54-65. PubMed

    Tofacitinib

    Listed in the ADVERSE REACTIONS section of the FDA label for Tofacitinib, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Diarrhea Additional detail

    Bacillus Subtilis

    “Orally, diarrhea has been reported rarely.”

    Bacillus Subtilis · Natural Medicines adverse-effect record, reported in diarrhea.

    1 source cited
    1. 110846. Freedman KE, Hill JL, Wei Y, et al. Examining the gastrointestinal and immunomodulatory effects of the novel probiotic Bacillus subtilis DE111. Int J Mol Sci 2021;22(5):2453. PubMed

    Tofacitinib

    Listed in the ADVERSE REACTIONS section of the FDA label for Tofacitinib. Read the label on DailyMed ›

Reported for Bacillus Subtilis but not commonly for Tofacitinib: kidney problems and itching.

Effects for Tofacitinib come from the ADVERSE REACTIONS section of its FDA label; effects for Bacillus Subtilis come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 185,980 voluntary FDA FAERS reports for Tofacitinib that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Overlapping uses

What Tofacitinib Is Prescribed For, and What Bacillus Subtilis Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Tofacitinib is a prescription medicine with approved uses on its FDA label. Bacillus Subtilis is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Bacillus Subtilis has been studied for:

  • Ulcerative colitis studied, not established Bacillus Subtilis has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Bacillus Subtilis for ulcerative colitis

    Oral Bacillus subtilis has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Tofacitinib on your own; if you are taking Bacillus Subtilis for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

Everything else you take

See Every Supplement That Interacts With Tofacitinib

This page covers Bacillus Subtilis only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tofacitinib page lists 184 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 3 major · 143 moderate · 38 minor.

From our pharmacist’s overview on the Tofacitinib page

“Supplements deserve genuine care alongside tofacitinib (Xeljanz, Xeljanz XR), a medicine that deliberately dials down the immune system to control conditions like rheumatoid arthritis and ulcerative colitis. Most of the interactions on this page run through the liver enzymes that clear the drug, meaning an herb can push its blood level…”

Reviewed by 2 · Jul 18, 2026

Open the Tofacitinib 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. Even though Bacillus Subtilis itself has no known interaction with Tofacitinib, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Bacillus Subtilis and Tofacitinib 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%

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

29 days ago today
Medication Tofacitinib
Steady interest

#1,746 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Bacillus Subtilis reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Bacillus Subtilis and Tofacitinib records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Bacillus subtilis · Bacillaceae · Live bacterial cells and spores (probiotic strains) · Capsules, tablets, powders, and multi-strain probiotic blends

An interaction check asks whether these two react with each other — it does not ask whether Bacillus Subtilis is a good idea for someone in your situation. Here is what our Bacillus Subtilis record says about it on its own.

Bacillus Subtilis: dosing

There is no official standard dose for Bacillus subtilis. Probiotic amounts are usually measured in CFUs (colony-forming units), and products vary widely.The best approach is to follow the directions on the product label and not exceed the recommended amount.

From our Bacillus Subtilis monograph — the full record covers uses, side effects and every documented interaction.

Read the full Bacillus Subtilis monograph & all interactions
Medication

About Tofacitinib

What Is Tofacitinib Used For?

Brand names: Xeljanz, Xeljanz XR

  • Tofacitinib is used alone or with other medications to treat rheumatoid arthritis (condition in which the body attacks its own joints causing pain, swelling, and loss of function) in adults who are unable to take or did not respond to one or more tumor necrosis factor (TNF) inhibitor medication(s). It is also used to treat psoriatic arthritis (a condition that causes joint pain and swelling and scales on the skin) in adults who are unable to take or did not respond to or tolerate one or more TNF inhibitor medication(s). Tofacitinib is used to treat ulcerative colitis (a condition which causes swelling and sores in the lining of the colon [large intestine] and rectum) in adults who are unable to take or who did not respond to one or more TNF inhibitor medication(s). It is also used to treat polyarticular juvenile idiopathic arthritis (PJIA; a type of childhood arthritis that affects five or more joints during the first six months of the condition, causing pain, swelling, and loss of function) in children 2 years and older who are unable to take or who did not respond to one or more TNF inhibitor medication(s). Tofacitinib is in a class of medications called Janus kinase (JAK) inhibitors. It works by decreasing the activity of the immune system.

See full Tofacitinib 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
182Moderate
0Minor
2,647No known interaction
182 Moderate 2,647 No interaction
Moderate

182 interactions

Showing 60 of 182 moderate interactions — see all 182 on the Bacillus Subtilis page.

No interaction 2,647 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 2,647 medications checked with no known interaction — see the full Bacillus Subtilis list.

See the full Bacillus Subtilis interactions page
See every supplement checked against Tofacitinib, ranked by severity
Evidence & sources

Bacillus Subtilis References

The 10 references that drive our Bacillus Subtilis monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Lampropoulos PK, Gkentzi D, Tzifas S, Dimitriou G. Neonatal sepsis due to Bacillus subtilis. Cureus 2021;13(9):e17692. PubMed
  3. La Jeon Y, Yang JJ, Kim MJ, et al. Combined Bacillus licheniformis and Bacillus subtilis infection in a patient with oesophageal perforation. J Med Microbiol 2012;61(Pt 12):1766-1769. PubMed
  4. Wallet F, Crunelle V, Roussel-Delvallez M, Fruchart A, Saunier P, Courcol RJ. Bacillus subtilis as a cause of cholangitis in polycystic kidney and liver disease. Am J Gastroenterol 1996;91(7):1477-8.
  5. Velasco E, Martins CA, Tabak D, Bouzas LF. "Bacillus subtilis" infection in a patient submitted to a bone marrow transplantation. Rev Paul Med 1992;110(3):116-7.
  6. Kato A, Yoshifuji A, Komori K, et al. A case of Bacillus subtilis var. natto bacteremia caused by ingestion of natto during COVID-19 treatment in a maintenance hemodialysis patient with multiple myeloma. J Infect Chemother 2022;28(8):1212-1215. PubMed
  7. Freedman KE, Hill JL, Wei Y, et al. Examining the gastrointestinal and immunomodulatory effects of the novel probiotic Bacillus subtilis DE111. Int J Mol Sci 2021;22(5):2453. PubMed
  8. Lefevre M, Racedo SM, Denayrolles M, et al. Safety assessment of Bacillus subtilis CU1 for use as a probiotic in humans. Regul Toxicol Pharmacol 2017;83:54-65. PubMed
  9. Hanifi A, Culpepper T, Mai V, et al. Evaluation of Bacillus subtilis R0179 on gastrointestinal viability and general wellness: a randomised, double-blind, placebo-controlled trial in healthy adults. Benef Microbes 2015;6(1):19-27. PubMed
  10. Tokano M, Tarumoto N, Imai K, et al. A case of bacterial meningitis caused by Bacillus subtilis var. natto. Intern Med. 2022. Epub ahead of print.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Bacillus Subtilis and Tofacitinib Together: Common Questions

Is it safe to take Bacillus Subtilis with Tofacitinib?
We do not list a known interaction between Bacillus Subtilis and Tofacitinib. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Bacillus Subtilis and Tofacitinib have any of the same side effects?
Yes — our sources link each of them separately to 3 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Are Bacillus Subtilis and Tofacitinib used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Bacillus Subtilis in each. That is a conversation for your prescriber, especially if Tofacitinib is being adjusted to a target.
How was the Bacillus Subtilis and Tofacitinib combination checked?
Interactions in our licensed database are recorded against drug classes. Tofacitinib is filed under 4 classifications, and Bacillus Subtilis has documented interactions with 1 drug class — none of Tofacitinib's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Bacillus Subtilis interact with any other medications?
Yes. Bacillus Subtilis has 182 documented drug interactions in our database — Tofacitinib is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Tofacitinib interact with any supplements?
Yes. Tofacitinib has documented interactions with 184 supplements in our database — Bacillus Subtilis is not one of them. The Tofacitinib interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Bacillus Subtilis monograph Uses, safety profile, and every drug interaction in one place Tofacitinib drug information The full plain-English guide to this medication Tofacitinib supplement interactions Every supplement checked against Tofacitinib, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 10 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Tofacitinib 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.