Drug & supplement interaction

Bifidobacterium Longum + Azithromycin

Azithromycin brand names: Zithromax, Zmax, Azasite.

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

Bifidobacterium Longum has a moderate interaction with Azithromycin. Theoretically, taking Bifidobacterium longum 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 Longum and Azithromycin

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

Moderate

ANTIBIOTIC DRUGS

Why this applies to Azithromycin

Azithromycin falls under ANTIBIOTIC DRUGS — the group Bifidobacterium Longum interacts with.

Theoretically, taking Bifidobacterium longum with antibiotic drugs might decrease the effectiveness of B. longum.
Since B. longum 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. longum 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 of this one. Azithromycin (Zithromax) is an antibiotic, and its whole job is to kill bacteria. The catch is that a Bifidobacterium longum probiotic is made of live, helpful bacteria. If you swallow them at the same time, the antibiotic can't tell friend from foe, so it may wipe out a good chunk of those probiotic organisms before they ever get to work. This doesn't make your azithromycin less effective or more dangerous. It just means the probiotic gets shortchanged.

The easy fix most pharmacists suggest is spacing them out by at least 2 hours. This concern is mostly theoretical, based on how the two work, so don't stress. Just check with your pharmacist on timing if you want the probiotic to do its job.

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 Longum Also Interacts With Other Medications

Bifidobacterium Longum has 181 moderate known drug interactions in our database — the Azithromycin 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. Azithromycin)
Taking anything else?

Check Another of Your Medications Against Bifidobacterium Longum

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

From our Q&A

Questions About Bifidobacterium Longum or Azithromycin

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Bifidobacterium Longum or Azithromycin, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Azithromycin

This page covers Bifidobacterium Longum only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Azithromycin page lists 92 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 · 71 moderate · 13 minor.

From our pharmacist’s overview on the Azithromycin page

“A five-day Z-Pak for a sinus or chest infection seems too brief to fuss over, but azithromycin (Zithromax, Zmax) deserves genuine caution around supplements, and the eight major-rated entries on this list are the ones to understand first. Most of those involve the heart.”

Reviewed by 2 · Jul 18, 2026

Open the Azithromycin interaction page

One more smart check

Taking Bifidobacterium Longum as Part of a Dietary Supplement Product? Check It for Interactions

We hold 3,189 real supplement products containing Bifidobacterium Longum, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bifidobacterium Longum. Your product may carry other ingredients that interact with Azithromycin too, on top of Bifidobacterium Longum — 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 Longum and Azithromycin 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 Longum
Top 10%

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

29 days ago today
Medication Azithromycin
Top 5%

#31 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 Longum

What is Bifidobacterium Longum?

  • Digestive health and regularity
  • Irritable bowel syndrome (IBS)
  • Diarrhea (including antibiotic-related)
  • Immune support
  • Mood and stress (gut-brain axis)

Bifidobacterium longum is a 'friendly' bacterium found naturally in the human gut and used as a probiotic. It is generally well tolerated and is most studied for digestive issues, though evidence for many uses is still limited or mixed. Talk to your pharmacist or doctor before using it, especially if you have a weakened immune system.

Read the full Bifidobacterium Longum monograph & all interactions
Medication

About Azithromycin

What Is Azithromycin Used For?

Brand names: Zithromax, Zmax, Azasite

Azithromycin treats mild to moderate infections caused by susceptible bacteria. Oral tablets and oral suspension are used for several infection types in adults and, for some, children.

Oral uses include acute bacterial flare-ups of chronic bronchitis, acute bacterial sinusitis, uncomplicated skin infections, urethritis and cervicitis, genital ulcer disease in men, ear infections (acute otitis media) in children, community-acquired pneumonia, and pharyngitis/tonsillitis. The injection (Zithromax and azithromycin for injection) is used for community-acquired pneumonia in adults and pelvic inflammatory disease. AzaSite eye drops are used only for bacterial conjunctivitis (pink eye).

See full Azithromycin drug information
Keep checking

Other Drugs & Bifidobacterium Longum

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

No interaction 2,648 drugs checked — show the list

We also checked Bifidobacterium Longum 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 Longum list.

See the full Bifidobacterium Longum interactions page
See every supplement checked against Azithromycin, 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 Longum monograph › Uses, safety, and every drug interaction in one place Azithromycin supplement interactions › Every supplement checked against Azithromycin, ranked by severity Azithromycin 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 Longum and Azithromycin Together: Common Questions

Can you take Bifidobacterium Longum with Azithromycin?
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 Longum and Azithromycin 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 Azithromycin and Bifidobacterium Longum?

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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.