Drug & supplement interaction

Lacticaseibacillus Rhamnosus + Methenamine Mandelate

Methenamine Mandelate brand names: Mandelamine, Methimazole.

Moderate Interaction
The bottom line Moderate

Lacticaseibacillus Rhamnosus has a moderate interaction with Methenamine Mandelate. Theoretically, taking Lacticaseibacillus rhamnosus 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 Rhamnosus and Methenamine Mandelate

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

Moderate

ANTIBIOTIC DRUGS

Why this applies to Methenamine Mandelate

Methenamine Mandelate falls under ANTIBIOTIC DRUGS — the group Lacticaseibacillus Rhamnosus interacts with.

Theoretically, taking Lacticaseibacillus rhamnosus with antibiotic drugs might decrease the effectiveness of L. rhamnosus.
L. rhamnosus 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. rhamnosus 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 thing to know: this interaction works in one direction. Methenamine mandelate is a urinary antiseptic that releases formaldehyde in acidic urine to fight bacteria. Because it's an antibacterial agent, taking it at the same time as your L. rhamnosus probiotic could kill off some of those live, helpful organisms, making the probiotic less effective. It won't make the methenamine dangerous or change how it treats your urinary tract.

The simple fix is timing. Try to separate the two by at least two hours so the probiotic has a better chance to survive and do its job. This is a theoretical concern based on how the drug works, so don't be alarmed, but check with your pharmacist or doctor if you have questions.

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 Rhamnosus Also Interacts With Other Medications

Lacticaseibacillus Rhamnosus has 181 moderate known drug interactions in our database — the Methenamine Mandelate 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 Rhamnosus

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

Everything else you take

See Every Supplement That Interacts With Methenamine Mandelate

This page covers Lacticaseibacillus Rhamnosus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Methenamine Mandelate page lists 91 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Siberian Cocklebur (major), Wine (major) and Ascophyllum Nodosum (moderate).

By severity: 4 major · 77 moderate · 10 minor.

From our pharmacist’s overview on the Methenamine Mandelate page

“People take methenamine mandelate (Mandelamine) day after day to keep urinary tract infections at bay, and that long habit is exactly why the 91 supplements on this page deserve genuine vigilance. Four carry a major rating, and most of those point at the liver: Siberian cocklebur has been linked to outright liver failure, and heavy bee…”

Reviewed by 2 · Jul 18, 2026

Open the Methenamine Mandelate interaction page

How much people look this up

Where Lacticaseibacillus Rhamnosus and Methenamine Mandelate 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 Rhamnosus
Steady interest

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

29 days ago today
Medication Methenamine Mandelate
Top half

#1,006 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 Rhamnosus

What is Lacticaseibacillus Rhamnosus?

  • Diarrhea (including antibiotic-related)
  • Digestive health
  • Vaginal and urinary health
  • Eczema and allergy prevention in children
  • Immune support

Lacticaseibacillus rhamnosus (often labeled L. rhamnosus GG) is a well-studied probiotic bacterium used mainly for diarrhea and general gut health. It is considered safe for most healthy people, with the best evidence for preventing certain types of diarrhea, but benefits for many other uses are uncertain. People who are seriously ill or have weakened immune systems should check with a doctor first.

Read the full Lacticaseibacillus Rhamnosus monograph & all interactions
Medication

About Methimazole

What Is Methimazole Used For?

Brand names: Mandelamine, Methimazole

Methimazole tablets are used in adults and children with hyperthyroidism (an overactive thyroid) due to Graves' disease or toxic multinodular goiter when surgery or radioactive iodine is not the right option. They work to lower thyroid hormone levels and ease symptoms.

Methimazole tablets are also used to bring thyroid hormone levels down before a patient undergoes thyroidectomy (thyroid surgery) or radioactive iodine treatment, making those procedures safer.

See full Methimazole drug information
Keep checking

Other Drugs & Lacticaseibacillus Rhamnosus

Browse every other medication we’ve checked against Lacticaseibacillus Rhamnosus — 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 Rhamnosus 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 Rhamnosus and Methenamine Mandelate Together: Common Questions

Can you take Lacticaseibacillus Rhamnosus with Methenamine Mandelate?
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 Rhamnosus and Methenamine Mandelate 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.