Interactions on record — worth a quick check against your medications. Check your meds →
Dietary supplement

60 Billion Probiotic Ingredients & Drug Interactions

by Physician's Choice

60 Billion Probiotic label
See full label image
Capsule Category: Other Combinations
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 60 Billion Probiotic 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

60 Billion Probiotic is a dietary supplement by Physician's Choice with 4 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, 2,108 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Acacia Fiber, Probiotic Blend, Inulin. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against 60 Billion Probiotic by Physician's Choice

Ask about any prescription or over-the-counter medication and we check it for interactions with 60 Billion Probiotic by Physician's Choice — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of 60 Billion Probiotic by Physician's Choice

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 13 active ingredients.
  • “Probiotic Blend” is a proprietary blend — the label gives one combined amount (220 mg) without saying how much of each component you get.
  • “Prebiotic Blend” is a proprietary blend — the label gives one combined amount (150 mg) without saying how much of each component you get.

This product contains 13 ingredients, with 8 active probiotic bacterial strains and 2 prebiotic fibers. The probiotics are Lactobacillus acidophilus, Bifidobacterium longum, Bifidobacterium bifidum, Bifidobacterium breve, Lactobacillus bulgaricus, Ligilactobacillus salivarius, Lactiplantibacillus plantarum, Lacticaseibacillus casei, and Lacticaseibacillus paracasei — each provides live, active organisms.

The prebiotics are inulin and acacia fiber, which feed beneficial bacteria in your gut. The remaining ingredients are inactive: hypromellose and gellan gum (capsule materials), rice flour, rice husks concentrate, gum arabic, and sunflower oil (fillers 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

This product doesn't appear to be marketed for a specific use, so we graded its ingredients' overall clinical evidence instead.

Moderate

Some clinical evidence supports its ingredients for:

Why this rating?
  • The label markets general wellness (“promote digestive health”), not a specific health condition, so there is no single claim to grade against clinical-evidence data.
  • Since the label doesn't commit to one use, we graded the ingredients' overall clinical evidence instead.
  • On file: Allergic rhinitis (hay fever) — rated "Possibly Effective" (Lacticaseibacillus Paracasei) (Natural Medicines).
  • On file: Antibiotic-associated diarrhea — rated "Possibly Effective" (Lactobacillus Acidophilus) (Natural Medicines).
  • On file: Bacterial vaginosis — rated "Possibly Effective" (Lactobacillus Acidophilus) (Natural Medicines).
  • On file: Common cold — rated "Possibly Effective" (Lactiplantibacillus Plantarum) (Natural Medicines).
  • On file: Constipation — rated "Possibly Effective" (Inulin) (Natural Medicines).

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

Bifidobacterium bifidum is possibly effective for IBS and respiratory tract infections. Lactiplantibacillus plantarum is possibly effective for atopic dermatitis (eczema), high cholesterol, ulcerative colitis, and the common cold.

Inulin is possibly effective for weight management, constipation, and diabetes. Several other strains—Bifidobacterium longum, Bifidobacterium breve, Ligilactobacillus salivarius, Lacticaseibacillus casei, and Lacticaseibacillus paracasei—have insufficient evidence to rate them for their intended uses.

The evidence for probiotics overall is still developing.

The evidence, ingredient by ingredient Lactobacillus Acidophilus Bifidobacterium Longum Bifidobacterium Bifidum Bifidobacterium Breve Ligilactobacillus Salivarius Lactiplantibacillus Plantarum Lacticaseibacillus Casei Lacticaseibacillus Paracasei

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 10 of the 10 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 10 of 10.
  • General safety write-ups exist for 10 of 10.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

The probiotic strains in this product are generally well tolerated in healthy adults and children, though some caution applies. Mild gastrointestinal side effects — bloating, flatulence, abdominal discomfort, and diarrhea — can occur, especially when first starting, though they're uncommon.

More serious infections (bacteremia, sepsis, abscess) are rare and have mainly been reported in critically ill or immunocompromised people. Inulin commonly causes bloating, gas, and diarrhea, especially at higher doses.

Bifidobacterium longum and Lacticaseibacillus paracasei are rated possibly safe in pregnancy and lactation; data are not on file for the other bacterial strains. If you're seriously ill, immunocompromised, or pregnant or breastfeeding, talk with your doctor or pharmacist before starting this product.

Side effects, ingredient by ingredient Lactobacillus Acidophilus Bifidobacterium Longum Bifidobacterium Bifidum Bifidobacterium Breve Ligilactobacillus Salivarius Lactiplantibacillus Plantarum Lacticaseibacillus Casei Lacticaseibacillus Paracasei

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?
  • 10 of the 10 matched ingredients can interact with medications — Gum Arabic, Lactobacillus Acidophilus, Inulin, Bifidobacterium Breve, Bifidobacterium Bifidum, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: diabetes medications.
  • For scale: 2,109 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.

Antibiotics are the primary concern — they're Moderate interactions with most of the bacterial strains in this product. Take your antibiotic and this probiotic several hours apart so the antibiotic doesn't kill the live organisms.

Diabetes medications (antidiabetes drugs) have a Minor interaction with inulin in this product; theoretically it could increase low blood sugar risk, though the evidence is unclear. If you take any of these, check with your doctor or pharmacist before adding this supplement.

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 behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.

This probiotic may help with IBS, certain diarrheal conditions, and other digestive or immune concerns, though the evidence varies by strain. The main thing to watch is timing with antibiotics — take them several hours apart so the antibiotics don't kill the probiotics.

If you're healthy, expect it to be well tolerated, but mild gas and bloating can happen. Check your exact medications on this page before starting, especially if you take antibiotics or diabetes drugs.

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

Assessment coverage: 11 of 13 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 25, 2025.

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 60 Billion Probiotic, straight from the product label.

Brand Physician's Choice
Net contents 60 Capsule(s)
Market status On market
Date entered into DSLD Sep 25, 2025
DSLD ID 335642
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), No Allergies, 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 60 Billion Probiotic by Physician's Choice, 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 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
Servings per container
30
IngredientAmount% DV
Lactobacillus acidophilus0 NP--
Bifidobacterium longum0 NP--
Bifidobacterium bifidum0 NP--
Bifidobacterium breve0 NP--
Acacia Fiber0 NP--
Probiotic Blend220 mg--
Prebiotic Blend150 mg--
Lactobacillus bulgaricus0 NP--
Inulin0 NP--
Inulin0 NP--
Bifidobacterium animalis lactis0 NP--
Ligilactobacillus salivarius0 NP--
Lactiplantibacillus plantarum0 NP--
Lacticaseibacillus casei0 NP--
Lacticaseibacillus paracasei0 NP--

Other ingredients: Hypromellose, Gellan Gum, Rice Flour, Rice Husks Concentrate, Gum Arabic, Sunflower Oil

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

Developed with Doctors Developed with our team of Physician's Choice doctors, please talk to your doctor before starting any new health routine.

Formula

10 Strains

60 Billion CFUs to promote digestive health 10 diverse strains because your gut loves variety 150mg prebiotics to fuel the good bacteria in your gut

FDA Statement of Identity

Probiotic Supplement

Formulation

Formulated without Dairy, Soy, Gluten, Wheat, Peanuts, Tree Nuts, Sesame, Eggs, Fish, Shellfish, Color Additives, Artificial Sweeteners or Preservatives Non GMO Project Verified nongmopreoject.org

Seals/Symbols

Non GMO Project Verified nongmopreoject.org

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.

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

See for yourself

60 Billion Probiotic by Physician's Choice label

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

60 Billion Probiotic 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 60 Billion Probiotic by Physician's Choice

These are the 4 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container30 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.

Probiotic Blend

Interacts with
182 drugs
220 mg per serving

Lactobacillus acidophilus is a 'friendly' bacterium used as a probiotic to support gut and vaginal health. It is generally well tolerated in healthy p...

Probiotic Blend monograph & interactions

Prebiotic Blend

150 mg per serving

Other (inactive) ingredients: Hypromellose, Gellan Gum, Rice Flour, Rice Husks Concentrate, Gum Arabic, Sunflower Oil. These complete the product’s ingredient list but are not active constituents.

Interaction report

60 Billion Probiotic by Physician's Choice Drug Interactions

Want to check YOUR meds against 60 Billion Probiotic?

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
2,108Drugs
2,080 Moderate 28 Minor

Ingredients driving the most interactions

Acacia Fiber 2,022
Probiotic Blend 182
Inulin 86

Individual Drug Interactions

The ingredients in 60 Billion Probiotic interact with 2,108 drugs. Click any drug to see the details.

3 of the 4 ingredients in 60 Billion Probiotic interact with drugs. Each result below shows which ingredient is responsible. Acacia Fiber Probiotic Blend Inulin

Each ingredient & the kinds of drugs it affects

For each ingredient in 60 Billion Probiotic 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.

Acacia Fiber2 drug types · 2,022 drugs

Amoxicillin (Amoxil, Trimox)

Gum arabic can reduce the absorption of amoxicillin.
A small study in healthy volunteers shows that taking amoxicillin and gum arabic concurrently significantly reduces the absorption of amoxicillin. Separate doses of amoxicillin from gum arabic by at least 2 hours.

Likelihood Probable Evidence B
Oral Drugs

Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.
Gum arabic has been used as a suspending osmotic agent in drug formulations. It might improve bioavailability of water-insoluble drugs like naproxen, but reduce absorption of polar drugs like amoxicillin. To avoid changes in absorption, take gum arabic 30-60 minutes after oral medications.

Likelihood Possible Evidence B
Acacia Fiber full monograph & interactions

Probiotic Blend1 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
Probiotic Blend full monograph & interactions

Inulin1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, inulin might increase the risk of hypoglycemia with antidiabetes drugs.
Some clinical research shows that inulin improves glycemic control in patients with diabetes; however, it is unclear if it has hypoglycemic effects.

Likelihood Unlikely Evidence D
Inulin full monograph & interactions
The maker

Brand information

Manufacturer and brand details for 60 Billion Probiotic, from the product label.

Physician's Choice

See all Physician's Choice products
Name
Physician's Choice
Pharmacist Counseling Corner

60 Billion Probiotic by Physician's Choice: Common Questions

Does 60 Billion Probiotic by Physician's Choice interact with any medications?
Yes. Based on its ingredients, 60 Billion Probiotic has a known interaction with 2,108 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
60 Billion Probiotic contains 4 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?
Technically you can, but timing matters. Antibiotics kill the live bacteria in probiotics, so you won't get the benefit if you take them at the same time. Separate them by a few hours — take your antibiotic dose, wait, then take your probiotic. Your pharmacist or doctor can help you space them out.
Will this give me side effects?
Most people tolerate it fine. The most common side effects are mild and digestive — bloating, gas, and diarrhea — especially when you first start. These are uncommon and usually settle down. Serious infections from probiotics are very rare and mostly happen in people who are critically ill or have weak immune systems.
Is this safe if I'm pregnant or breastfeeding?
Two of the strains here — Bifidobacterium longum and Lacticaseibacillus paracasei — are rated possibly safe during pregnancy and lactation. We don't have enough safety data on file for the other strains, so talk with your doctor or pharmacist for personalized advice before using it.
What's the difference between the probiotics and prebiotics in here?
Probiotics are the live beneficial bacteria — the eight different strains. Prebiotics are fibers (inulin and acacia fiber) that feed those bacteria so they can grow and thrive in your gut. You need both working together for best results.
Will this actually help my IBS or digestive issues?
Some of the strains here — Lactobacillus acidophilus and Bifidobacterium bifidum — are possibly effective for IBS based on clinical evidence. Others have insufficient evidence yet. Results vary person to person, and probiotics work best as part of an overall approach with diet and lifestyle. Give it a fair trial and talk with your doctor if you don't see improvement.
Can I take this with my diabetes medicine?
The inulin in this product theoretically might increase the risk of low blood sugar when combined with diabetes medications, though the evidence isn't clear. If you take diabetes drugs, mention this supplement to your pharmacist or doctor before starting, and monitor your blood sugar as advised.

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

Not sure if 60 Billion Probiotic is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.

60 Billion Probiotic label
Go deeper

The Full Monographs Behind 60 Billion Probiotic’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

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 → Herb & supplement monograph

Bifidobacterium Breve

Interacts with 182 drugs

Bifidobacterium breve is a 'friendly' gut bacterium taken as a probiotic, most often to support digestion and balance the gut microbiome. Some studies suggest possible benefits for certain d...

Read the full Bifidobacterium Breve monograph → Herb & supplement monograph

Ligilactobacillus Salivarius

Interacts with 182 drugs

Ligilactobacillus salivarius (formerly called Lactobacillus salivarius) is a probiotic bacterium found naturally in the mouth and gut of humans and animals. People take it to support digesti...

Read the full Ligilactobacillus Salivarius monograph → Herb & supplement monograph

Lactiplantibacillus Plantarum

Interacts with 182 drugs

Lactiplantibacillus plantarum is a 'friendly' bacterium (probiotic) found in fermented foods and many supplements, studied mainly for digestive health. It is generally well tolerated in heal...

Read the full Lactiplantibacillus Plantarum monograph → Herb & supplement monograph

Lacticaseibacillus Casei

Interacts with 182 drugs

Lacticaseibacillus casei (formerly Lactobacillus casei) is a 'friendly' probiotic bacterium found in fermented foods and many supplements. It is most studied for digestive issues like diarrh...

Read the full Lacticaseibacillus Casei monograph → Herb & supplement monograph

Lacticaseibacillus Paracasei

Interacts with 182 drugs

Lacticaseibacillus paracasei (formerly Lactobacillus paracasei) is a probiotic bacterium found in fermented foods and supplements that is widely used to support gut and immune health. Some s...

Read the full Lacticaseibacillus Paracasei monograph → Herb & supplement monograph

Gum Arabic

Interacts with 2,022 drugs

Gum arabic is a soluble dietary fiber from the acacia tree that is widely used as a safe food additive and is sometimes taken as a supplement for digestive health and as a prebiotic. Early s...

Read the full Gum Arabic monograph → Herb & supplement monograph

Inulin

Interacts with 86 drugs

Inulin is a type of plant fiber (a prebiotic) found naturally in foods like chicory root, onions, and garlic, and it is widely added to supplements and processed foods. It may help with regu...

Read the full Inulin monograph →
Sources

Sources & How We Checked

60 Billion Probiotic'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 125 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.
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  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 →

Bifidobacterium Bifidum 7 references
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  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
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  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.
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See these in context on the Bifidobacterium Bifidum monograph →

Bifidobacterium Breve 9 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. 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.
  4. Ohishi A, Takahashi S, Ito Y, et al. Bifidobacterium septicemia associated with postoperative probiotic therapy in a neonate with omphalocele. J Pediatr. 2010;156(4):679-81. PubMed
  5. Sakurai Y, Watanabe T, Miura Y, et al. Clinical and bacteriologic characteristics of six cases of Bifidobacterium breve bacteremia due to probiotic administration in the neonatal intensive care unit. Pediatr Infect Dis J 2022;41(1):62-65. PubMed
  6. 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
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Gum Arabic 8 references
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See these in context on the Gum Arabic monograph →

Inulin 17 references
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  11. Smiljanec K, Mitchell CM, Privitera OF, Neilson AP, Davy KP, Davy BM. Pre-meal inulin consumption does not affect acute energy intake in overweight and obese middle-aged and older adults: A randomized controlled crossover pilot trial. Nutr Health. 2017;23 PubMed
  12. Cai X, Yu H, Liu L, et al. Milk powder co-supplemented with inulin and resistant dextrin improves glycemic control and insulin resistance in elderly type 2 diabetes mellitus: a 12-week randomized, double-blind, placebo-controlled trial. Mol Nutr Food Res PubMed
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  17. Risso D, Kaczmarczyk M, Laurie I, et al. Moderate intakes of soluble corn fibre or inulin do not cause gastrointestinal discomfort and are well tolerated in healthy children. Int J Food Sci Nutr 2022;73(8):1104-1115. PubMed

See these in context on the Inulin monograph →

Ligilactobacillus Salivarius 10 references
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  2. Lindsay KL, Brennan L, Kennelly MA, et al. Impact of probiotics in women with gestational diabetes mellitus on metabolic health: a randomized controlled trial. Am J Obstet Gynecol. 2015;212(4):496.e1-11. PubMed
  3. Fernández L, Cárdenas N, Arroyo R, et al. Prevention of Infectious Mastitis by Oral Administration of Lactobacillus salivarius PS2 During Late Pregnancy. Clin Infect Dis. 2016;62(5):568-573.
  4. 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
  5. 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
  6. Grazioli-Gauthier L, Rigamonti E, Leo LA, Martinetti Lucchini G, Lo Priore E, Bernasconi E. Lactobacillus jensenii mitral valve endocarditis: Case report, literature review and new perspectives. IDCases 2022;27:e01401. PubMed
  7. 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
  8. 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.
  9. Wang HK, Teng LJ, Chen YC, Du SH, Hsueh PR. Lactobacillus salivarius empyema with respiratory failure. J Microbiol Immunol Infect 2017;50(6):923-925. PubMed
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See these in context on the Ligilactobacillus Salivarius monograph →

Lactiplantibacillus Plantarum 12 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Ducrotté P, Sawant P, Jayanthi V. Clinical trial: Lactobacillus plantarum 299v (DSM 9843) improves symptoms of irritable bowel syndrome. World J Gastroenterol 2012;18(30):4012-8.
  3. 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
  4. Topcuoglu S, Gursoy T, Ovali F, Serce O, Karatekin G. A new risk factor for neonatal vancomycin-resistant Enterococcus colonisation: bacterial probiotics. J Matern Fetal Neonatal Med. 2015;28(12):1491-4. PubMed
  5. 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
  6. 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
  7. Axling U, Önning G, Martinsson Niskanen T, Larsson N, Hansson SR, Hulthén L. The effect of Lactiplantibacillus plantarum 299v together with a low dose of iron on iron status in healthy pregnant women: A randomized clinical trial. Acta Obstet Gynecol Scand
  8. Matsuura H, Kiura Y, Ito T, et al. Lactobacillus bacteremia: a diagnostic clue of rectal cancer. QJM. 2021;114(2):122-123. PubMed
  9. Lazou Ahrén I, Berggren A, Teixeira C, Martinsson Niskanen T, Larsson N. Evaluation of the efficacy of Lactobacillus plantarum HEAL9 and Lactobacillus paracasei 8700:2 on aspects of common cold infections in children attending day care: a randomised, doub
  10. Busch R, Gruenwald J, Dudek S. Randomized, double blind and placebo controlled study using a combination of two probiotic lactobacilli to alleviate symptoms and frequency of common cold. Food Nutr Sci 2013;4(11A):13-2. DOI
  11. Bengtsson J, Adlerberth I, Östblom A, Saksena P, Öresland T, Börjesson L. Effect of probiotics (Lactobacillus plantarum 299 plus Bifidobacterium Cure21) in patients with poor ileal pouch function: a randomised controlled trial. Scand J Gastroenterol 2016;
  12. Canaviri-Paz P, Oscarsson E, Kjellström A, Olsson H, Jois C, Håkansson Å. Effects on Microbiota Composition after Consumption of Quinoa Beverage Fermented by a Novel Xylose-Metabolizing L. plantarum Strain. Nutrients 2021;13(10):3318. PubMed

See these in context on the Lactiplantibacillus Plantarum monograph →

Lacticaseibacillus Casei 10 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Orkaby AR, Chen B, Iliaki EF, Sulis CA, Oates DJ. A curious case of Lactobacillus casei in a prosthetic joint: was it the yogurt? J Am Geriatr Soc. 2012;60(6):1177-8.
  3. 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
  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. Topcuoglu S, Gursoy T, Ovali F, Serce O, Karatekin G. A new risk factor for neonatal vancomycin-resistant Enterococcus colonisation: bacterial probiotics. J Matern Fetal Neonatal Med. 2015;28(12):1491-4. 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. 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
  8. de Seynes C, Dutronc H, Cremer P, Dupon M. Lactobacillus casei prosthetic joint infection. Med Mal Infect 2018;48(6):422-423. PubMed
  9. Russo A, Angeletti S, Lorino G, et al. A case of Lactobacillus casei bacteraemia associated with aortic dissection: is there a link?. New Microbiol 2010;33(2):175-8.
  10. Rahman A, Alqaisi S, Nath J. A Case of Lactobacillus casei endocarditis associated with probiotic intake in an immunocompromised patient. Cureus. 2023;15(4):e38049. PubMed

See these in context on the Lacticaseibacillus Casei monograph →

Lacticaseibacillus Paracasei 16 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. Franko B, Vaillant M, Recule C, Vautrin E, Brion JP, Pavese P. Lactobacillus paracasei endocarditis in a consumer of probiotics. Med Mal Infect 2013;43(4):171-3. PubMed
  4. Orkaby AR, Chen B, Iliaki EF, Sulis CA, Oates DJ. A curious case of Lactobacillus casei in a prosthetic joint: was it the yogurt? J Am Geriatr Soc. 2012;60(6):1177-8.
  5. 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
  6. 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;224:157-61. PubMed
  7. Lee C, Wongjarupong N, Narayan M, Melzer AC. Acute cholecystitis complicated with gallbladder perforation and peritonitis caused by vancomycin-resistant Lactobacillus paracasei. Cureus. 2020;12(3):e7476. PubMed
  8. Cai T, Gallelli L, Cione E, et al. The use of Lactobacillus casei DG® prevents symptomatic episodes and reduces the antibiotic use in patients affected by chronic bacterial prostatitis: results from a phase IV study. World J Urol. 2021. DOI
  9. 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
  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. Campbell RE, Miller A, Afroze A. Native valve endocarditis secondary to Lactobacillus paracasei bacteremia. Consultant. 2020;60(9):27-8. DOI
  12. Harding-Theobald E, Maraj B. Spontaneous bacterial peritonitis due to Lactobacillus paracasei in cirrhosis. Case Rep Gastrointest Med 2018;2018:5714053.
  13. Tan C, Howard JL, Bondy L. Prosthetic joint infection after total hip arthroplasty caused by Lactobacillus paracasei. CMAJ 2020;192(44):E1357-E1360.
  14. Sathikulpakdee S, Kanokrungsee S, Vitheejongjaroen P, Kamanamool N, Udompataikul M, Taweechotipatr M. Efficacy of probiotic-derived lotion from Lactobacillus paracasei MSMC 39-1 in mild to moderate acne vulgaris, randomized controlled trial. J Cosmet Derm
  15. Miwa T, Tanaka H, Shiojiri T. Infected pancreatic necrosis and retroperitoneal abscess associated with Lactobacillus paracasei. BMJ Case Rep 2021;14(8):e243936.
  16. Thijssen AY, Clemens CH, Vankerckhoven V, Goossens H, Jonkers DM, Masclee AA. Efficacy of Lactobacillus casei Shirota for patients with irritable bowel syndrome. Eur J Gastroenterol Hepatol 2016;28(1):8-14. PubMed

See these in context on the Lacticaseibacillus Paracasei monograph →

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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.

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