Drug & supplement interaction

Probiotics + Esketamine

Esketamine brand name: Spravato.

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 Probiotics and Esketamine 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

Probiotics and Esketamine

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 Esketamine and Probiotics 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.

Probiotics safety at a glance

Probiotics overall Use caution Generally well tolerated in healthy people, but those who are seriously ill or immunocompromised should use them only under medical guidance.
Pregnancy Possibly Safe When Lactobacillus acidophilus, Lacticaseibacillus casei, Lacticaseibacillus paracasei, Lactiplantibacillus plantarum, Ligilactobacillus salivarius, Limosilacto... Read the full pregnancy detail
Breastfeeding Possibly Safe When Lacticaseibacillus paracasei, Limosilactobacillus fermentum, Limosilactobacillus reuteri, Lacticaseibacillus rhamnosus, and Bifidobacterium longum are used... 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 Esketamine and Probiotics? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Esketamine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Esketamine is filed under 2 classifications — tricyclic antidepressants (tcas), antidepressant drugs. Probiotics has documented interactions with 2 drug classes — the most serious being antibiotic drugs (moderate) and antifungals (minor) — and none of Esketamine’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

Probiotics Does Interact With Other Medications

Probiotics has 182 moderate, 40 minor known drug interactions in our database — Esketamine isn’t one of them. If you take anything else, check it against the full list below.

Moderate 182 Minor 40 No known interaction 2,608 (incl. Esketamine)
Taking anything else?

Check Another of Your Medications Against Probiotics

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

What to actually watch for

No Interaction Found — But Data Suggests Probiotics and Esketamine 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.

  • Nausea / Vomiting reported in 5.4% of FDA reports for Esketamine Additional detail

    Probiotics

    “Orally, gastrointestinal adverse effects such as diarrhea, dyspepsia, abdominal pain, nausea, vomiting, bloating, belching, and flatulence have been reported rarely with probiotics (2,3169,16841,90235,90239,90271,90291,95381,107520,110846). See individual topics for details.”

    Probiotics · Natural Medicines adverse-effect record, reported in diarrhea.

    6 sources cited
    1. 2. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
    2. 3169. Phuapradit P, Varavithya W, Vathanophas K, et al. Reduction of rotavirus infection in children receiving bifidobacteria-supplemented formula. J Med Assoc Thai 1999;82:S43-8.
    3. 16841. Miele E, Pascarella F, Giannetti E. et al. Effect of a probiotic preparation (VSL#3) on induction and maintenance of remission in children with ulcerative colitis. Am J Gastroenterol 2009;104:437-43. PubMed
    4. 90235. Beerepoot MA, ter Riet G, Nys S, van der Wal WM, de Borgie CA, de Reijke TM,Prins JM, Koeijers J, Verbon A, Stobberingh E, Geerlings SE. Lactobacilli vs antibiotics to prevent urinary tract infections: a randomized, double-blind, noninferiority trial in p DOI
    5. 90239. Chatterjee S, Kar P, Das T, Ray S, Gangulyt S, Rajendiran C, Mitra M. Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12 for prevention of antibiotic-associated
    6. 90271. Krag A, Munkholm P, Israelsen H, von Ryberg B, Andersen KK, Bendtsen F. Profermin is efficacious in patients with active ulcerative colitis--a randomized controlled trial. Inflamm Bowel Dis. 2013;19(12):2584-92. PubMed

    Esketamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Esketamine, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Reported for Probiotics but not commonly for Esketamine: stomach pain, bloating or gas, a skin rash and a higher chance of infection.

Effects for Esketamine come from the ADVERSE REACTIONS section of its FDA label; effects for Probiotics come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 17,728 voluntary FDA FAERS reports for Esketamine 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

Probiotics in Pregnancy & Breastfeeding

Pregnancy Possibly Safe

When Lactobacillus acidophilus, Lacticaseibacillus casei, Lacticaseibacillus paracasei, Lactiplantibacillus plantarum, Ligilactobacillus salivarius, Limosilactobacillus reuteri, Lacticaseibacillus rhamnosus, Bifidobacterium bifidum, and Bifidobacterium longum are used orally and appropriately, short-term. See individual topics for details. There is insufficient reliable information available about the safety of other probiotics during pregnancy.

Lactation Possibly Safe

When Lacticaseibacillus paracasei, Limosilactobacillus fermentum, Limosilactobacillus reuteri, Lacticaseibacillus rhamnosus, and Bifidobacterium longum are used orally and appropriately, short-term. See individual topics for details. There is insufficient reliable information available about the safety of other probiotics during lactation.

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

From our Q&A

Questions About Probiotics or Esketamine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Probiotics or Esketamine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Esketamine

This page covers Probiotics only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Esketamine page lists 11 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Scopolia (major), Cowhage (moderate), Dhea (moderate), Griffonia Simplicifolia (moderate) and Indian Snakeroot (moderate).

By severity: 1 major · 6 moderate · 4 minor.

From our pharmacist’s overview on the Esketamine page

“Esketamine (Spravato) is the nasal spray for depression that hasn't responded to standard treatment, and its supplement list deserves genuine respect. Scopolia carries the only major rating and is the entry to understand before any other; pairing it with the medication can raise the risk of anticholinergic effects, meaning dry mouth, b…”

Reviewed by 2 · Jul 18, 2026

Open the Esketamine interaction page

One more smart check

Taking Probiotics as Part of a Dietary Supplement Product? Check It for Interactions

We hold 15 real supplement products containing Probiotics, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Probiotics. Even though Probiotics itself has no known interaction with Esketamine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Probiotics and Esketamine 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 Probiotics
Top half

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

29 days ago today
Medication Esketamine
Steady interest

#1,871 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 Probiotics reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Probiotics and Esketamine records this page draws on were last updated July 11, 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 Probiotics

What is Probiotics?

  • Digestive health and regularity
  • Antibiotic-associated diarrhea
  • Irritable bowel syndrome (IBS)
  • Vaginal and urinary health
  • Immune support
  • General gut microbiome balance

Probiotics are live 'friendly' microbes that may help certain digestive conditions, such as antibiotic-associated diarrhea and some cases of IBS, though benefits depend heavily on the specific strain and dose. They are generally well tolerated for healthy people but should be used with caution by those with serious illness or weakened immune systems. Talk with your pharmacist or doctor to pick a product that matches your goal.

Live microorganisms (bacteria and yeasts) · Capsules, tablets, powders, chewables, gummies, drops, and fermented foods (yogurt, kefir, kombucha, sauerkraut)

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

Probiotics: dosing

There is no single standardized dose for probiotics, because the right amount depends on the specific strain and the reason for use. Doses are often listed in colony-forming units (CFU), and products can range widely.The best approach is to follow the directions on the product label and choose a product whose strain has been studied for your specific goal. A pharmacist can help you match a product to your needs and check that it is appropriate for you. Store probiotics as directed—some require refrigeration to keep the organisms alive.

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

Read the full Probiotics monograph & all interactions
Medication

About Esketamine Nasal Spray

What Is Esketamine Nasal Spray Used For?

Brand name: Spravato

Spravato nasal spray is approved for two uses in adults. First, it treats treatment-resistant depression (TRD) — depression that has not responded to other antidepressants — either on its own or alongside an oral antidepressant. Second, it treats depressive symptoms in adults with major depressive disorder (MDD) who have acute suicidal ideation or behavior, always used together with an oral antidepressant in this case.

Important limits: Spravato has not been shown to prevent suicide or reduce suicidal thoughts or behavior on its own. It is not a replacement for hospitalization if that is clinically needed, and it is not approved as an anesthetic.

Most-Reported Side Effects for Esketamine

From FAERS, the FDA’s public side-effect reporting system (17,728 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Dissociation 3,733 reports
Sedation 2,706 reports
Suicidal ideation 1,351 reports
Nausea 957 reports
Depression 873 reports
See full Esketamine Nasal Spray drug information
Keep checking

Other Drugs & Probiotics

Browse every other medication we’ve checked against Probiotics — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
182Moderate
40Minor
2,607No known interaction
182 Moderate 40 Minor 2,607 No interaction
Moderate

182 interactions

Showing 60 of 182 moderate interactions — see all 182 on the Probiotics page.

Minor

40 interactions

No interaction 2,607 drugs checked — show the list

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

Showing the 60 most looked-up of 2,607 medications checked with no known interaction — see the full Probiotics list.

See the full Probiotics interactions page
See every supplement checked against Esketamine, ranked by severity
Evidence & sources

Probiotics References

The 77 references that drive our Probiotics 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. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Niault M, Thomas F, Prost J, et al. Fungemia due to Saccharomyces species in a patient treated with enteral Saccharomyces boulardii. Clin Infect Dis 1999;28:930.
  3. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  4. Phuapradit P, Varavithya W, Vathanophas K, et al. Reduction of rotavirus infection in children receiving bifidobacteria-supplemented formula. J Med Assoc Thai 1999;82:S43-8.
  5. Pletinex M, Legein J, Vandenplas Y. Fungemia with Saccharomyces boulardii in a 1-year-old girl with protracted diarrhea. J Pediatr Gastroenterol Nutr 1995;21:113-5. DOI
  6. Fredenucci I, Chomarat M, Boucaud C, et al. Saccharomyces boulardii fungemia in a patient receiving ultra-levure therapy. Clin Infect Dis 1998;27:222-3.
  7. Elmer GW, McFarland LV, Surawicz CM, et al. Behaviour of Saccharomyces boulardii in recurrent Clostridium difficile disease patients. Aliment Pharmacol Ther 1999;13:1663-8.
  8. Lewis SJ, Freedman AR. Review article: the use of biotherapeutic agents in the prevention and treatment of gastrointestinal disease. Aliment Pharmacol Ther 1998;12:807-22. PubMed
  9. Saxelin M, Chuang NH, Chassy B, et al. Lactobacilli and bacteremia in southern Finland 1989-1992. Clin Infect Dis 1996;22:564-6. PubMed
  10. Tynkkynen S, Singh KV, Varmanen P. Vancomycin resistance factor of Lactobacillus rhamnosus GG in relation to enterococcal vancomycin resistance (van) genes. Int J Food Microbiol 1998;41:195-204. PubMed
  11. Klein G, Zill E, Schindler R, et al. Peritonitis associated with vancomycin-resistant Lactobacillus rhamnosus in a continuous ambulatory peritoneal dialysis patient; organism identification, antibiotic therapy, and case report. J Clin Microbiol 1998;36:
  12. Kalima P, Masterton RG, Roddie PH, et al. Lactobacillus rhamnosus infection in a child following bone marrow transplant. J Infect 1996;32:165-7. PubMed
  13. Goldin BR. Health Benefits of probiotics. Br J Nutr 1998;80:S203-7. DOI
  14. Rautio M, Jousimies-Somer H, Kauma H, et al. Liver abscess due to Lactobacillus rhamnosus strain indistinguishable from L. rhamnosus strain GG. Clin Infect Dis 1999;28:1159-60.
  15. Cesaro S, Chinello P, Rossi L, Zanesco L. Saccharomyces cerevisiae fungemia in a neutropenic patient treated with Saccharomyces boulardii. Support Care Cancer 2000;8:504-5. PubMed

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 Probiotics and Esketamine Together: Common Questions

Is it safe to take Probiotics with Esketamine?
We do not list a known interaction between Probiotics and Esketamine. 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 Probiotics and Esketamine 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.
How was the Probiotics and Esketamine combination checked?
Interactions in our licensed database are recorded against drug classes. Esketamine is filed under 2 classifications, and Probiotics has documented interactions with 2 drug classes — none of Esketamine'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 Probiotics interact with any other medications?
Yes. Probiotics has 222 documented drug interactions in our database — Esketamine 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 Esketamine interact with any supplements?
Yes. Esketamine has documented interactions with 11 supplements in our database — Probiotics is not one of them. The Esketamine 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

Probiotics monograph Uses, safety profile, and every drug interaction in one place Esketamine Nasal Spray drug information The full plain-English guide to this medication Esketamine supplement interactions Every supplement checked against Esketamine, 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 77 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Esketamine and Probiotics?

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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.