Drug & supplement interaction

Lacticaseibacillus Paracasei + Plazomicin Sulfate

Plazomicin Sulfate brand name: Zemdri.

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

Lacticaseibacillus Paracasei has a moderate interaction with Plazomicin Sulfate. Theoretically, taking Lacticaseibacillus paracasei 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 Paracasei and Plazomicin Sulfate

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

Moderate

ANTIBIOTIC DRUGS

Why this applies to Plazomicin Sulfate

Plazomicin Sulfate falls under ANTIBIOTIC DRUGS — the group Lacticaseibacillus Paracasei interacts with.

Theoretically, taking Lacticaseibacillus paracasei with antibiotic drugs might decrease the effectiveness of L. paracasei.
L. paracasei 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. paracasei 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: this interaction works the other way around from what most people worry about. The probiotic won't change how well plazomicin fights your infection. Instead, plazomicin (an antibiotic that kills bacteria) can also kill off the live, friendly bacteria in your L. paracasei supplement, so the probiotic may not do much while you're being treated.

One thing to keep in mind: plazomicin is given as an injection in a hospital or clinic setting for serious urinary and kidney infections, so a daily oral probiotic isn't always part of the picture. This concern is mostly theoretical and based on how these products work, not strong studies. If you do want to take a probiotic, ask your pharmacist or doctor about timing it well apart from your antibiotic.

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.

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 Paracasei Also Interacts With Other Medications

Lacticaseibacillus Paracasei has 181 moderate known drug interactions in our database — the Plazomicin Sulfate one above is one of them. If you take anything else, check it against the full list below.

Moderate 181 No known interaction 2,649 (incl. Plazomicin Sulfate)
Taking anything else?

Check Another of Your Medications Against Lacticaseibacillus Paracasei

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

Everything else you take

See Every Supplement That Interacts With Plazomicin Sulfate

This page covers Lacticaseibacillus Paracasei only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Plazomicin Sulfate page lists 35 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Asarabacca (major), Siberian Cocklebur (major), Aristolochia (moderate), Bacillus Coagulans (moderate) and Bacillus Subtilis (moderate).

By severity: 2 major · 31 moderate · 2 minor.

From our pharmacist’s overview on the Plazomicin Sulfate page

“Plazomicin (Zemdri) is an IV antibiotic reserved for serious urinary tract infections, and like other aminoglycosides it can strain the kidneys all by itself. That is why the two major-rated entries on this list matter most: Siberian cocklebur and asarabacca can both harm the kidneys, and stacking either onto plazomicin could compound…”

Reviewed by 2 · Jul 18, 2026

Open the Plazomicin Sulfate interaction page

How much people look this up

Where Lacticaseibacillus Paracasei and Plazomicin Sulfate 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 Paracasei
Steady interest

#1,131 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Plazomicin Sulfate
Steady interest

#2,579 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 Paracasei

What is Lacticaseibacillus Paracasei?

  • Digestive health and regularity
  • Immune support
  • Diarrhea (including antibiotic-associated)
  • Allergy and eczema symptoms
  • Gut microbiome balance

Lacticaseibacillus paracasei (formerly Lactobacillus paracasei) is a probiotic bacterium found in fermented foods and supplements that is widely used to support gut and immune health. Some strains have promising research for digestion, diarrhea, and allergies, but results vary by strain and many uses are not firmly proven. It is generally well tolerated in healthy people, but those who are seriously ill or immune-compromised should check with a doctor first.

Read the full Lacticaseibacillus Paracasei monograph & all interactions
Medication

About Plazomicin Injection

What Is Plazomicin Injection Used For?

Brand name: Zemdri

Zemdri (plazomicin) is approved for adults 18 and older to treat complicated urinary tract infections (cUTI), including pyelonephritis (a serious kidney infection), caused by certain susceptible bacteria such as Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Enterobacter cloacae.

Because clinical data on Zemdri are still limited, it is reserved for patients who have few or no other treatment options. It should only be used when the infection is confirmed or strongly suspected to be caused by bacteria that respond to it, in order to reduce the development of antibiotic-resistant bacteria.

See full Plazomicin Injection drug information
Keep checking

Other Drugs & Lacticaseibacillus Paracasei

Browse every other medication we’ve checked against Lacticaseibacillus Paracasei — 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
181 Moderate 2,648 No interaction
Moderate

181 interactions

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

No interaction 2,648 drugs checked — show the list

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

Showing the 60 most looked-up of 2,648 medications checked with no known interaction — see the full Lacticaseibacillus Paracasei list.

See the full Lacticaseibacillus Paracasei interactions page
See every supplement checked against Plazomicin Sulfate, 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
Lacticaseibacillus Paracasei monograph › Uses, safety, and every drug interaction in one place Plazomicin Sulfate supplement interactions › Every supplement checked against Plazomicin Sulfate, ranked by severity Plazomicin Injection 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 Lacticaseibacillus Paracasei and Plazomicin Sulfate Together: Common Questions

Can you take Lacticaseibacillus Paracasei with Plazomicin Sulfate?
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 Paracasei and Plazomicin Sulfate 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 Plazomicin Sulfate and Lacticaseibacillus Paracasei?

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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.