Interactions on record — worth a quick check against your medications. Based on 4 of 6 ingredients. Check your meds →
Dietary supplement

4x6 Acidophilus Ingredients & Drug Interactions

by NOW

4x6 Acidophilus label
See full label image
Capsule Category: Non-nutrient/non-botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking 4x6 Acidophilus 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

4x6 Acidophilus is a dietary supplement by NOW with 6 active ingredients. Its ingredients are commonly taken for digestive health and balance, diarrhea (including antibiotic-related), vaginal yeast and bacterial infections.Based on those ingredients, 182 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Lactobacillus acidophilus (La-14), Bifidobacterium longum (Bl-05), Lactobacillus bulgaricus (Lb-87). Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against 4x6 Acidophilus by NOW

Ask about any prescription or over-the-counter medication and we check it for interactions with 4x6 Acidophilus by NOW — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of 4x6 Acidophilus by NOW

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 0 of its 6 active ingredients.
  • “Blend of Probiotic Bacteria” is a proprietary blend — the label doesn't break down how much of each component you get.

This product contains six active probiotic bacteria strains: Lactobacillus acidophilus (La-14), Bifidobacterium lactis (Bl-04), Bifidobacterium longum (Bl-05), Streptococcus thermophilus (St-21), Lactobacillus bulgaricus (Lb-87), and Lactobacillus paracasei Lpc-37. Each is a live, beneficial microorganism intended to support your gut.

The inactive ingredients are microcrystalline cellulose, hypromellose, stearic acid, and silicon dioxide—standard capsule materials and binders.

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: maintain healthy intestinal flora and bacteria balance.
  • We looked for evidence on: Antibiotic-associated diarrhea, Bacterial vaginosis, Clostridioides difficile infection, Constipation, Diarrhea, Inflammatory bowel disease (IBD) — and 4 related terms.
  • The strongest evidence on file: Lactobacillus Acidophilus is rated "Possibly Effective" for Antibiotic-associated diarrhea (Natural Medicines).
  • Also on file: Lactobacillus Acidophilus is rated "Possibly Effective" for Bacterial vaginosis, Irritable bowel syndrome (IBS).
  • Also on file: Lactobacillus Acidophilus is rated "Insufficient Reliable Evidence To Rate" for Constipation, Inflammatory bowel disease (IBD), Radiation-induced diarrhea, Lactose intolerance.

The evidence on these strains is mixed. Lactobacillus acidophilus is possibly effective for irritable bowel syndrome (IBS), Helicobacter pylori infection, antibiotic-associated diarrhea, and bacterial vaginosis.

For the other four strains, we don't yet have enough reliable evidence to rate them—most carry an "insufficient evidence" rating across a range of uses including antibiotic-associated diarrhea, hay fever, and anxiety. This doesn't mean they don't work; it means the science isn't settled yet.

The evidence, ingredient by ingredient Lactobacillus Acidophilus Bifidobacterium Longum Streptococcus Thermophilus Lactobacillus Delbrueckii

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 4 of the 4 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 4 of 4.
  • General safety write-ups exist for 4 of 4.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

These probiotics are generally well tolerated in healthy adults and children. That said, they contain live microorganisms, so there is some theoretical concern about infection in patients who are severely ill, immune-compromised, or have central venous catheters—though such cases are rare.

Minor digestive side effects like bloating, gas, abdominal discomfort, or diarrhea can occur but are uncommon. One probiotic combination in a trial was linked to a rash and itching in two cases, though it's unclear whether L. acidophilus alone was responsible.

Pregnancy data on L. acidophilus rates it possibly safe; data are limited for the other strains, so talk with your doctor.

Side effects, ingredient by ingredient Lactobacillus Acidophilus Bifidobacterium Longum Streptococcus Thermophilus Lactobacillus Delbrueckii

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 4 matched ingredients can interact with medications — Lactobacillus Acidophilus, Bifidobacterium Longum, Lactobacillus Delbrueckii.
  • The most serious interaction on file is rated Moderate.
  • For scale: 182 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, check with your pharmacist about any antibiotic drugs you're on. Antibiotics can reduce how well these probiotics work, so you'll want to separate the timing.

We have no other documented drug interactions for the ingredients we could check, but use the search tool on this page to confirm your specific medications.

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.

This product is a common multi-strain probiotic that works best for people aiming to support general gut health or manage IBS or antibiotic-related diarrhea. If you take antibiotics, space them apart from this product.

If you're seriously ill, immune-compromised, or pregnant, check with your doctor first—and always run your exact medications through the interaction checker below.

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

Assessment coverage: 4 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 23, 2019.

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 4x6 Acidophilus, straight from the product label.

Brand NOW
Barcode (UPC) 733739029201
Net contents 60 Veg Capsule(s)
Market status On market
Date entered into DSLD Aug 23, 2019
DSLD ID 205770
Product type Non-nutrient/non-botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegan, Vegetarian, Adult (18 - 50 Years), Kosher, Gluten Free, Dairy Free
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 4x6 Acidophilus by NOW, 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 Veg Capsule(s)
Maximum serving Sizes:
1 Veg Capsule(s)
UPC/BARCODE
733739029201
IngredientAmount% DV
Blend of Probiotic Bacteria0 NP--
Lactobacillus acidophilus (La-14)0 NP--
Bifidobacterium lactis (Bl-04)0 NP--
Bifidobacterium longum (Bl-05)0 NP--
Streptococcus thermophilus (St-21)0 NP--
Lactobacillus bulgaricus (Lb-87)0 NP--
Lactobacillus paracasei Lpc-370 NP--

Other ingredients: Microcrystalline Cellulose, Hypromellose, Stearic Acid, Silicon Dioxide

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.
Suggested/Recommended/Usage/Directions

Suggested Usage: Take 1 capsule 1 to 2 times daily between meals or on an empty stomach.

Storage

Refrigerate to maintain potency.

General Statements

This NOW product has been designed to supply a balanced spectrum of beneficial bacteria found in human intestinal tracts. Regular intake of probiotics can aid in maintaining healthy intestinal flora.

Healthy intestinal flora 4 billion potency / 6 probiotic strains Promotes positive probiotic balance

Probiotics/Enzymes/Digestive Family owned since 1968.

This product is formulated to deliver a potency of 4 billion CFU through the best by date. The probiotic strains in this product have been identity-verified using DNA-fingerprinting technology.

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.

Formulation

Not manufactured with wheat, gluten, soy, milk, egg, fish, shellfish or tree nut ingredients.

Dairy, soy & gluten free

Non-GMO

Vegetarian/Vegan

Precautions

Not manufactured with wheat, gluten, soy, milk, egg, fish, shellfish or tree nut ingredients. Produced in a GMP facility that process other ingredients containing these allergens.

Caution: Consult physician if pregnant/nursing, taking medication (especially immune-suppressing drugs), or have a medical condition (especially if immune system is compromised).

Keep out of reach of children.

Seals/Symbols

GMP Quality Assured

Triangle K Non-GMO Strain Verified

Formula

Triangle K

FDA Statement of Identity

A Dietary Supplement

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

See for yourself

4x6 Acidophilus by NOW label

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

4x6 Acidophilus 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 4x6 Acidophilus by NOW

These are the 6 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Veg Capsule(s) Dosage formCapsule 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.

Blend of Probiotic Bacteria

0 NP per serving

Other (inactive) ingredients: Microcrystalline Cellulose, Hypromellose, Stearic Acid, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.

Interaction report

4x6 Acidophilus by NOW Drug Interactions

Want to check YOUR meds against 4x6 Acidophilus?

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
182Drugs
182 Moderate

Ingredients driving the most interactions

Lactobacillus acidophilus (La-14) 182
Bifidobacterium longum (Bl-05) 182
Lactobacillus bulgaricus (Lb-87) 182

Individual Drug Interactions

The ingredients in 4x6 Acidophilus interact with 182 drugs. Click any drug to see the details.

3 of the 6 ingredients in 4x6 Acidophilus interact with drugs. Each result below shows which ingredient is responsible. Lactobacillus acidophilus (La-14) Bifidobacterium longum (Bl-05) Lactobacillus bulgaricus (Lb-87)

Each ingredient & the kinds of drugs it affects

For each ingredient in 4x6 Acidophilus 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.

Lactobacillus acidophilus (La-14)1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Lactobacillus acidophilus with antibiotic drugs might decrease the effectiveness of L. acidophilus.
L. acidophilus 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. acidophilus preparations by at least two hours.

Likelihood Probable Evidence D
Lactobacillus acidophilus (La-14) full monograph & interactions

Bifidobacterium longum (Bl-05)1 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 (Bl-05) full monograph & interactions

Lactobacillus bulgaricus (Lb-87)1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Lactobacillus delbrueckii with antibiotic drugs might decrease the effectiveness of L. delbrueckii.
Lactobacillus delbrueckii 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. delbrueckii preparations by at least two hours.

Likelihood Probable Evidence D
Lactobacillus bulgaricus (Lb-87) full monograph & interactions
The maker

Brand information

Manufacturer and brand details for 4x6 Acidophilus, from the product label.

NOW

See all NOW products
Name
NOW Foods
Street Address
395 S. Glen Ellyn Rd.
City
Bloomingdale
State
IL
ZipCode
60108
Web Address
nowfoods.com
Pharmacist Counseling Corner

4x6 Acidophilus by NOW: Common Questions

Does 4x6 Acidophilus by NOW interact with any medications?
Yes. Based on its ingredients, 4x6 Acidophilus has a known interaction with 182 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
4x6 Acidophilus contains 6 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.
Can I take this while I'm on antibiotics?
Not at the same time. Three of the strains in this product—L. acidophilus, B. longum, and L. delbrueckii—can be killed by antibiotics, making the probiotic less effective. Ask your pharmacist to help you space them out; a common approach is to take them several hours apart or finish your antibiotics before starting the probiotic.
Is this safe during pregnancy?
L. acidophilus is rated possibly safe in pregnancy, but data are limited for the other four strains we checked. It's best to talk with your doctor or pharmacist before taking this while pregnant, since they know your full health picture.
What side effects might I get?
Most people tolerate it well. Digestive discomfort—bloating, gas, mild belly pain, or loose stool—can happen but is uncommon. A rash or itching was reported in a couple of people in one trial, though it's unclear if the probiotic was the cause. If symptoms are bothersome or don't settle, stop and tell your pharmacist.
Does it actually work for IBS?
L. acidophilus in this product is possibly effective for IBS according to available research. The other strains don't yet have enough evidence to say one way or the other. Results vary by person, so it may take a few weeks to notice a difference.
What exactly are these strains?
They're live bacteria normally found in your gut and fermented foods like yogurt. Each strain has a specific code—like La-14 or Bl-04—so manufacturers can track quality and consistency. All six in this product are recognized beneficial species.
Is there anything else in the capsule besides the bacteria?
Yes—the capsule contains microcrystalline cellulose, hypromellose, stearic acid, and silicon dioxide. These are standard inactive ingredients that hold the capsule together and keep the product stable.

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

Not sure if 4x6 Acidophilus 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.

4x6 Acidophilus label
Go deeper

The Full Monographs Behind 4x6 Acidophilus’s Ingredients

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

Herb & supplement monograph

Lactobacillus Acidophilus

Interacts with 182 drugs

Lactobacillus acidophilus is a 'friendly' bacterium used as a probiotic to support gut and vaginal health. It is generally well tolerated in healthy people, and there is reasonable evidence...

Read the full Lactobacillus Acidophilus 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

Streptococcus Thermophilus

Streptococcus thermophilus is a friendly bacterium used as a probiotic, often combined with other strains in yogurt and supplements. It is generally well tolerated in healthy people and may...

Read the full Streptococcus Thermophilus monograph → Herb & supplement monograph

Lactobacillus Delbrueckii

Interacts with 182 drugs

Lactobacillus delbrueckii is a 'friendly' bacterium used in food fermentation and sold as a probiotic, often as part of multi-strain products. It is generally considered safe for healthy peo...

Read the full Lactobacillus Delbrueckii monograph →
Sources

Sources & How We Checked

4x6 Acidophilus'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.

Lactobacillus Acidophilus 15 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Begtrup LM, de Muckadell OB, Kjeldsen J, Christensen RD, Jarbøl DE. Long-term treatment with probiotics in primary care patients with irritable bowel syndrome--a randomised, double-blind, placebo controlled trial. Scand J Gastroenterol 2013;48(10):1127-35 PubMed
  3. 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
  4. Shavakhi A, Tabesh E, Yaghoutkar A, Hashemi H, Tabesh F, Khodadoostan M,Minakari M, Shavakhi S, Gholamrezaei A. The effects of multistrain probiotic compound on bismuth-containing quadruple therapy for Helicobacter pylori infection: a randomized placebo-c
  5. 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
  6. 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.
  7. Kumar S, Kumar R, Rohilla L, Jacob N, Yadav J, Sachdeva N. A high potency multi-strain probiotic improves glycemic control in children with new-onset type 1 diabetes mellitus: A randomized, double-blind, and placebo-controlled pilot study. Pediatr Diabete
  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. Xiao SD, Zhang DZ, Lu H, et al. Multicenter, randomized, controlled trial of heat-killed Lactobacillus acidophilus LB in patients with chronic diarrhea. Adv Ther. 2003;20(5):253-60.
  10. Rossi F, Amadoro C, Gasperi M, Colavita G. Lactobacilli infection case reports in the last three years and safety implications. Nutrients. 2022;14(6):1178. PubMed
  11. Ozer M, Goksu SY, Shahverdiani A, Mustafa M. Lactobacillus acidophilus-induced endocarditis and associated splenic abscess. Case Rep Infect Dis 2020;2020:1382709.
  12. Sadrin S, Sennoune S, Gout B, et al. A 2-strain mixture of Lactobacillus acidophilus in the treatment of irritable bowel syndrome: A placebo-controlled randomized clinical trial. Dig Liver Dis 2020;52(5):534-540. PubMed
  13. Stoffer JN, Slingsby TJ, Giuliari GP. Lactobacillus acidophilus endophthalmitis after intravitreal bevacizumab injection requiring intraocular lens explantation. Can J Ophthalmol 2022;57(1):e21-e22. PubMed
  14. Cukovic-Cavka S, Likic R, Francetic I, Rustemovic N, Opacic M, Vucelic B. Lactobacillus acidophilus as a cause of liver abscess in a NOD2/CARD15-positive patient with Crohn's disease. Digestion 2006;73(2-3):107-10.
  15. Hui J, Ren Y, Wang Y, Han Q. Lactobacillus acidophilus endophthalmitis postcataract operation: A case report with a literature review. Ocul Immunol Inflamm 2023.

See these in context on the Lactobacillus Acidophilus monograph →

Bifidobacterium Longum 21 references
  1. Ha GY, Yang CH, Kim H, Chong Y. Case of sepsis caused by Bifidobacterium longum. J Clin Microbiol 1999;37:1227-8.
  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
  5. 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.
  6. Pellonperä O, Vahlberg T, Mokkala K, et al. Weight gain and body composition during pregnancy: a randomised pilot trial with probiotics and/or fish oil. Br J Nutr. 2020 Nov 4:1-11. PubMed
  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
  11. US Food and Drug Administration (FDA). Dear Healthcare Provider Letter: Warning Regarding Use of Probiotics in Preterm Infants. September 2023. Available at: https://www.fda.gov/media/172606/download?attachment. Accessed November 1, 2023.
  12. Pillai A, Tan J, Paquette V, Panczuk J. Does probiotic bacteremia in premature infants impact clinically relevant outcomes? A case report and updated review of literature. Clin Nutr ESPEN. 2020;39:255-259. PubMed
  13. Sabaté JM, Iglicki F. Effect of Bifidobacterium longum 35624 on disease severity and quality of life in patients with irritable bowel syndrome. World J Gastroenterol 2022;28(7):732-744.
  14. Malaguarnera M, Greco F, Barone G, Gargante MP, Malaguarnera M, Toscano MA. Bifidobacterium longum with fructo-oligosaccharide (FOS) treatment in minimal hepatic encephalopathy: a randomized, double-blind, placebo-controlled study. Dig Dis Sci 2007;52(11) PubMed
  15. Zbinden A, Zbinden R, Berger C, Arlettaz R. Case series of Bifidobacterium longum bacteremia in three preterm infants on probiotic therapy. Neonatology 2015;107(1):56-9.
  16. Tamaki H, Nakase H, Inoue S, et al. Efficacy of probiotic treatment with Bifidobacterium longum 536 for induction of remission in active ulcerative colitis: A randomized, double-blinded, placebo-controlled multicenter trial. Dig Endosc 2016;28(1):67-74.
  17. Bertelli C, Pillonel T, Torregrossa A, et al. Bifidobacterium longum bacteremia in preterm infants receiving probiotics. Clin Infect Dis 2015;60(6):924-7. PubMed
  18. Esaiassen E, Cavanagh P, Hjerde E, Simonsen GS, Støen R, Klingenberg C. Bifidobacterium longum subspecies infantis bacteremia in 3 extremely preterm infants receiving probiotics. Emerg Infect Dis 2016;22(9):1664-6.
  19. Tena D, Losa C, Medina MJ, Sáez-Nieto JA. Peritonitis caused by Bifidobacterium longum: case report and literature review. Anaerobe 2014;27:27-30. PubMed
  20. Sangkanjanavanich S, Pradubpongsa P, Mitthamsiri W, Sangasapaviliya A, Boonpiyathad T. Bifidobacterium infantis 35624 efficacy in patients with uncontrolled asthma: A randomized placebo-controlled trial. Ann Allergy Asthma Immunol 2022;129(6):790-792. PubMed
  21. Wilson HL, Ong CW. Bifidobacterium longum vertebrodiscitis in a patient with cirrhosis and prostate cancer. Anaerobe 2017;47:47-50. PubMed

See these in context on the Bifidobacterium Longum monograph →

Streptococcus Thermophilus 21 references
  1. Saxelin M, Chuang NH, Chassy B, et al. Lactobacilli and bacteremia in southern Finland 1989-1992. Clin Infect Dis 1996;22:564-6. PubMed
  2. 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
  3. 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:
  4. 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
  5. Goldin BR. Health Benefits of probiotics. Br J Nutr 1998;80:S203-7. DOI
  6. 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.
  7. MacGregor G, Smith AJ, Thakker B, Kinsella J. Yoghurt biotherapy: contraindicated in immunosuppressed patients? Postgrad Med J 2002;78:366-7. PubMed
  8. Land MH, Rouster-Stevens K, Woods CR, et al. Lactobacillus sepsis associated with probiotic therapy. Pediatrics 2005;115:178-81.
  9. De Groote MA, Frank DN, Dowell E, et al. Lactobacillus rhamnosus GG bacteremia associated with probiotic use in a child with short gut syndrome. Pediatr Infect Dis J 2005;24:278-80. PubMed
  10. Vahabnezhad E, Mochon AB, Wozniak LJ, Ziring DA. Lactobacillus bacteremia associated with probiotic use in a pediatric patient with ulcerative colitis. J Clin Gastroenterol. 2013;47(5):437-9. PubMed
  11. Dolatkhah N, Hajifaraji M, Abbasalizadeh F, Aghamohammadzadeh N, Mehrabi Y, Abbasi MM. Is there a value for probiotic supplements in gestational diabetes mellitus? A randomized clinical trial. J Health Popul Nutr. 2015;33:25. PubMed
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  21. Kato K, Funabashi N, Takaoka H, et al. Lactobacillus paracasei endocarditis in a consumer of probiotics with advanced and severe bicuspid aortic valve stenosis complicated with diffuse left ventricular mid-layer fibrosis. Int J Cardiol. 2016;224:157-161. PubMed

See these in context on the Streptococcus Thermophilus monograph →

Lactobacillus Delbrueckii 9 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Rossi F, Amadoro C, Gasperi M, Colavita G. Lactobacilli infection case reports in the last three years and safety implications. Nutrients. 2022;14(6):1178. PubMed
  3. Ranchal P, Gupta R, Goldberg R, A Lobo S, Pascual A, El Khoury MY. Penicillin-sensitive Lactobacillus jensenii bacteremia. Am J Ther 2021;28(2):e250-e252. PubMed
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  5. Toprak NU, Bozan T, Yilmaz S, Buyukbayrak EE, Tigen ET. Polymicrobial bacteremia due to Lactobacillus jensenii and Veillonella montpellierensis in a pregnant patient; case report and review of literature. Anaerobe 2022;75:102576. PubMed
  6. Chazan B, Raz R, Shental Y, Sprecher H, Colodner R. Bacteremia and pyelonephritis caused by Lactobacillus jensenii in a patient with urolithiasis. Isr Med Assoc J 2008;10(2):164-5.
  7. Neonakis IK, Skamagkas I, Stafylaki D, Maraki S. Lactobacillus delbrueckii urinary tract infection in a male patient: a case report. Germs 2022;12(2):304-307. PubMed
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See these in context on the Lactobacillus Delbrueckii 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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