Drug & supplement interaction

Lacticaseibacillus Casei + Ketoconazole

Ketoconazole brand name: Nizoral.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Lacticaseibacillus Casei and Ketoconazole in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Lacticaseibacillus Casei and Ketoconazole

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Ketoconazole and Lacticaseibacillus Casei in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Lacticaseibacillus Casei safety at a glance

Lacticaseibacillus... overall Use caution Generally well tolerated in healthy people, but caution is needed for those with weakened immune systems or serious illness.
Pregnancy Possibly Safe When used orally and appropriately. A combination of Lacticaseibacillus casei, Lactobacillus acidophilus, and Bifidobacterium bifidum has been used with apparen... Read the full pregnancy detail
Breastfeeding Use caution Likely low risk but not well studied; talk to your healthcare provider first.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Ketoconazole and Lacticaseibacillus Casei? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Ketoconazole

Interactions in our licensed database are recorded against drug classes, not just single drug names. Ketoconazole is filed under 8 classifications — including antifungals, cytochrome p450 2c19 (cyp2c19) inhibitors, cytochrome p450 2c9 (cyp2c9) inhibitors. Lacticaseibacillus Casei has documented interactions with 1 drug class — the most serious being antibiotic drugs (moderate) — and none of Ketoconazole’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Lacticaseibacillus Casei Does Interact With Other Medications

Lacticaseibacillus Casei has 182 moderate known drug interactions in our database — Ketoconazole isn’t one of them. If you take anything else, check it against the full list below.

Moderate 182 No known interaction 2,648 (incl. Ketoconazole)
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.

What to actually watch for

No Interaction Found — But Data Suggests Lacticaseibacillus Casei and Ketoconazole May Share a Side Effect

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Stomach pain Additional detail

    Lacticaseibacillus Casei

    “Orally, taking Lacticaseibacillus casei in combination with other probiotics may cause gastrointestinal side effects including abdominal pain; however, these events are uncommon.”

    Lacticaseibacillus Casei · Natural Medicines adverse-effect record, reported in pain.

    1 source cited
    1. 90291. Shavakhi A, Tabesh E, Yaghoutkar A, Hashemi H, Tabesh F, Khodadoostan M,Minakari M, Shavakhi S, Gholamrezaei A. The effects of multistrain probiotic compound on bismuth-containing quadruple therapy for Helicobacter pylori infection: a randomized placebo-c

    Ketoconazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoconazole. Read the label on DailyMed ›

Reported for Lacticaseibacillus Casei but not commonly for Ketoconazole: raised blood pressure and a higher chance of infection.

Effects for Ketoconazole come from the ADVERSE REACTIONS section of its FDA label; effects for Lacticaseibacillus Casei come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Lacticaseibacillus Casei in Pregnancy & Breastfeeding

Pregnancy Possibly Safe

When used orally and appropriately. A combination of Lacticaseibacillus casei, Lactobacillus acidophilus, and Bifidobacterium bifidum has been used with apparent safety for 6 weeks, starting at 24-28 weeks' gestation.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

From our Q&A

Questions About Lacticaseibacillus Casei or Ketoconazole

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Lacticaseibacillus Casei or Ketoconazole, 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 Ketoconazole

This page covers Lacticaseibacillus Casei only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ketoconazole page lists 182 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 135 moderate · 41 minor.

From our pharmacist’s overview on the Ketoconazole page

“Ketoconazole (Nizoral) is already hard on the liver, so treat its 182 interacting supplements with genuine care, starting with the six rated major. Most of the list runs through CYP3A4, the liver enzyme ketoconazole strongly blocks, so it can raise levels of over a hundred herbal ingredients, while grapefruit pushes ketoconazole itself…”

Reviewed by 2 · Jul 18, 2026

Open the Ketoconazole interaction page

How much people look this up

Where Lacticaseibacillus Casei and Ketoconazole 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
Steady interest

#1,127 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Ketoconazole
Steady interest

#1,952 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Lacticaseibacillus Casei reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Lacticaseibacillus Casei and Ketoconazole records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Lacticaseibacillus casei · Lactobacillaceae · Whole live bacteria (probiotic strain) · Capsules, tablets, powders, fermented dairy products like yogurt and probiotic drinks

An interaction check asks whether these two react with each other — it does not ask whether Lacticaseibacillus Casei is a good idea for someone in your situation. Here is what our Lacticaseibacillus Casei record says about it on its own.

Lacticaseibacillus Casei: dosing

There is no single official standardized dose for L. casei. Probiotic amounts are usually measured in colony-forming units (CFUs), and products vary widely.The best approach is to follow the directions on the product label.

From our Lacticaseibacillus Casei monograph — the full record covers uses, side effects and every documented interaction.

Read the full Lacticaseibacillus Casei monograph & all interactions
Medication

About Ketoconazole

What Is Ketoconazole Used For?

Brand name: Nizoral

Ketoconazole 2% shampoo and foam are used to treat tinea versicolor (also called pityriasis versicolor) — a fungal infection caused by Pityrosporum orbiculare (also known as Malassezia furfur), a yeast that naturally lives on the skin.

This infection creates light or dark patches, most often on the trunk, neck, arms, and upper thighs. Even after the fungus is cleared, those skin patches may take months to return to their normal color — that's normal, and depends on your skin type and sun exposure. Tinea versicolor can also come back, since the fungus lives on healthy skin even when there's no active infection.

Most-Reported Side Effects for Ketoconazole

From FAERS, the FDA’s public side-effect reporting system (0 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Pruritus 984 reports
Fatigue 975 reports
Nausea 873 reports
Rash 858 reports
Diarrhea 814 reports
See full Ketoconazole 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
182Moderate
0Minor
2,647No known interaction
182 Moderate 2,647 No interaction
Moderate

182 interactions

Showing 60 of 182 moderate interactions — see all 182 on the Lacticaseibacillus Casei page.

No interaction 2,647 drugs checked — show the list

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

Showing the 60 most looked-up of 2,647 medications checked with no known interaction — see the full Lacticaseibacillus Casei list.

See the full Lacticaseibacillus Casei interactions page
See every supplement checked against Ketoconazole, ranked by severity
Evidence & sources

Lacticaseibacillus Casei References

The 10 references that drive our Lacticaseibacillus Casei monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Orkaby AR, Chen B, Iliaki EF, Sulis CA, Oates DJ. A curious case of Lactobacillus casei in a prosthetic joint: was it the yogurt? J Am Geriatr Soc. 2012;60(6):1177-8.
  3. Shavakhi A, Tabesh E, Yaghoutkar A, Hashemi H, Tabesh F, Khodadoostan M,Minakari M, Shavakhi S, Gholamrezaei A. The effects of multistrain probiotic compound on bismuth-containing quadruple therapy for Helicobacter pylori infection: a randomized placebo-c
  4. Karamali M, Dadkhah F, Sadrkhanlou M, et al. Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Metab 2016;42(4):234-41. PubMed
  5. Topcuoglu S, Gursoy T, Ovali F, Serce O, Karatekin G. A new risk factor for neonatal vancomycin-resistant Enterococcus colonisation: bacterial probiotics. J Matern Fetal Neonatal Med. 2015;28(12):1491-4. PubMed
  6. Badehnoosh B, Karamali M, Zarrati M, et al. The effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. J Matern Fetal Neonatal Med. 2018 May;31(9):1128-1136.
  7. Rossi F, Amadoro C, Gasperi M, Colavita G. Lactobacilli infection case reports in the last three years and safety implications. Nutrients. 2022;14(6):1178. PubMed
  8. de Seynes C, Dutronc H, Cremer P, Dupon M. Lactobacillus casei prosthetic joint infection. Med Mal Infect 2018;48(6):422-423. PubMed
  9. Russo A, Angeletti S, Lorino G, et al. A case of Lactobacillus casei bacteraemia associated with aortic dissection: is there a link?. New Microbiol 2010;33(2):175-8.
  10. Rahman A, Alqaisi S, Nath J. A Case of Lactobacillus casei endocarditis associated with probiotic intake in an immunocompromised patient. Cureus. 2023;15(4):e38049. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Lacticaseibacillus Casei and Ketoconazole Together: Common Questions

Is it safe to take Lacticaseibacillus Casei with Ketoconazole?
We do not list a known interaction between Lacticaseibacillus Casei and Ketoconazole. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Lacticaseibacillus Casei and Ketoconazole have any of the same side effects?
Yes — our sources link each of them separately to one of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Lacticaseibacillus Casei and Ketoconazole combination checked?
Interactions in our licensed database are recorded against drug classes. Ketoconazole is filed under 8 classifications, and Lacticaseibacillus Casei has documented interactions with 1 drug class — none of Ketoconazole's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Lacticaseibacillus Casei interact with any other medications?
Yes. Lacticaseibacillus Casei has 182 documented drug interactions in our database — Ketoconazole is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Ketoconazole interact with any supplements?
Yes. Ketoconazole has documented interactions with 182 supplements in our database — Lacticaseibacillus Casei is not one of them. The Ketoconazole interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Lacticaseibacillus Casei monograph Uses, safety profile, and every drug interaction in one place Ketoconazole drug information The full plain-English guide to this medication Ketoconazole supplement interactions Every supplement checked against Ketoconazole, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 10 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Ketoconazole and Lacticaseibacillus Casei?

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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.