Drug & supplement interaction

Galacto-oligosaccharides (gos) + Tocilizumab

Tocilizumab brand name: Actemra.

Moderate Interaction
The bottom line Moderate

Galacto-oligosaccharides (gos) has a moderate interaction with Tocilizumab. Theoretically, GOS might reduce the effects of immunosuppressants.

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

Galacto-oligosaccharides (gos) and Tocilizumab

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

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Tocilizumab

Tocilizumab falls under IMMUNOSUPPRESSANTS — the group Galacto-oligosaccharides (gos) interacts with.

Theoretically, GOS might reduce the effects of immunosuppressants.
Human and animal studies suggest that GOS may stimulate the immune system. This could theoretically alter the effects of immunosuppressant medications.
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 idea behind this one. Tocilizumab (Actemra) works by quieting down part of your immune system to calm the inflammation behind rheumatoid arthritis and similar conditions. GOS is a prebiotic fiber that, in lab and animal research, seems to gently stimulate immune activity. So the theoretical worry is that GOS could nudge your immune system in the opposite direction from what tocilizumab is trying to do, possibly making your treatment work a little less well (think more joint pain or stiffness creeping back).

I want to be honest with you though: this is theoretical only, based on how things behave in studies, not real-world reports of people on Actemra. It's not a reason to panic or stop your fiber. If you'd like, bring it up with your doctor or pharmacist so they can keep an eye on how well your arthritis is controlled.

References
  1. Bakker-Zierikzee AM, Tol EA, Kroes H, et al. Faecal sIgA secretion in infants fed on pre- or probiotic infant formula. Pediatr Allergy Immunol 2006;17(2):134-140. PubMed
  2. Vos AP, Haarman M, Buco A, et al. A specific prebiotic oligosaccharide mixture stimulates delayed-type hypersensitivity in a murine influenza vaccination model. Int Immunopharmacol 2006;6(8):1277-1286. 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

Galacto-oligosaccharides (gos) Also Interacts With Other Medications

Galacto-oligosaccharides (gos) has 120 moderate known drug interactions in our database — the Tocilizumab 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 Galacto-oligosaccharides (gos)

Covers the 2,830 medications we’ve checked against Galacto-oligosaccharides (gos). Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Tocilizumab

This page covers Galacto-oligosaccharides (gos) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tocilizumab page lists 89 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Beer (major), Siberian Cocklebur (major), Wine (major), Active Hexose Correlated Compound (ahcc) (moderate) and Alfalfa (moderate).

By severity: 3 major · 85 moderate · 1 minor.

From our pharmacist’s overview on the Tocilizumab page

“Tocilizumab (Actemra) calms an overactive immune system in conditions like rheumatoid arthritis, and it is also known to strain the liver, which is exactly where its supplement interactions concentrate. This page deserves genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Tocilizumab interaction page

How much people look this up

Where Galacto-oligosaccharides (gos) and Tocilizumab 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 Galacto-oligosaccharides (gos)
Steady interest

#1,267 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Tocilizumab
Top half

#1,284 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 Galacto-oligosaccharides (gos)

What is Galacto-oligosaccharides (gos)?

  • Prebiotic to support gut bacteria
  • Constipation
  • Digestive health
  • Immune support
  • Infant gut health

Galacto-oligosaccharides (GOS) are a type of prebiotic fiber that feed the helpful bacteria in your gut. They are generally well tolerated and may help with digestive regularity and gut balance, though they can cause gas and bloating, especially at higher doses. Evidence is promising but still limited for many uses, so talk with your pharmacist or doctor before starting.

Read the full Galacto-oligosaccharides (gos) monograph & all interactions
Medication

About Tocilizumab Injection

What Is Tocilizumab Injection Used For?

Brand name: Actemra

Tocilizumab injection is used to treat several serious inflammatory and immune-related conditions. Actemra (tocilizumab) is indicated for moderately to severely active rheumatoid arthritis in adults who haven't responded well to other disease-modifying drugs, giant cell arteritis in adults, systemic sclerosis-associated interstitial lung disease (SSc-ILD) to slow lung function decline, polyarticular and systemic juvenile idiopathic arthritis in patients 2 years and older, and severe or life-threatening cytokine release syndrome (CRS) caused by CAR T-cell therapy in adults and children 2 and older.

Actemra is also approved for hospitalized adults and children aged 2 and older with COVID-19 who are on corticosteroids and need supplemental oxygen or mechanical breathing support. Not every brand or route is approved for every use — your prescriber will choose the right form for your specific condition.

See full Tocilizumab Injection drug information
Keep checking

Other Drugs & Galacto-oligosaccharides (gos)

Browse every other medication we’ve checked against Galacto-oligosaccharides (gos) — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
120Moderate
0Minor
2,709No known interaction
Moderate

120 interactions

Showing 60 of 120 moderate interactions — see all 120 on the Galacto-oligosaccharides (gos) page.

No interaction 2,709 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

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Pharmacist Counseling Corner

Taking Galacto-oligosaccharides (gos) and Tocilizumab Together: Common Questions

Can you take Galacto-oligosaccharides (gos) with Tocilizumab?
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 Galacto-oligosaccharides (gos) and Tocilizumab 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.