Drug & supplement interaction

Fermented Milk + Phenazopyridine, Sulfamethizole

Phenazopyridine, Sulfamethizole brand names: Thiosulfil-A, Thiosulfil-A Forte.

Moderate Interaction
The bottom line Moderate

Fermented Milk has a moderate interaction with Phenazopyridine, Sulfamethizole. Theoretically, antibiotic drugs might decrease the effectiveness of fermented milk.

Read the full interaction report
SeverityModerate
LikelihoodProbable
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Fermented Milk and Phenazopyridine, Sulfamethizole

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

Moderate

ANTIBIOTIC DRUGS

Why this applies to Phenazopyridine, Sulfamethizole

Phenazopyridine, Sulfamethizole falls under ANTIBIOTIC DRUGS — the group Fermented Milk interacts with.

Theoretically, antibiotic drugs might decrease the effectiveness of fermented milk.
Some fermented milk preparations contain live and active organisms, including lactobacilli and bifidobacteria strains. Simultaneously taking antibiotics might kill a significant number of these organisms. Tell patients to separate administration of antibiotics and fermented milk 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 good news: this combo is mostly about protecting your fermented milk, not your medicine. Your product (Thiosulfil-A) pairs phenazopyridine, a urinary pain reliever that turns your urine orange, with sulfamethizole, a sulfa antibiotic. That antibiotic is meant to kill bacteria, and it can't tell the difference between bad bugs and the friendly lactobacilli and bifidobacteria in your yogurt or kefir.

So the antibiotic may simply wipe out the live probiotics, making the fermented milk less useful for your gut. This is a theoretical concern based on how these drugs work, not a dangerous reaction. A simple fix is to space them out by at least 2 hours. Your antibiotic still works fine either way. Check with your pharmacist if you have questions.

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

Fermented Milk Also Interacts With Other Medications

Fermented Milk has 473 moderate known drug interactions in our database — the Phenazopyridine, Sulfamethizole one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Fermented Milk

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

Everything else you take

See Every Supplement That Interacts With Phenazopyridine, Sulfamethizole

This page covers Fermented Milk only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Phenazopyridine, Sulfamethizole page lists 44 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Bacillus Coagulans (moderate), Bacillus Subtilis (moderate), Bifidobacterium Animalis Subsp. Lactis (moderate) and Bifidobacterium Bifidum (moderate).

By severity: 1 major · 33 moderate · 10 minor.

From our pharmacist’s overview on the Phenazopyridine, Sulfamethizole page

“Phenazopyridine with sulfamethizole (Thiosulfil-A) pairs a sulfa antibiotic with a urinary pain reliever, usually prescribed for a bladder infection, and this list deserves real attention, not a glance. The single major-rated interaction among the 44 ingredients on file is activated charcoal, which can bind the medication in the gut an…”

Reviewed by 2 · Jul 18, 2026

Open the Phenazopyridine, Sulfamethizole interaction page

How much people look this up

Where Fermented Milk and Phenazopyridine, Sulfamethizole 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 Fermented Milk
Top half

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

29 days ago today
Medication Phenazopyridine, Sulfamethizole
Top 10%

#276 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 Fermented Milk

What is Fermented Milk?

  • Digestive health
  • Supporting gut bacteria (probiotics)
  • Lactose-related digestive discomfort
  • General nutrition (protein, calcium)
  • Immune support
  • Diarrhea prevention

Fermented milk is a food made by culturing milk with helpful bacteria or yeast, and it provides protein, calcium, and probiotics. It is generally safe for most people and may help digestion and gut health, though benefits depend on the product and strains used. People with milk allergy or weakened immune systems should be cautious.

Read the full Fermented Milk monograph & all interactions
Keep checking

Other Drugs & Fermented Milk

Browse every other medication we’ve checked against Fermented Milk — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
473Moderate
0Minor
2,356No known interaction
Moderate

473 interactions

Showing 60 of 473 moderate interactions — see all 473 on the Fermented Milk page.

No interaction 2,356 drugs checked — show the list
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
Pharmacist Counseling Corner

Taking Fermented Milk and Phenazopyridine, Sulfamethizole Together: Common Questions

Can you take Fermented Milk with Phenazopyridine, Sulfamethizole?
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 Fermented Milk and Phenazopyridine, Sulfamethizole 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 Phenazopyridine, Sulfamethizole and Fermented Milk?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.