Drug & supplement interaction

Fermented Milk + Pretomanid

Pretomanid brand name: Pretomanid.

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

Pretomanid falls into 2 drug categories that Fermented Milk can interact with; the most serious is rated moderate. Theoretically, antibiotic drugs might decrease the effectiveness of fermented milk.

Read the full interaction report
SeverityModerate
LikelihoodProbable
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Fermented Milk and Pretomanid

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Fermented Milk interacts with whole categories of medication. Pretomanid falls into 2 of those categories, so it can interact with Fermented Milk in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTIBIOTIC DRUGS

1 of 2

Why this applies to Pretomanid

Pretomanid 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 thing to know about pairing fermented milk like yogurt or kefir with Pretomanid: the concern runs in only one direction. Pretomanid is an antibiotic, and antibiotics can kill off the live probiotic bacteria (the lactobacilli and bifidobacteria) in fermented milk. So it's the supplement that may lose some benefit here, not your TB treatment. Pretomanid's effectiveness against tuberculosis is not weakened by yogurt.

This is a theoretical interaction based on how these things work, not strong real-world data, so don't worry. If you take fermented milk for gut health, simply space it about 2 hours apart from your dose. Keep taking your Pretomanid exactly as prescribed, and ask your pharmacist if you have questions.

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
Moderate

IMMUNOSUPPRESSANTS

2 of 2

Pretomanid also falls under IMMUNOSUPPRESSANTS.

Theoretically, fermented milk might decrease the effects of immunosuppressants.
Clinical research suggests that fermented milk has immunostimulant effects.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the honest picture with pretomanid: the interaction we have on file is really about immune-suppressing drugs, and the idea is that fermented milk may gently nudge the immune system to be a bit more active. The thinking is that this could work against medicines whose whole job is to quiet down the immune system.

But pretomanid isn't one of those. It's an antibacterial that kills the TB bug, not an immunosuppressant, so this particular concern doesn't really map onto it. On top of that, this is a theoretical flag based on how things work in the lab, not on real cases. I wouldn't expect your yogurt or kefir to weaken pretomanid or change its usual effects. Still, since you're on a serious TB regimen, run your full food and supplement list past your pharmacist or TB doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Turchet, P., Laurenzano, M., Auboiron, S., and Antoine, J. M. Effect of fermented milk containing the probiotic Lactobacillus casei DN-114001 on winter infections in free-living elderly subjects: a randomised, controlled pilot study. J Nutr Health Aging 2
  2. Fukushima, Y., Miyaguchi, S., Yamano, T., Kaburagi, T., Iino, H., Ushida, K., and Sato, K. Improvement of nutritional status and incidence of infection in hospitalised, enterally fed elderly by feeding of fermented milk containing probiotic Lactobacillus
  3. Cobo Sanz, J. M., Mateos, J. A., and Munoz Conejo A. [Effect of Lactobacillus casei on the incidence of infectious conditions in children]. Nutr Hosp 2006;21(4):547-551.
  4. Tormo Carnicer R., Infante Pina D., Rosello Mayans E., and Bartolome Comas R. [Intake of fermented milk containing Lactobacillus casei DN-114 001 and its effect on gut flora]. An Pediatr (Barc) 2006;65(5):448-453.
  5. Rio, M. E., Zago Beatriz L., Garcia, H., and Winter, L. [The nutritional status change the effectiveness of a dietary supplement of lactic bacteria on the emerging of respiratory tract diseases in children]. Arch Latinoam Nutr 2002;52(1):29-34.

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 Pretomanid one above is among them. If you take anything else, check it against the full list below.

Moderate 473 No known interaction 2,357 (incl. Pretomanid)
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 Pretomanid

This page covers Fermented Milk 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

How much people look this up

Where Fermented Milk 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 Fermented Milk
Top half

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

29 days ago today
Medication Pretomanid
Steady interest

#2,238 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
Medication

About Pretomanid

What Is Pretomanid Used For?

Brand name: Pretomanid

Pretomanid Tablet is used only as part of a three-drug regimen — together with bedaquiline and linezolid — to treat adults with pulmonary (lung) tuberculosis that is resistant to multiple antibiotics, including isoniazid, rifamycins, a fluoroquinolone, and a second-line injectable TB drug. It is also used for adults whose TB is resistant to isoniazid and rifampin and who cannot tolerate or are not responding to standard TB therapy.

Pretomanid Tablets are not for drug-sensitive TB, latent (inactive) TB infection, TB outside the lungs, or TB that responds to standard treatment. They should only be used in combination with bedaquiline and linezolid — safety and effectiveness with other drug combinations have not been established.

See full Pretomanid drug information
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
473 Moderate 2,356 No 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

We also checked Fermented Milk against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,356 medications checked with no known interaction — see the full Fermented Milk list.

See the full Fermented Milk 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
Fermented Milk 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 Fermented Milk and Pretomanid Together: Common Questions

Can you take Fermented Milk 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.
Why are there 2 interactions listed for Fermented Milk and Pretomanid?
Pretomanid belongs to more than one drug category, and Fermented Milk interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Fermented Milk 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

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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.