Drug & supplement interaction

Lacticaseibacillus Paracasei + Tofacitinib

Tofacitinib brand names: Xeljanz, Xeljanz XR.

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 Paracasei and Tofacitinib 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 Paracasei and Tofacitinib

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 Tofacitinib and Lacticaseibacillus Paracasei 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 Paracasei safety at a glance

Lacticaseibacillus... overall Use caution Generally well tolerated in healthy people, but caution is needed for those who are seriously ill or have weakened immune systems.
Pregnancy Possibly Safe When used orally and appropriately. A combination of Lacticaseibacillus paracasei and Bifidobacterium longum from 2 months prior to delivery until 2 months afte... Read the full pregnancy detail
Breastfeeding Possibly Safe When used orally and appropriately. A combination of Lacticaseibacillus paracasei and Bifidobacterium longum from 2 months prior to delivery until 2 months afte... Read the full breastfeeding detail

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 Tofacitinib and Lacticaseibacillus Paracasei? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Tofacitinib

Interactions in our licensed database are recorded against drug classes, not just single drug names. Tofacitinib is filed under 4 classifications — including cytochrome p450 2c19 (cyp2c19) substrates, immunosuppressants, cytochrome p450 3a4 (cyp3a4) substrates. Lacticaseibacillus Paracasei has documented interactions with 1 drug class — the most serious being antibiotic drugs (moderate) — and none of Tofacitinib’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 Paracasei Does Interact With Other Medications

Lacticaseibacillus Paracasei has 182 moderate known drug interactions in our database — Tofacitinib 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. Tofacitinib)
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.

What to actually watch for

No Interaction Found — But Data Suggests Lacticaseibacillus Paracasei and Tofacitinib May Share Several of the Same Side Effects

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. One of them is worth acting on rather than waiting out — marked below.

  • A higher chance of infection Worth acting on Additional detail

    Lacticaseibacillus Paracasei

    “Since Lacticaseibacillus paracasei preparations contain live and active microorganisms, there is some concern that they might cause pathogenic infection in some patients. Lactobacilli species, including L. paracasei, have been isolated in some cases of bacteremia, sepsis, splenic abscess, endocarditis, necrotizing fasciitis, pancreatic necrosis, meningoencephalitis, and prosthetic joint infections. Most cases of L.”

    Lacticaseibacillus Paracasei · Natural Medicines adverse-effect record, reported in cardiovascular disease (cvd).

    6 sources cited
    1. 107543. 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
    2. 111942. Harding-Theobald E, Maraj B. Spontaneous bacterial peritonitis due to Lactobacillus paracasei in cirrhosis. Case Rep Gastrointest Med 2018;2018:5714053.
    3. 111944. Tan C, Howard JL, Bondy L. Prosthetic joint infection after total hip arthroplasty caused by Lactobacillus paracasei. CMAJ 2020;192(44):E1357-E1360.
    4. 111946. Miwa T, Tanaka H, Shiojiri T. Infected pancreatic necrosis and retroperitoneal abscess associated with Lactobacillus paracasei. BMJ Case Rep 2021;14(8):e243936.
    5. 90282. 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.
    6. 90254. Franko B, Vaillant M, Recule C, Vautrin E, Brion JP, Pavese P. Lactobacillus paracasei endocarditis in a consumer of probiotics. Med Mal Infect 2013;43(4):171-3. PubMed

    Tofacitinib

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

  • A skin rash Additional detail

    Lacticaseibacillus Paracasei

    “Orally, in one clinical trial, a combination of Lacticaseibacillus paracasei subsp. paracasei F19, Lactobacillus acidophilus La-5, and Bifidobacterium animalis subsp. lactis BB-12 was associated with two cases of rash, one with itching. However, it is not clear if these adverse effects were due to L.”

    Lacticaseibacillus Paracasei · Natural Medicines adverse-effect record, reported in erythema.

    2 sources cited
    1. 90236. Begtrup LM, de Muckadell OB, Kjeldsen J, Christensen RD, Jarbøl DE. Long-term treatment with probiotics in primary care patients with irritable bowel syndrome--a randomised, double-blind, placebo controlled trial. Scand J Gastroenterol 2013;48(10):1127-35 PubMed
    2. 111945. Sathikulpakdee S, Kanokrungsee S, Vitheejongjaroen P, Kamanamool N, Udompataikul M, Taweechotipatr M. Efficacy of probiotic-derived lotion from Lactobacillus paracasei MSMC 39-1 in mild to moderate acne vulgaris, randomized controlled trial. J Cosmet Derm

    Tofacitinib

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

Reported for Lacticaseibacillus Paracasei but not commonly for Tofacitinib: bloating or gas, stomach upset, itching and nausea.

Effects for Tofacitinib come from the ADVERSE REACTIONS section of its FDA label; effects for Lacticaseibacillus Paracasei come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 185,980 voluntary FDA FAERS reports for Tofacitinib that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. 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 Paracasei in Pregnancy & Breastfeeding

Pregnancy And Lactation Possibly Safe

When used orally and appropriately. A combination of Lacticaseibacillus paracasei and Bifidobacterium longum from 2 months prior to delivery until 2 months after delivery has been used with apparent safety.

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

Overlapping uses

What Tofacitinib Is Prescribed For, and What Lacticaseibacillus Paracasei Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Tofacitinib is a prescription medicine with approved uses on its FDA label. Lacticaseibacillus Paracasei is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Lacticaseibacillus Paracasei has been studied for:

  • Ulcerative colitis studied, not established Lacticaseibacillus Paracasei has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Lacticaseibacillus Paracasei for ulcerative colitis

    Oral Lacticaseibacillus paracasei has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Tofacitinib on your own; if you are taking Lacticaseibacillus Paracasei for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

Everything else you take

See Every Supplement That Interacts With Tofacitinib

This page covers Lacticaseibacillus Paracasei only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tofacitinib page lists 184 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 3 major · 143 moderate · 38 minor.

From our pharmacist’s overview on the Tofacitinib page

“Supplements deserve genuine care alongside tofacitinib (Xeljanz, Xeljanz XR), a medicine that deliberately dials down the immune system to control conditions like rheumatoid arthritis and ulcerative colitis. Most of the interactions on this page run through the liver enzymes that clear the drug, meaning an herb can push its blood level…”

Reviewed by 2 · Jul 18, 2026

Open the Tofacitinib interaction page

How much people look this up

Where Lacticaseibacillus Paracasei and Tofacitinib 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

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

29 days ago today
Medication Tofacitinib
Steady interest

#1,746 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 Paracasei reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Lacticaseibacillus Paracasei and Tofacitinib records this page draws on were last updated July 10, 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 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.

Lacticaseibacillus paracasei · Lactobacillaceae · Live bacterial cells (probiotic strain) · Capsules, tablets, powders, sachets, fermented dairy products (yogurt, kefir), and functional foods

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

Lacticaseibacillus Paracasei: dosing

There is no single official or standardized dose of L. paracasei. Probiotic doses are usually measured in colony-forming units (CFU), and the right amount can depend on the strain and the intended use.Because formulations differ, the best approach is to follow the dose on the product label. Storing the product as directed (some need refrigeration) helps keep the bacteria alive and effective.

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

Read the full Lacticaseibacillus Paracasei monograph & all interactions
Medication

About Tofacitinib

What Is Tofacitinib Used For?

Brand names: Xeljanz, Xeljanz XR

  • Tofacitinib is used alone or with other medications to treat rheumatoid arthritis (condition in which the body attacks its own joints causing pain, swelling, and loss of function) in adults who are unable to take or did not respond to one or more tumor necrosis factor (TNF) inhibitor medication(s). It is also used to treat psoriatic arthritis (a condition that causes joint pain and swelling and scales on the skin) in adults who are unable to take or did not respond to or tolerate one or more TNF inhibitor medication(s). Tofacitinib is used to treat ulcerative colitis (a condition which causes swelling and sores in the lining of the colon [large intestine] and rectum) in adults who are unable to take or who did not respond to one or more TNF inhibitor medication(s). It is also used to treat polyarticular juvenile idiopathic arthritis (PJIA; a type of childhood arthritis that affects five or more joints during the first six months of the condition, causing pain, swelling, and loss of function) in children 2 years and older who are unable to take or who did not respond to one or more TNF inhibitor medication(s). Tofacitinib is in a class of medications called Janus kinase (JAK) inhibitors. It works by decreasing the activity of the immune system.

See full Tofacitinib 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
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 Paracasei page.

No interaction 2,647 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 2,647 medications checked with no known interaction — see the full Lacticaseibacillus Paracasei list.

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

Lacticaseibacillus Paracasei References

The 16 references that drive our Lacticaseibacillus Paracasei 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. Begtrup LM, de Muckadell OB, Kjeldsen J, Christensen RD, Jarbøl DE. Long-term treatment with probiotics in primary care patients with irritable bowel syndrome--a randomised, double-blind, placebo controlled trial. Scand J Gastroenterol 2013;48(10):1127-35 PubMed
  3. Franko B, Vaillant M, Recule C, Vautrin E, Brion JP, Pavese P. Lactobacillus paracasei endocarditis in a consumer of probiotics. Med Mal Infect 2013;43(4):171-3. PubMed
  4. 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.
  5. Rautava S, Kainonen E, Salminen S, Isolauri E. Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant. J Allergy Clin Immunol. 2012;130(6):1355-60. PubMed
  6. Kato K, Funabashi N, Takaoka H, et al. Lactobacillus paracasei endocarditis in a consumer of probiotics with advanced and severe bicuspid aortic valve stenosis complicated with diffuse left ventricular mid-layer fibrosis. Int J Cardiol 2016;224:157-61. PubMed
  7. Lee C, Wongjarupong N, Narayan M, Melzer AC. Acute cholecystitis complicated with gallbladder perforation and peritonitis caused by vancomycin-resistant Lactobacillus paracasei. Cureus. 2020;12(3):e7476. PubMed
  8. Cai T, Gallelli L, Cione E, et al. The use of Lactobacillus casei DG® prevents symptomatic episodes and reduces the antibiotic use in patients affected by chronic bacterial prostatitis: results from a phase IV study. World J Urol. 2021. DOI
  9. Kumar S, Kumar R, Rohilla L, Jacob N, Yadav J, Sachdeva N. A high potency multi-strain probiotic improves glycemic control in children with new-onset type 1 diabetes mellitus: A randomized, double-blind, and placebo-controlled pilot study. Pediatr Diabete
  10. 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
  11. Campbell RE, Miller A, Afroze A. Native valve endocarditis secondary to Lactobacillus paracasei bacteremia. Consultant. 2020;60(9):27-8. DOI
  12. Harding-Theobald E, Maraj B. Spontaneous bacterial peritonitis due to Lactobacillus paracasei in cirrhosis. Case Rep Gastrointest Med 2018;2018:5714053.
  13. Tan C, Howard JL, Bondy L. Prosthetic joint infection after total hip arthroplasty caused by Lactobacillus paracasei. CMAJ 2020;192(44):E1357-E1360.
  14. Sathikulpakdee S, Kanokrungsee S, Vitheejongjaroen P, Kamanamool N, Udompataikul M, Taweechotipatr M. Efficacy of probiotic-derived lotion from Lactobacillus paracasei MSMC 39-1 in mild to moderate acne vulgaris, randomized controlled trial. J Cosmet Derm
  15. Miwa T, Tanaka H, Shiojiri T. Infected pancreatic necrosis and retroperitoneal abscess associated with Lactobacillus paracasei. BMJ Case Rep 2021;14(8):e243936.

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 Paracasei and Tofacitinib Together: Common Questions

Is it safe to take Lacticaseibacillus Paracasei with Tofacitinib?
We do not list a known interaction between Lacticaseibacillus Paracasei and Tofacitinib. 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 Paracasei and Tofacitinib have any of the same side effects?
Yes — our sources link each of them separately to 2 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.
Are Lacticaseibacillus Paracasei and Tofacitinib used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Lacticaseibacillus Paracasei in each. That is a conversation for your prescriber, especially if Tofacitinib is being adjusted to a target.
How was the Lacticaseibacillus Paracasei and Tofacitinib combination checked?
Interactions in our licensed database are recorded against drug classes. Tofacitinib is filed under 4 classifications, and Lacticaseibacillus Paracasei has documented interactions with 1 drug class — none of Tofacitinib'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 Paracasei interact with any other medications?
Yes. Lacticaseibacillus Paracasei has 182 documented drug interactions in our database — Tofacitinib 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 Tofacitinib interact with any supplements?
Yes. Tofacitinib has documented interactions with 184 supplements in our database — Lacticaseibacillus Paracasei is not one of them. The Tofacitinib 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 Paracasei monograph Uses, safety profile, and every drug interaction in one place Tofacitinib drug information The full plain-English guide to this medication Tofacitinib supplement interactions Every supplement checked against Tofacitinib, 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 16 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Tofacitinib 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.