Drug & supplement interaction

Bifidobacterium Breve + Pretomanid

Pretomanid brand name: Pretomanid.

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

Bifidobacterium Breve has a moderate interaction with Pretomanid. Theoretically, taking Bifidobacterium breve 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

Bifidobacterium Breve 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 Bifidobacterium Breve interacts with.

Theoretically, taking Bifidobacterium breve with antibiotic drugs might decrease the effectiveness of B. breve.
Since B. breve 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. breve 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 simple version: this interaction runs in one direction. Pretomanid is an antibiotic that kills the tough bacteria behind multi-drug resistant tuberculosis, and it isn't picky about only attacking TB. Since Bifidobacterium breve is a probiotic made of live, friendly bacteria, taking it at the same time as Pretomanid means the antibiotic may wipe out a chunk of those probiotic organisms before they can do much good.

So this is about the probiotic being weakened, not your TB treatment. Pretomanid keeps working as usual, and your TB regimen stays effective. To get more value from the probiotic, a common tip is to space the two doses apart by at least 2 hours. This advice is theory-based, but it's easy and harmless. Always run any supplement past your doctor or pharmacist while you're on TB therapy.

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.
  2. Xiao JZ, Takahashi S, Odamaki T, et al. Antibiotic susceptibility of bifidobacterial strains distributed in the Japanese market. Biosci Biotechnol Biochem. 2010;74(2):336-42. PubMed

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

Bifidobacterium Breve Also Interacts With Other Medications

Bifidobacterium Breve 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 Bifidobacterium Breve

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

Everything else you take

See Every Supplement That Interacts With Pretomanid

This page covers Bifidobacterium Breve 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 Bifidobacterium Breve as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,771 real supplement products containing Bifidobacterium Breve, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bifidobacterium Breve. Your product may carry other ingredients that interact with Pretomanid too, on top of Bifidobacterium Breve — 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 Bifidobacterium Breve 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 Bifidobacterium Breve
Top 25%

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

29 days ago today
Medication Pretomanid
Steady interest

#2,515 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 Bifidobacterium Breve

What is Bifidobacterium Breve?

  • Digestive health and regularity
  • Infant colic and gut support
  • Diarrhea (including antibiotic-related)
  • Constipation
  • General immune and gut microbiome support

Bifidobacterium breve is a 'friendly' gut bacterium taken as a probiotic, most often to support digestion and balance the gut microbiome. Some studies suggest possible benefits for certain digestive and infant conditions, but evidence is still limited and varies by strain. It is generally well tolerated in healthy people, but anyone with a weak immune system or serious illness should check with a doctor or pharmacist first.

Read the full Bifidobacterium Breve 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 & Bifidobacterium Breve

Browse every other medication we’ve checked against Bifidobacterium Breve — 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 Bifidobacterium Breve page.

No interaction 2,648 drugs checked — show the list

We also checked Bifidobacterium Breve 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 Bifidobacterium Breve list.

See the full Bifidobacterium Breve 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
Bifidobacterium Breve 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 Bifidobacterium Breve and Pretomanid Together: Common Questions

Can you take Bifidobacterium Breve 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 Bifidobacterium Breve 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 Bifidobacterium Breve?

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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.