Drug & supplement interaction

Levilactobacillus Brevis + Lefamulin Acetate

Lefamulin Acetate brand name: Xenleta.

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

Levilactobacillus Brevis has a moderate interaction with Lefamulin Acetate. Theoretically, taking Levilactobacillus brevis 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

Levilactobacillus Brevis and Lefamulin Acetate

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

Moderate

ANTIBIOTIC DRUGS

Why this applies to Lefamulin Acetate

Lefamulin Acetate falls under ANTIBIOTIC DRUGS — the group Levilactobacillus Brevis interacts with.

Theoretically, taking Levilactobacillus brevis with antibiotic drugs might decrease the effectiveness of L. brevis.
Levilactobacillus brevis 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. brevis 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: lefamulin (Xenleta) is an antibiotic, and antibiotics don't pick favorites. If you swallow a probiotic like Levilactobacillus brevis at the same time you're taking lefamulin, the antibiotic can kill off a good chunk of those live, helpful bacteria before they ever do their job. So the worry here isn't that the probiotic makes your lefamulin stronger or weaker, or that it causes new side effects. It's the other way around: the antibiotic may simply waste your probiotic.

This is a theoretical concern based on how these products work, not something proven in big studies. A practical fix is to space them out, taking your probiotic at least two hours apart from your lefamulin. When in doubt, ask your pharmacist or doctor.

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

Levilactobacillus Brevis Also Interacts With Other Medications

Levilactobacillus Brevis has 181 moderate known drug interactions in our database — the Lefamulin Acetate 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. Lefamulin Acetate)
Taking anything else?

Check Another of Your Medications Against Levilactobacillus Brevis

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

Everything else you take

See Every Supplement That Interacts With Lefamulin Acetate

This page covers Levilactobacillus Brevis only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Lefamulin Acetate page lists 178 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 8 major · 130 moderate · 40 minor.

From our pharmacist’s overview on the Lefamulin Acetate page

“Before adding any supplement to lefamulin acetate (Xenleta), a short-course antibiotic for pneumonia, look hard at the eight major-rated entries among its 178 documented interactions. They cluster around two dangers: ingredients that change how much lefamulin reaches your blood, and ingredients that can stretch the heart's rhythm on to…”

Reviewed by 2 · Jul 18, 2026

Open the Lefamulin Acetate interaction page

How much people look this up

Where Levilactobacillus Brevis and Lefamulin Acetate 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 Levilactobacillus Brevis
Steady interest

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

29 days ago today
Medication Lefamulin Acetate
Steady interest

#2,140 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 Levilactobacillus Brevis

What is Levilactobacillus Brevis?

  • Digestive health
  • Gut microbiome support
  • Immune support
  • Oral and dental health
  • Vaginal health

Levilactobacillus brevis (formerly Lactobacillus brevis) is a lactic acid bacterium found in fermented foods like sauerkraut, pickles, and kimchi, and is used as a probiotic. Early research suggests possible benefits for gut and immune health, but strong human evidence is still limited. It is generally well tolerated in healthy people, but anyone with a weakened immune system or serious illness should talk to a doctor first.

Read the full Levilactobacillus Brevis monograph & all interactions
Medication

About Lefamulin Injection

What Is Lefamulin Injection Used For?

Brand name: Xenleta

Xenleta Injection is approved for treating community-acquired bacterial pneumonia (CABP) — a type of lung infection caught outside of a hospital — in adults. It targets specific bacteria known to cause this infection, including Streptococcus pneumoniae, Staphylococcus aureus (methicillin-susceptible strains), Haemophilus influenzae, Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydophila pneumoniae.

Xenleta Injection is given intravenously (by IV infusion) and is only intended for bacterial infections — it will not work against viral illnesses like the flu or COVID-19.

See full Lefamulin Injection drug information
Keep checking

Other Drugs & Levilactobacillus Brevis

Browse every other medication we’ve checked against Levilactobacillus Brevis — 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 Levilactobacillus Brevis page.

No interaction 2,648 drugs checked — show the list

We also checked Levilactobacillus Brevis 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 Levilactobacillus Brevis list.

See the full Levilactobacillus Brevis interactions page
See every supplement checked against Lefamulin Acetate, 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
Levilactobacillus Brevis monograph › Uses, safety, and every drug interaction in one place Lefamulin Acetate supplement interactions › Every supplement checked against Lefamulin Acetate, ranked by severity Lefamulin 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 Levilactobacillus Brevis and Lefamulin Acetate Together: Common Questions

Can you take Levilactobacillus Brevis with Lefamulin Acetate?
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 Levilactobacillus Brevis and Lefamulin Acetate 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 Lefamulin Acetate and Levilactobacillus Brevis?

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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.