Drug & supplement interaction

Ligilactobacillus Salivarius + Tobramycin

Tobramycin brand names: Nebcin, Tobi Podhaler, Bethkis, Kitabis PAK.

Moderate Interaction
The bottom line Moderate

Ligilactobacillus Salivarius has a moderate interaction with Tobramycin. Theoretically, taking Ligilactobacillus salivarius 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

Ligilactobacillus Salivarius and Tobramycin

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

Moderate

ANTIBIOTIC DRUGS

Why this applies to Tobramycin

Tobramycin falls under ANTIBIOTIC DRUGS — the group Ligilactobacillus Salivarius interacts with.

Theoretically, taking Ligilactobacillus salivarius with antibiotic drugs might decrease the effectiveness of L. salivarius.
Ligilactobacillus salivarius 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. salivarius 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: tobramycin is an antibiotic, and its whole job is to kill bacteria. The catch is that Ligilactobacillus salivarius is a live, friendly bacterium. So if the two cross paths at the same time, the tobramycin may wipe out a good chunk of the probiotic before it can do anything useful. In short, this isn't about tobramycin becoming dangerous, it's about the probiotic working less well.

Good news: this is a theoretical concern based on how antibiotics behave, not a serious safety problem. Tobramycin's real risks (like kidney or hearing effects) come from the drug itself, not from mixing it with the probiotic. If you want the probiotic to have a fighting chance, space it at least two hours apart from your antibiotic, and check with your pharmacist if you're unsure.

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

Ligilactobacillus Salivarius Also Interacts With Other Medications

Ligilactobacillus Salivarius has 181 moderate known drug interactions in our database — the Tobramycin 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 Ligilactobacillus Salivarius

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

Everything else you take

See Every Supplement That Interacts With Tobramycin

This page covers Ligilactobacillus Salivarius only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tobramycin page lists 52 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 3 major · 38 moderate · 11 minor.

From our pharmacist’s overview on the Tobramycin page

“Kidney protection is the first thing to understand with tobramycin (Nebcin, Tobi Podhaler, Bethkis, Kitabis PAK), an aminoglycoside antibiotic that can stress the kidneys even on its own, so this list warrants genuine care rather than a quick glance. The worst pairings, Siberian cocklebur and asarabacca, can injure the kidneys themselv…”

Reviewed by 2 · Jul 18, 2026

Open the Tobramycin interaction page

How much people look this up

Where Ligilactobacillus Salivarius and Tobramycin 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 Ligilactobacillus Salivarius
Steady interest

#1,073 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Tobramycin
Steady interest

#2,503 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 Ligilactobacillus Salivarius

What is Ligilactobacillus Salivarius?

  • Digestive and gut health
  • Oral and dental health
  • Immune support
  • Vaginal and urinary health
  • General probiotic supplementation

Ligilactobacillus salivarius (formerly called Lactobacillus salivarius) is a probiotic bacterium found naturally in the mouth and gut of humans and animals. People take it to support digestion, oral health, and immunity, but solid human evidence is still limited for most uses. It is generally well tolerated in healthy people, but those with weakened immune systems should check with a doctor first.

Read the full Ligilactobacillus Salivarius monograph & all interactions
Medication

About Tobramycin Injection

What Is Tobramycin Injection Used For?

Brand names: Nebcin, Tobi Podhaler, Bethkis, Kitabis PAK

Tobramycin Injection is used to treat serious and life-threatening bacterial infections caused by susceptible bacteria. It is approved for adults and children for infections of the blood (septicemia), lungs and airways, brain and spinal cord (meningitis), abdomen, skin, bones, and urinary tract.

Because antibiotic resistance is a growing concern, Tobramycin Injection should only be used when there is a proven or strongly suspected bacterial infection. Your care team will use culture and lab results to confirm it is the right choice.

See full Tobramycin Injection drug information
Keep checking

Other Drugs & Ligilactobacillus Salivarius

Browse every other medication we’ve checked against Ligilactobacillus Salivarius — 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 Ligilactobacillus Salivarius 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 Ligilactobacillus Salivarius and Tobramycin Together: Common Questions

Can you take Ligilactobacillus Salivarius with Tobramycin?
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 Ligilactobacillus Salivarius and Tobramycin 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.