Interactions on record — worth a quick check against your medications. Based on 3 of 5 ingredients. Check your meds →
Dietary supplement

4X Probiotic Digestive Care Supplement Ingredients & Drug Interactions

by Simply Right

4X Probiotic Digestive Care Supplement label
See full label image
Other (e.g. Tea Bag) Category: Non-nutrient/non-botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking 4X Probiotic Digestive Care Supplement against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Moderate

4X Probiotic Digestive Care Supplement is a dietary supplement by Simply Right with 5 active ingredients. Its ingredients are commonly taken for replacing fluids and electrolytes, preventing dehydration during exercise or illness, treating low blood sodium (under medical care).Based on those ingredients, 387 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Sodium, Bifidobacterium longum, Bifidobacterium bifidum. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against 4X Probiotic Digestive Care Supplement by Simply Right

Ask about any prescription or over-the-counter medication and we check it for interactions with 4X Probiotic Digestive Care Supplement by Simply Right — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of 4X Probiotic Digestive Care Supplement by Simply Right

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 2 of its 5 active ingredients.
  • “Proprietary Probiotic Blend” is a proprietary blend — the label gives one combined amount (15 mg) without saying how much of each component you get.

This product contains 5 ingredients. The active ones are sodium and four Bifidobacterium species: Bifidobacterium infantis SD-5845, Bifidobacterium animalis lactis, Bifidobacterium longum, and Bifidobacterium bifidum.

These are live-organism probiotics meant to support digestive function. Sodium is an electrolyte your body needs in small amounts.

The product also contains a proprietary probiotic blend, which combines component ingredients listed individually elsewhere on the label. Inactive ingredients—microcrystalline cellulose, hypromellose, pectin, sodium carbonate, stearic acid, guar gum, and turmeric—serve as binders, thickeners, and capsule materials.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: Support healthy digestive system and gastrointestinal balance.
  • We looked for evidence on: Abdominal pain, Antibiotic-associated diarrhea, Clostridioides difficile infection, Colic, Constipation, Diarrhea — and 4 related terms.
  • The strongest evidence on file: Bifidobacterium Bifidum is rated "Possibly Effective" for Irritable bowel syndrome (IBS) (Natural Medicines).
  • Also on file: Bifidobacterium Bifidum is rated "Insufficient Reliable Evidence To Rate" for Antibiotic-associated diarrhea, Constipation, Helicobacter pylori, Necrotizing enterocolitis (NEC), and more.

Evidence for this product's probiotic strains is mixed and often limited. Bifidobacterium bifidum is possibly effective for irritable bowel syndrome and respiratory tract infections; the evidence for other uses we checked—such as hay fever, Alzheimer disease, and anxiety—is insufficient to rate.

For Bifidobacterium longum, the evidence is insufficient for all the conditions we reviewed, including cognitive decline, hay fever, antibiotic-associated diarrhea, anxiety, asthma, and athletic performance. The sodium in this product is likely effective for cystic fibrosis and possibly effective for amphotericin B nephrotoxicity (a kidney side effect of an antifungal drug), but data are insufficient for congestive heart failure and bipolar disorder.

Overall, solid proof of benefit for digestive health with this specific formulation is not established in our data.

The evidence, ingredient by ingredient Sodium Bifidobacterium Longum Bifidobacterium Bifidum

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 3 of the 3 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 3 of 3.
  • General safety write-ups exist for 3 of 3.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Sodium is well tolerated at normal dietary amounts but can strain the heart and raise blood pressure when intake is too high. The safety notes advise against sodium supplements or very high intake without medical guidance—normal food sources are fine.

Both Bifidobacterium strains we could check are generally well tolerated in healthy people but warrant caution in those with weakened immune systems or serious illness; very rare cases of Bifidobacterium infection in the bloodstream (bacteremia) have occurred in critically ill patients. Rare gastrointestinal side effects reported with these probiotics include abdominal discomfort, flatulence, constipation, and one dry cough.

For pregnancy, sodium is likely safe, though one safety entry rates it possibly unsafe—discuss your individual situation with your doctor. For Bifidobacterium longum, pregnancy safety is possibly safe; for B. bifidum, it is possibly safe in pregnancy, but lactation data are on file.

Side effects, ingredient by ingredient Sodium Bifidobacterium Longum Bifidobacterium Bifidum

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 3 of the 3 matched ingredients can interact with medications — Sodium, Bifidobacterium Bifidum, Bifidobacterium Longum.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: lithium.
  • For scale: 387 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking this product, double-check your medications with our tool if you take lithium, blood pressure medications, corticosteroids, didanosine, sodium phosphates, tolvaptan, other sodium-containing drugs, or antibiotics. Lithium requires the most caution because sodium in your diet and supplements directly affects its blood levels.

Antibiotics may reduce how well the live probiotic organisms work, so space them apart if possible.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

If you're a generally healthy adult with no kidney disease, high blood pressure, or heart problems, and you don't take lithium, blood pressure drugs, corticosteroids, or antibiotics, this probiotic may be worth a try. Stop taking it and talk to your pharmacist or doctor if you're on any regular medications—especially lithium—or if you're seriously ill or immunocompromised.

Check your exact medications on this page before you start.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 3 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Mar 25, 2013.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about 4X Probiotic Digestive Care Supplement, straight from the product label.

Brand Simply Right
Barcode (UPC) 078742005645
Net contents 84 Caplet(s)
Market status On market
Date entered into DSLD Mar 25, 2013
DSLD ID 19322
Product type Non-nutrient/non-botanical
Supplement form Other (e.g. Tea Bag)
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for 4X Probiotic Digestive Care Supplement by Simply Right, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Caplet(s)
Maximum serving Sizes:
1 Caplet(s)
Servings per container
84
UPC/BARCODE
078742005645
IngredientAmount% DV
Total Carbohydrates1 g1%
Sodium25 mg1%
Bifidobacterium infantis SD-584510 mg--
Proprietary Probiotic Blend15 mg--
Bifidobacterium animalis lactis0 NP--
Bifidobacterium longum0 NP--
Bifidobacterium bifidum0 NP--

Other ingredients: Microcrystalline Cellulose, Hypromellose, Pectin, Sodium Carbonate, Stearic Acid, Guar Gum, Turmeric

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Precautions

Do not use if blister unit is broken or torn

CAUTION: If you are pregnant or nursing a baby or if you are taking any medication (including oral antibiotics), or have a medical condition, consult your doctor before using this product.

Keep out of the reach of children.

Brand IP Statement(s)

This product is not manufactured or distributed by The Procter & Gamble Company, owner of the registered trademark Align(R).

Compare vs. Align(R) see top panel

THE SIMPLY RIGHT(TM) PROMISE Simply Right is dedicated to providing healthful, gentle, and safe personal care products for the entire family. We continuously strive to be your trusted partner in wellness and exceed your expectations.

{chart} Compare the differences of 4x Probiotic(TM) to Align(R) 4X Probiotic(TM) Align(R) Bifidobacterium infantis 10 mg 4 mg per serving Bifidobacterium SD-5845 35624 infantis strain Probiotic Blend B. lactis 15 mg -- B. longum B. bifidum Total live probiotic cells 5-billion 1-billion when manufactured Form of Product Gradual- Capsule release Caplet

General Statements

TWIN PACK

Helps to support & maintain a healthy digestive system.** Promotes gastrointestinal health & digestive system balance**

3 MONTH SUPPLY

We would like to hear from you with any comments or suggestions. In the continental US or Canada, you can call us toll-free at 1-800-809-0469, Monday through Friday, from 8 am to 5 pm CST.

***Based on a national survey of gastroenterologists who recommend probiotics to their patients PATENT PENDING TECHNOLOGY Patent pending caplet technology protects delicate probiotics from stomach acid.

actual size

Releases gradually over time to protect delicate probiotics from stomach acids.

A few words on probiotic bacteria The body needs beneficial bacteria for digestive system health.** Bifidobacteria are an important component of the intestinal microflora. As we age, the numbers of Bifidobacteria may be reduced. Other lifestyle factors, such as diet and stress, may also affect the composition of the microflora. Why take probiotics? When taken daily, this product helps maintain digestive health with active probiotic bacteria.** What are probiotics? Simply put, probiotics are bacteria that help maintain a healthy digestive system. Probiotics contribute to a healthy microflora and support immune system function.** About this product This product contains 4 strains of natural beneficial bacteria: Bifidobacterium infantis, Bificdobacterium lactis, Bifidobacterium longum, Bifidobacterium bifidum. When taken daily, this product will help support and maintain a healthy digestive system.**

Wellness & Nutrition

FDA Statement of Identity

Dietary Supplement

FDA Disclaimer Statement

**These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Suggested/Recommended/Usage/Directions

DIRECTIONS: Adults, take one caplet daily. As a reminder, discuss the supplements and medications you take with your healthcare provider. Do not take within two hours of taking antibiotics

Storage

Store at room temperature (59(0)-86(0)F).

Formula

Contains 4 strains of natural, beneficial bacteria. With B. infantis 10 mg

CONTAINS: SOY

Seals/Symbols

Gastroenterologists recommend B. infantis***

LABORATORY TESTED QUALITY ASSURED

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

4X Probiotic Digestive Care Supplement by Simply Right label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

4X Probiotic Digestive Care Supplement label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in 4X Probiotic Digestive Care Supplement by Simply Right

These are the 5 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Caplet(s) Dosage formOther (e.g. Tea Bag) Servings per container84 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Sodium

Interacts with
205 drugs
25 mg per serving

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...

Sodium monograph & interactions

Bifidobacterium infantis SD-5845

10 mg per serving

Proprietary Probiotic Blend

15 mg per serving

Other (inactive) ingredients: Microcrystalline Cellulose, Hypromellose, Pectin, Sodium Carbonate, Stearic Acid, Guar Gum, Turmeric. These complete the product’s ingredient list but are not active constituents.

Interaction report

4X Probiotic Digestive Care Supplement by Simply Right Drug Interactions

Want to check YOUR meds against 4X Probiotic Digestive Care Supplement?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
387Drugs
387 Moderate

Ingredients driving the most interactions

Sodium 205
Bifidobacterium longum 182
Bifidobacterium bifidum 182

Individual Drug Interactions

The ingredients in 4X Probiotic Digestive Care Supplement interact with 387 drugs. Click any drug to see the details.

3 of the 5 ingredients in 4X Probiotic Digestive Care Supplement interact with drugs. Each result below shows which ingredient is responsible. Sodium Bifidobacterium longum Bifidobacterium bifidum

Each ingredient & the kinds of drugs it affects

For each ingredient in 4X Probiotic Digestive Care Supplement with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Sodium7 drug types · 205 drugs

Antihypertensive Drugs

Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.

Likelihood Probable Evidence A
Corticosteroids

Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.

Likelihood Possible Evidence D
Didanosine (Videx)

Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.

Likelihood Probable Evidence C
Lithium

Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.

Likelihood Probable Evidence B
Sodium Phosphates

Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Sodium-Containing Drugs

Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Tolvaptan (Samsca)

Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.

Likelihood Probable Evidence C
Sodium full monograph & interactions

Bifidobacterium longum1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Bifidobacterium longum with antibiotic drugs might decrease the effectiveness of B. longum.
Since B. longum preparations usually contain live and active organisms, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and B. longum preparations by at least 2 hours.

Likelihood Probable Evidence D
Bifidobacterium longum full monograph & interactions

Bifidobacterium bifidum1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Bifidobacterium. bifidum with antibiotic drugs might decrease the effectiveness of B. bifidum.
Since B. bifidum preparations usually contain live and active organisms, simultaneously taking antibiotics might kill a significant number of the organisms. Tell patients to separate administration of antibiotics and B. bifidum preparations by at least 2 hours.

Likelihood Probable Evidence D
Bifidobacterium bifidum full monograph & interactions
The maker

Brand information

Manufacturer and brand details for 4X Probiotic Digestive Care Supplement, from the product label.

Simply Right

See all Simply Right products
Name
SAM'S West, Inc.
City
Bentonville
State
AR
ZipCode
72716
Pharmacist Counseling Corner

4X Probiotic Digestive Care Supplement by Simply Right: Common Questions

Does 4X Probiotic Digestive Care Supplement by Simply Right interact with any medications?
Yes. Based on its ingredients, 4X Probiotic Digestive Care Supplement has a known interaction with 387 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
4X Probiotic Digestive Care Supplement contains 5 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Will this probiotic work if I'm on antibiotics?
Theoretically, no—antibiotics kill bacteria, including the live Bifidobacterium organisms in this supplement. The data suggest you should separate doses of antibiotics and this probiotic if you can. Talk to your pharmacist about the best timing.
Is it safe if I have high blood pressure?
Sodium can raise blood pressure and may make your blood pressure medications less effective. If you have high blood pressure or take blood pressure drugs, check with your doctor before adding sodium from a supplement.
Can I take this while I'm pregnant or breastfeeding?
Sodium is likely safe in pregnancy, though one entry rates it possibly unsafe—talk to your doctor. For the Bifidobacterium strains, pregnancy data suggest possibly safe; for breastfeeding, data are limited, especially for B. bifidum, so ask your doctor or pharmacist before use.
What are the Bifidobacterium strains supposed to do?
They're live-organism probiotics intended to support digestive health. Bifidobacterium bifidum has some evidence for irritable bowel syndrome and respiratory infections, but evidence for other strains in this product and other uses is limited or insufficient.
What side effects might I notice?
Gastrointestinal upset—bloating, flatulence, abdominal discomfort, or constipation—has been reported rarely with these probiotics. A single patient reported a dry cough. More serious infection is extremely rare and mainly in critically ill patients.
Can I take this if I take lithium?
Not without careful medical oversight. Sodium and lithium interact directly—more sodium can lower lithium levels, and less sodium can raise them to dangerous levels. You must talk to your doctor before adding this or any sodium supplement.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Not sure if 4X Probiotic Digestive Care Supplement is safe with your meds?

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

4X Probiotic Digestive Care Supplement label
Go deeper

The Full Monographs Behind 4X Probiotic Digestive Care Supplement’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Sodium

Interacts with 205 drugs

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from...

Read the full Sodium monograph → Herb & supplement monograph

Bifidobacterium Longum

Interacts with 182 drugs

Bifidobacterium longum is a 'friendly' bacterium found naturally in the human gut and used as a probiotic. It is generally well tolerated and is most studied for digestive issues, though evi...

Read the full Bifidobacterium Longum monograph → Herb & supplement monograph

Bifidobacterium Bifidum

Interacts with 182 drugs

Bifidobacterium bifidum is a 'friendly' bacteria (probiotic) that naturally lives in the human gut and is taken to support digestion and gut balance. Some evidence suggests probiotics may he...

Read the full Bifidobacterium Bifidum monograph →
Sources

Sources & How We Checked

4X Probiotic Digestive Care Supplement's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 66 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Sodium 38 references
  1. Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
  2. Food and Drug Administration Science Background: Safety of Sodium Phosphates Oral Solution. September 17, 2001. Available at: http://www.fda.gov/cder/drug/safety/sodiumphospate.htm
  3. Coton T, Mallaret C, Coilliot C, Carre D, Guisset M. Severe acute ulcerated gastritis induced by salt. Presse Med 2009;38(3):499-500. PubMed
  4. Frings-Meuthen P, Buehlmeier J, Baecker N, et al. High sodium chloride intake exacerbates immobilization-induced bone resorption and protein losses. J Appl Physiol 2011;111(2):537-542. PubMed
  5. Frings-Meuthen P, Baecker N, Heer M. Low-grade metabolic acidosis may be the cause of sodium chloride-induced exaggerated bone resorption. J Bone Miner Res 2008;23(4):517-524. PubMed
  6. Alam S, Johnson AG. A meta-analysis of randomised controlled trials (RCT) among healthy normotensive and essential hypertensive elderly patients to determine the effect of high salt (NaCl) diet of blood pressure. J Hum Hypertens 1999;13(6):367-74.
  7. Boudville N, Ward S, Benaroia M, House AA. Increased sodium intake correlates with greater use of antihypertensive agents by subjects with chronic kidney disease. Am J Hypertens 2005;18(10):1300-5. PubMed
  8. Bennett WM. Drug interactions and consequences of sodium restriction. Am J Clin Nutr 1997;65(2 Suppl):678S-681S. PubMed
  9. Okusa MD, Crystal LJ. Clinical manifestations and management of acute lithium intoxication. Am J Med 1994;97(4):383-9. PubMed
  10. Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, DC: National Academy Press, 2005. Available at: http://www.nap.edu/openbook.php?record_id=10925. DOI
  11. D'Elia L, Rossi G, Ippolito R, Cappuccio FP, Strazzullo P. Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr 2012;31(4):489-98. PubMed
  12. Goldsmith SR. Hyponatremia in heart failure: time for a trial. J Card Fail 2013;19(6):398-400. PubMed
  13. Willocks L, Brettle R, Keen J, Valentine C, Pinching AJ. Formulations of didanosine (ddI) and salt overload. Lancet 1992;339(8786):190.
  14. Chen L, Zhang Z, Chen W, Whelton PK, Appel LJ. Lower Sodium Intake and Risk of Headaches: Results From the Trial of Nonpharmacologic Interventions in the Elderly. Am J Public Health. 2016;106(7):1270-5. PubMed
  15. Cook NR, Appel LJ, Whelton PK. Lower levels of sodium intake and reduced cardiovascular risk. Circulation. 2014;129(9):981-9. PubMed
  16. Cook NR, Appel LJ, Whelton PK. Sodium Intake and All-Cause Mortality Over 20 Years in the Trials of Hypertension Prevention. J Am Coll Cardiol. 2016;68(15):1609-1617. PubMed
  17. Mente A, O'Donnell M, Rangarajan S, et al. Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Lancet. 2016;388(10043):465-75. PubMed
  18. Moosavian SP, Haghighatdoost F, Surkan PJ, Azadbakht L. Salt and obesity: a systematic review and meta-analysis of observational studies. Int J Food Sci Nutr. 2017;68(3):265-277. PubMed
  19. O'Donnell M, Mente A, Rangarajan S, et al. Urinary sodium and potassium excretion, mortality, and cardiovascular events. N Engl J Med. 2014;371(7):612-23. DOI
  20. Poggio R, Gutierrez L, Matta MG, Elorriaga N, Irazola V, Rubinstein A. Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies. Public Health Nutr. 2015;18(4):695-704. PubMed
  21. Stallings VA, Harrison M, Oria M; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Washington (DC): National Acad
  22. Mahtani KR, Heneghan C, Onakpoya I, et al. Reduced Salt Intake for Heart Failure: A Systematic Review. JAMA Intern Med. 2018 Dec 1;178(12):1693-1700. PubMed
  23. Yancy CW. Sodium Restriction in Heart Failure: Too Much Uncertainty-Do the Trials. JAMA Intern Med. 2018 Dec 1;178(12):1700-1701. PubMed
  24. He FJ, Campbell NRC, Ma Y, MacGregor GA, Cogswell ME, Cook NR. Errors in estimating usual sodium intake by the Kawasaki formula alter its relationship with mortality: implications for public health. Int J Epidemiol. 2018;47(6):1784-1795. PubMed
  25. Murthy K, Ondrey GJ, Malkani N, et al. THE EFFECTS OF HYPONATREMIA ON BONE DENSITY AND FRACTURES: A SYSTEMATIC REVIEW AND META-ANALYSIS. Endocr Pract. 2019;25(4):366-378. PubMed
  26. Messerli FH, Hofstetter L, Syrogiannouli L, et al. Sodium intake, life expectancy, and all-cause mortality. Eur Heart J 2021;42(21):2103-2112. PubMed
  27. Graudal NA, Hubeck-Graudal T, Jurgens G. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database Syst Rev 2020;12(12):CD004022. PubMed
  28. Giatti S, Santos RB, Aielo AN, et al. Association of sodium with obstructive sleep apnea. The ELSA-Brasil study. Ann Am Thorac Soc 2021;18(3):502-510. PubMed
  29. Nan X, Lu H, Wu J, et al. The interactive association between sodium intake, alcohol consumption and hypertension among elderly in northern China: a cross-sectional study. BMC Geriatr 2021;21(1):135. PubMed
  30. Kyozuka H, Fukusda T, Murata T, et al. Impact of preconception sodium intake on hypertensive disorders of pregnancy: The Japan Environment and Children's study. Pregnancy Hypertens 2021;23:66-72. PubMed
  31. Zhao L, Ogden CL, Yang Q, et al. Association of usual sodium intake with obesity among US children and adolescents, NHANES 2009-2016. Obesity (Silver Spring) 2021;29(3):587-594. PubMed
  32. Ma Y, He FJ, Sun Q, et al. 24-Hour urinary sodium and potassium excretion and cardiovascular risk. N Engl J Med 2022;386(3):252-263. PubMed
  33. Liu J, Yang X, Zhang P, et al. Association of urinary sodium excretion and left ventricular hypertrophy in people with type 2 diabetes mellitus: A cross-sectional study. Front Endocrinol (Lausanne) 2021;12:728493. PubMed
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See these in context on the Sodium monograph →

Bifidobacterium Longum 21 references
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  2. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  3. Xiao JZ, Takahashi S, Odamaki T, et al. Antibiotic susceptibility of bifidobacterial strains distributed in the Japanese market. Biosci Biotechnol Biochem. 2010;74(2):336-42. PubMed
  4. 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
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  7. Pellonperä O, Mokkala K, Houttu N, et al. Efficacy of fish oil and/or probiotic intervention on the incidence of gestational diabetes mellitus in an at-risk group of overweight and obese women: A randomized, placebo-controlled, double-blind clinical trial PubMed
  8. Shahriari A, Karimi E, Shahriari M, Aslani N, Khooshideh M, Arab A. The effect of probiotic supplementation on the risk of gestational diabetes mellitus among high-risk pregnant women: A parallel double-blind, randomized, placebo-controlled clinical trial PubMed
  9. Esaiassen E, Hjerde E, Cavanagh JP, Simonsen GS, Klingenberg C; Norwegian Study Group on Invasive Bifidobacterial Infections. Bifidobacterium bacteremia: Clinical characteristics and a genomic approach to assess pathogenicity. J Clin Microbiol. 2017;55(7) PubMed
  10. Enomoto T, Sowa M, Nishimori K, et al. Effects of bifidobacterial supplementation to pregnant women and infants in the prevention of allergy development in infants and on fecal microbiota. Allergol Int 2014;63(4):575-85. PubMed
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See these in context on the Bifidobacterium Longum monograph →

Bifidobacterium Bifidum 7 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Xiao JZ, Takahashi S, Odamaki T, et al. Antibiotic susceptibility of bifidobacterial strains distributed in the Japanese market. Biosci Biotechnol Biochem. 2010;74(2):336-42. PubMed
  3. Rerksuppaphol S, Rerksuppaphol L. Randomized controlled trial of probiotics to reduce common cold in schoolchildren. Pediatr Int. 2012;54(5):682-7. PubMed
  4. Karamali M, Dadkhah F, Sadrkhanlou M, et al. Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Metab 2016;42(4):234-41. PubMed
  5. Badehnoosh B, Karamali M, Zarrati M, et al. The effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. J Matern Fetal Neonatal Med. 2018 May;31(9):1128-1136.
  6. Pruccoli G, Silvestro E, Pace Napoleone C, Aidala E, Garazzino S, Scolfaro C. Are probiotics safe? Bifidobacterium bacteremia in a child with severe heart failure. Infez Med. 2019;27(2):175-178.
  7. Esaiassen E, Hjerde E, Cavanagh JP, Simonsen GS, Klingenberg C; Norwegian Study Group on Invasive Bifidobacterial Infections. Bifidobacterium bacteremia: Clinical characteristics and a genomic approach to assess pathogenicity. J Clin Microbiol. 2017;55(7) PubMed

See these in context on the Bifidobacterium Bifidum monograph →

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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