Drug & supplement interaction

Lacticaseibacillus Casei + Cefixime

Cefixime brand name: Suprax.

Moderate Interaction
The bottom line Moderate

Lacticaseibacillus Casei has a moderate interaction with Cefixime. Theoretically, taking Lacticaseibacillus casei with antibiotic drugs might decrease the effectiveness of L.

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

Lacticaseibacillus Casei and Cefixime

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

Moderate

ANTIBIOTIC DRUGS

Why this applies to Cefixime

Cefixime falls under ANTIBIOTIC DRUGS — the group Lacticaseibacillus Casei interacts with.

Theoretically, taking Lacticaseibacillus casei with antibiotic drugs might decrease the effectiveness of L. casei.
L. casei preparations usually contain live and active organisms. Therefore, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and L. casei preparations by at least two 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: Cefixime (Suprax) is an antibiotic, and antibiotics don't tell the difference between bad bacteria and the friendly bacteria in your probiotic. So if you swallow your L. casei at the same time as your cefixime dose, the antibiotic can kill off a chunk of those live probiotic organisms before they ever get to work. This doesn't make the cefixime weaker or more dangerous, and it won't change how it fights your infection. The only thing that takes a hit is the probiotic.

An easy fix is to space them out. Taking your L. casei at least two hours apart from your cefixime dose gives the probiotic a better shot at surviving. This is based on how the two work together rather than hard studies, so it's a sensible habit, not a strict rule. Your pharmacist can help you set up the timing.

References
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.

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

Lacticaseibacillus Casei Also Interacts With Other Medications

Lacticaseibacillus Casei has 181 moderate known drug interactions in our database — the Cefixime 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 Lacticaseibacillus Casei

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

Everything else you take

See Every Supplement That Interacts With Cefixime

This page covers Lacticaseibacillus Casei only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cefixime page lists 60 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Siberian Cocklebur (major), African Wild Potato (moderate) and Aristolochia (moderate).

By severity: 3 major · 46 moderate · 11 minor.

From our pharmacist’s overview on the Cefixime page

“Cefixime (Suprax) is an oral antibiotic for bacterial infections, and this list of 60 supplements and herbs deserves a careful read, because three entries are rated major. Siberian cocklebur and asarabacca can both damage the kidneys, and activated charcoal can soak up the antibiotic in your gut so less of it reaches your blood.”

Reviewed by 2 · Jul 18, 2026

Open the Cefixime interaction page

How much people look this up

Where Lacticaseibacillus Casei and Cefixime 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 Lacticaseibacillus Casei
Top half

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

29 days ago today
Medication Cefixime
Top 25%

#425 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 Lacticaseibacillus Casei

What is Lacticaseibacillus Casei?

  • Digestive health
  • Diarrhea (including antibiotic-related)
  • Immune support
  • Constipation
  • Gut microbiome balance

Lacticaseibacillus casei (formerly Lactobacillus casei) is a 'friendly' probiotic bacterium found in fermented foods and many supplements. It is most studied for digestive issues like diarrhea, where some evidence is encouraging, but results vary by strain and condition. It is generally well tolerated in healthy people, but those with weakened immune systems should check with a doctor first.

Read the full Lacticaseibacillus Casei monograph & all interactions
Medication

About Cefixime

What Is Cefixime Used For?

Brand name: Suprax

Cefixime treats several bacterial infections in adults and children six months and older. These include uncomplicated urinary tract infections (UTIs), otitis media (ear infections), pharyngitis and tonsillitis (strep throat and tonsil infections), acute exacerbations of chronic bronchitis (sudden worsening of ongoing bronchitis), and uncomplicated gonorrhea (cervical or urethral).

Cefixime tablets are indicated only for adults and children weighing more than 45 kg or older than 12 years, and tablets are not approved for otitis media — ear infections must be treated with the oral suspension or, where available, chewable tablets. Cefixime oral suspension and capsules are approved for the same infections across the full pediatric age range (six months and older).

See full Cefixime drug information
Keep checking

Other Drugs & Lacticaseibacillus Casei

Browse every other medication we’ve checked against Lacticaseibacillus Casei — 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
Moderate

181 interactions

Showing 60 of 181 moderate interactions — see all 181 on the Lacticaseibacillus Casei page.

No interaction 2,648 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 Lacticaseibacillus Casei and Cefixime Together: Common Questions

Can you take Lacticaseibacillus Casei with Cefixime?
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 Lacticaseibacillus Casei and Cefixime 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.