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Dietary supplement

Fortify Optima Daily Probiotic Ingredients & Drug Interactions

by Nature's Way

Fortify Optima Daily 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 Fortify Optima Daily 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

Fortify Optima Daily Probiotic is a dietary supplement by Nature's Way with 3 active ingredients.Based on those ingredients, 2,108 medications have a known interaction with it, the most serious rated moderate. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Fortify Optima Daily Probiotic by Nature's Way

Ask about any prescription or over-the-counter medication and we check it for interactions with Fortify Optima Daily Probiotic by Nature's Way — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Fortify Optima Daily Probiotic by Nature's Way

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 30, 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 18 active ingredients.
  • “Proprietary Plant-Based Prebiotic Blend” is a proprietary blend — the label gives one combined amount (75 mg) without saying how much of each component you get.
  • “Lactobacilli Blend” is a proprietary blend — the label doesn't break down how much of each component you get.
  • “Bifidobacteria/Streptococcus Blend” is a proprietary blend — the label doesn't break down how much of each component you get.

This product contains 18 ingredients, including 11 different probiotic strains (live beneficial bacteria) and prebiotic fibers. The probiotic strains include Bifidobacterium bifidum, Bifidobacterium lactis, Streptococcus thermophilus, Lactobacillus gasseri, Lactobacillus acidophilus, and several others — these are meant to support your gut flora.

The fibers — Chicory root Fiber, Gum Acacia Fiber, and organic Blue Agave Inulin — act as prebiotics, feeding the beneficial bacteria. The inactive ingredients are Cellulose, plant-derived Capsule, Magnesium Stearate, and Silica.

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: digestive and immune health support.
  • We looked for evidence on: Antibiotic-associated diarrhea, Constipation, Diarrhea, Irritable bowel syndrome (IBS), Lactose intolerance, gut microbiome balance — and 2 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 Irritable bowel syndrome (IBS).
  • Also on file: Inulin is rated "Possibly Effective" for Constipation.

For Lactobacillus acidophilus, the ingredient we hold the most data on, there's possibly effective evidence for irritable bowel syndrome (IBS), Helicobacter pylori infection, antibiotic-associated diarrhea, and bacterial vaginosis — though the strength of that evidence varies. Bifidobacterium bifidum is possibly effective for IBS and respiratory tract infections.

Organic Blue Agave Inulin is possibly effective for obesity, constipation, and diabetes. For many of the other conditions listed in the product or on ingredient monographs — like hay fever, anxiety, and several others — the evidence is insufficient to rate.

The effectiveness of this blend as a whole isn't established in the data we hold.

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 7 of the 7 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 7 of 7.
  • General safety write-ups exist for 7 of 7.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

The live-organism probiotics in this product are generally well tolerated in healthy people, though those with weakened immune systems should be cautious. The most common side effects reported are digestive: bloating, flatulence, gas, mild diarrhea, abdominal discomfort, and cramping, especially when starting the supplement — these often ease within a couple of weeks.

Rare cases of infection (bacteremia or sepsis) have been reported with some probiotic strains, but only in severely ill or immunocompromised patients, not in otherwise healthy people. Chicory root Fiber may trigger allergies in people sensitive to ragweed, chrysanthemums, and related plants.

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?
  • 6 of the 7 matched ingredients can interact with medications — Chicory, Gum Arabic, Lactobacillus Acidophilus, Inulin, 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.

Check with your doctor or pharmacist before combining this product with antibiotic drugs (Moderate severity — the probiotics and antibiotics may interfere with each other). If you take antidiabetes medications or amoxicillin, also discuss this supplement beforehand: Chicory root Fiber and Inulin may theoretically raise the risk of low blood sugar, and Gum Acacia Fiber can reduce amoxicillin absorption.

For any other prescription or over-the-counter medications you take, use the interaction checker below to be sure.

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 probiotic blend might help if you have IBS, antibiotic-associated diarrhea, or constipation, though the evidence is stronger for some strains than others. If you take antibiotics, antidiabetes medications, or amoxicillin, talk with your doctor or pharmacist before starting this product — several ingredients interact with these drug types.

Anyone with a weakened immune system or serious illness should check with their healthcare provider first. Most people tolerate it well, but digestive upset is common when starting.

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

Assessment coverage: 7 of 18 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 22, 2022.

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 Fortify Optima Daily Probiotic, straight from the product label.

Brand Nature's Way
Net contents 30 Delayed Release Capsule(s)
Market status On market
Date entered into DSLD Sep 22, 2022
DSLD ID 273452
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Gluten 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 Fortify Optima Daily Probiotic by Nature's Way, 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
L. rhamnosus GG0 NP--
B. bifidum Bb-060 NP--
Bifidobacterium lactis Bl-040 NP--
Chicory root Fiber0 NP--
Streptococcus thermophilus St-210 NP--
Gum Acacia Fiber0 NP--
organic Blue Agave Inulin0 NP--
Lactobacillus paracasei Lpc-370 NP--
L. plantarum Lp-1150 NP--
B. lactis Bi-070 NP--
L. brevis Lbr-350 NP--
L. gasseri Lg-360 NP--
B. infantis Bi-260 NP--
Proprietary Plant-Based Prebiotic Blend75 mg--
Lactobacilli Blend0 NP--
Bifidobacteria/Streptococcus Blend0 NP--
L. bulgaricus Lb-870 NP--
L. reuteri 1E10 NP--
HOWARU B. lactis HN0190 NP--
HOWARU L. rhamnosus HN0010 NP--
Fortify Optima Daily 35 Billion CFU Proprietary Probiotic Blend525 mg--
HOWARU L. acidophilus NCFM0 NP--

Other ingredients: Cellulose, plant-derived Capsule, Magnesium Stearate, Silica

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.
Formulation

Powerful probiotics for daily digestive & immune health

One capsule, multiple benefits

Targeted delivery

Gluten free. No artificial colors.

Non GMO Project Verified Nongmoproject.org

Everyday care

Formula

Formulated with 15 probiotic strains + prebiotics

35 billion active cultures, guaranteed!

Daily Probiotic + Prebiotics

35 billion live probiotic cultures per capsule 15 probiotic strains

Precautions

Keep out of reach of children.

Safety sealed with inner seal. Do not use if seal is broken or missing.

If you are pregnant, nursing or taking any medications, consult a healthcare professional before use.

Storage

Keep tightly closed. Can be stored at room temperature or refrigerated. Avoid excessive heat and direct sunlight.

Brand IP Statement(s)

Howaru Probiotic quality you can feel Howaru is a registered trademark of IFF and is used under license. HN019 and HN001 are trademarks of the Fonterra Group of companies used under license. The probiotic strains contained in this product are manufactured by IFF.

Copyright 2022 Nature's Way Brands, LLC

Seals/Symbols

Certified Gluten-free gfco.org Non GMO Project Verified Nongmoproject.org

FDA Disclaimer Statement

This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

FDA Statement of Identity

Probiotic Supplement

Suggested/Recommended/Usage/Directions

Recommendation: Take 1 capsule daily. May be taken at any time, with or without food.

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

See for yourself

Fortify Optima Daily Probiotic by Nature's Way label

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

Fortify Optima Daily 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 Fortify Optima Daily Probiotic by Nature's Way

These are the 3 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.

Fortify Optima Daily 35 Billion CFU Proprietary Probiotic Blend

525 mg per serving
  • › Proprietary Plant-Based Prebiotic Blend
  • › Lactobacilli Blend
  • › Bifidobacteria/Streptococcus Blend

Other (inactive) ingredients: Cellulose, Plant-derived Capsule, Magnesium Stearate, Silica. These complete the product’s ingredient list but are not active constituents.

Interaction report

Fortify Optima Daily Probiotic by Nature's Way Drug Interactions

Want to check YOUR meds against Fortify Optima Daily 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
2,108 Moderate

Ingredients driving the most interactions

Individual Drug Interactions

The ingredients in Fortify Optima Daily Probiotic interact with 2,108 drugs. Click any drug to see the details.

0 of the 3 ingredients in Fortify Optima Daily Probiotic interact with drugs. Each result below shows which ingredient is responsible.

Each ingredient & the kinds of drugs it affects

For each ingredient in Fortify Optima Daily Probiotic with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.

The maker

Brand information

Manufacturer and brand details for Fortify Optima Daily Probiotic, from the product label.

Nature's Way

See all Nature's Way products
Name
Nature's Way Brands, LLC
City
Green Bay
State
WI
ZipCode
54311
Phone Number
1-800-962-8873
Web Address
fortifyprobiotics.com
Pharmacist Counseling Corner

Fortify Optima Daily Probiotic by Nature's Way: Common Questions

Does Fortify Optima Daily Probiotic by Nature's Way interact with any medications?
Yes. Based on its ingredients, Fortify Optima Daily 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?
Fortify Optima Daily Probiotic contains 3 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 on antibiotics?
Theoretically, antibiotics might kill a significant number of the live organisms in this probiotic, making it less effective. We recommend separating doses — take the probiotic and antibiotic at different times, several hours apart. Talk with your pharmacist about the best timing for your specific antibiotic.
Can I take this if I have diabetes or am on diabetes medication?
Chicory root Fiber and Inulin in this product may theoretically increase your risk of low blood sugar when combined with diabetes medications. Check with your doctor or pharmacist before taking this product, especially if your blood sugar is already well controlled.
Will this give me gas and bloating?
Yes, digestive side effects like bloating, gas, and mild cramping are common, especially at first, because both the probiotics and the fiber can feed your gut bacteria. These effects often improve within a couple of weeks. If they're severe, start with a smaller dose or take it with food.
Is this safe during pregnancy?
The probiotic strains Bifidobacterium bifidum and Lactobacillus acidophilus are rated Possibly Safe in pregnancy, and Inulin is rated Likely Safe. However, Chicory root Fiber is rated Possibly Unsafe in pregnancy in medicinal amounts because of traditional concerns about uterine stimulation. Talk with your doctor or midwife before taking this product during pregnancy.
Does this actually help with IBS or constipation?
Two of the probiotics in this blend — Lactobacillus acidophilus and Bifidobacterium bifidum — are rated Possibly Effective for IBS. Inulin is also rated Possibly Effective for constipation. The evidence for the blend as a whole isn't established, so results may vary from person to person.
What are the live bacteria in this for?
The probiotic strains are meant to support your gut flora — the beneficial bacteria that live in your digestive system. They're thought to help with digestion, immune function, and gut health. The prebiotic fibers (chicory, gum acacia, and inulin) feed those bacteria to help them thrive.

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

Not sure if Fortify Optima Daily 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.

Fortify Optima Daily Probiotic label
Sources

Sources & How We Checked

Fortify Optima Daily 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 93 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.

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 →

Chicory 13 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Stone-Dorshow T, Levitt MD. Gaseous response to ingestion of a poorly absorbed fructo-oligosaccharide sweetener. Am J Clin Nutr 1987;46:61-5. PubMed
  3. Briet F, et al. Symptomatic response to varying levels of fructo-oligosaccharides consumed occasionally or regularly. Eur J Clin Nutr 1995;49:501-7.
  4. Bouhnik Y, Vahedi K, Achour L, et al. Short-chain fructo-oligosaccharide administration dose-dependently increases fecal bifidobacteria in healthy humans. J Nutr 1999;129:113-6. PubMed
  5. Cummings JH, Macfarlane GT, Englyst HN. Prebiotic digestion and fermentation. Am J Clin Nutr 2001;73:415S-420S. PubMed
  6. Cadot, P., Kochuyt, A. M., van Ree, R., and Ceuppens, J. L. Oral allergy syndrome to chicory associated with birch pollen allergy. Int.Arch.Allergy Immunol. 2003;131(1):19-24. PubMed
  7. Friis, B., Hjorth, N., Vail, J. T., Jr., and Mitchell, J. C. Occupational contact dermatitis from Cichorium (chicory, endive) and Lactuca (lettuce). Contact Dermatitis 1975;1(5):311-313.
  8. Nemery, B. and Demedts, M. Occupational asthma in a chicory grower. Lancet 3-25-1989;1(8639):672-673. PubMed
  9. Pirson F, Detry B, Pilette C. Occupational rhinoconjunctivitis and asthma caused by chicory and oral allergy syndrome associated with bet v 1-related protein. J Investig Allergol Clin Immunol 2009;19(4):306-10.
  10. Willi R, Pfab F, Huss-Marp J, et al. Contact anaphylaxis and protein contact dermatitis in a cook handling chicory leaves. Contact Dermatitis 2009;60(4):226-7. PubMed
  11. Street RA, Sidana J, Prinsloo G. Cichorium intybus: traditional uses, phytochemistry, pharmacology, and toxicology. Evid Based Complement Alternat Med 2013;2013:579319.
  12. Bonnema AL, Kolberg LW, Thomas W, Slavin JL. Gastrointestinal tolerance of chicory inulin products. J Am Diet Assoc 2010;110(6):865-8. PubMed
  13. Devi Kt R, Sivalingam N. Cichorium intybus attenuates Streptozotocin-induced pancreatic ß-cell damage by inhibiting NF-?B activation and oxidative stress. J Appl Biomed 2020;18(2-3):70-9. PubMed

See these in context on the Chicory 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
  12. 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.
  13. Sendil S, Shrimanker I, Mansoora Q, Goldman J, Nookala VK. Lactobacillus rhamnosus bacteremia in an immunocompromised renal transplant patient. Cureus. 2020;12(2):e6887. PubMed
  14. Albarillo FS, Shah U, Joyce C, Slade D. Lactobacillus rhamnosus Infection: A single-center 4-year descriptive analysis. J Glob Infect Dis. 2020;12(3):119-123. PubMed
  15. Pasala S, Singer L, Arshad T, Roach K. Lactobacillus endocarditis in a healthy patient with probiotic use. IDCases. 2020;22:e00915. PubMed
  16. Agrawal S, Tuchman ES, Bruce MJ, Theodorou ME. Fatal Lactobacillus endocarditis in a patient with transcatheter aortic valve replacement. BMJ Case Rep. 2020;13(11):e236835.
  17. Antoun M, Hattab Y, Akhrass FA, Hamilton LD. Uncommon pathogen, Lactobacillus, causing infective endocarditis: Case report and review. Case Rep Infect Dis. 2020;2020:8833948. PubMed
  18. 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
  19. Franko B, Vaillant M, Recule C, Vautrin E, et al. Lactobacillus paracasei endocarditis in a consumer of probiotics. Med Mal Infect. 2013;43(4):171-3. PubMed
  20. Campbell RE, Miller A, Afroze A. Native valve endocarditis secondary to Lactobacillus paracasei bacteremia. Consultant. 2020;60(9):27-8. DOI
  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 →

Gum Arabic 8 references
  1. Jensen CD, Spiller GA, Gates JE, et al. The effect of acacia gum and a water-soluble dietary fiber mixture on blood lipids in humans. J Am Coll Nutr 1993;12:147-54. PubMed
  2. Eltayeb IB, Awad AI, Elderbi MA, Shadad SA. Effect of gum arabic on the absorption of a single oral dose of amoxicillin in healthy Sudanese volunteers. J Antimicrob Chemother 2004;54:577-8. PubMed
  3. Babiker R, Merghani TH, Elmusharaf K, et al. Effects of gum Arabic ingestion on body mass index and body fat percentage in healthy adult females: two-arm randomized, placebo controlled, double-blind trial. Nutr J 2012;11:111. PubMed
  4. Babiker R, Elmusharaf K, Keogh MB, Banaga AS, Saeed AM. Metabolic effect of gum Arabic (Acacia senegal) in patients with type 2 diabetes mellitus (T2DM): randomized, placebo controlled double blind trial. Functional Foods in Health and Disease. 2017;7(3): DOI
  5. Beneke CE, Viljoen AM, Hamman JH. Polymeric plant-derived excipients in drug delivery. Molecules. 2009;14(7):2602-20. PubMed
  6. Ali NE, Kaddam LA, Alkarib SY, et al. Gum Arabic (Acacia Senegal) Augmented Total Antioxidant Capacity and Reduced C-Reactive Protein among Haemodialysis Patients in Phase II Trial. Int J Nephrol. 2020;2020:7214673.
  7. Mortensen A, Aguilar F, Crebelli R, et al. Re-evaluation of acacia gum (E 414) as a food additive. EFSA J. 2017;15(4):e04741. PubMed
  8. Larson R, Nelson C, Korczak R, et al. Acacia Gum Is Well Tolerated While Increasing Satiety and Lowering Peak Blood Glucose Response in Healthy Human Subjects. Nutrients 2021;13(2):618. PubMed

See these in context on the Gum Arabic monograph →

Inulin 17 references
  1. Williams CM. Effects of inulin on lipid parameters in humans. J Nutr 1999 Jul;129(7 Suppl):1471S-3S. PubMed
  2. Pedersen A, Sandstrom B, Van Amelsvoort JM. The effect of ingestion of inulin on blood lipids and gastrointestinal symptoms in healthy females. Br J Nutr 1997;78:215-22. PubMed
  3. Cummings JH, Macfarlane GT, Englyst HN. Prebiotic digestion and fermentation. Am J Clin Nutr 2001;73:415S-420S. PubMed
  4. Bonnema AL, Kolberg LW, Thomas W, Slavin JL. Gastrointestinal tolerance of chicory inulin products. J Am Diet Assoc 2010;110(6):865-8. PubMed
  5. Dehghan P, Gargari BP, Jafar-Abadi MA, Aliasgharzadeh A. Inulin controls inflammation and metabolic endotoxemia in women with type 2 diabetes mellitus: a randomized-controlled clinical trial. Int J Food Sci Nutr 2014;65(1):117-23. PubMed
  6. Guess ND, Dornhorst A, Oliver N, Frost GS. A randomised crossover trial: the effect of inulin on glucose homeostasis in subtypes of prediabetes. Ann Nutr Metab 2016;68(1):26-34. PubMed
  7. Marteau P, Jacobs H, Cazaubiel M, Signoret C, Prevel JM, Housez B. Effects of chicory inulin in constipated elderly people: a double-blind controlled trial. Int J Food Sci Nutr 2011;62(2):164-70. PubMed
  8. Mensink MA, Frijlink HW, van der Voort Maarschalk K, Hinrichs WL. Inulin, a flexible oligosaccharide I: review of its physicochemical characteristics. Carbohydr Polym 2015;130:405-19. PubMed
  9. Slavin J, Feirtag J. Chicory inulin does not increase stool weight or speed up intestinal transit time in healthy male subjects. Food Funct. 2011;2(1):72-7. PubMed
  10. Micka A, Siepelmeyer A, Holz A, Theis S, Schön C. Effect of consumption of chicory inulin on bowel function in healthy subjects with constipation: a randomized, double-blind, placebo-controlled trial. Int J Food Sci Nutr. 2017;68(1):82-89. PubMed
  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
  13. Rao M, Gao C, Xu L, et al. Effect of inulin-type carbohydrates on insulin resistance in patients with type 2 diabetes and obesity: a systematic review and meta-analysis. J Diabetes Res. 2019;2019:5101423. PubMed
  14. Mitchell CM, Davy BM, Ponder MA, et al. Prebiotic Inulin Supplementation and Peripheral Insulin Sensitivity in adults at Elevated Risk for Type 2 Diabetes: A Pilot Randomized Controlled Trial. Nutrients 2021;13(9):3235. PubMed
  15. Li L, Li P, Xu L. Assessing the effects of inulin-type fructan intake on body weight, blood glucose, and lipid profile: A systematic review and meta-analysis of randomized controlled trials. Food Sci Nutr 2021;9(8):4598-4616. PubMed
  16. Ziaei R, Shahshahan Z, Ghasemi-Tehrani H, Heidari Z, Ghiasvand R. Effects of inulin-type fructans with different degrees of polymerization on inflammation, oxidative stress and endothelial dysfunction in women with polycystic ovary syndrome: A randomized,
  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 →

Lactobacillus Gasseri 12 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Ramachandran L, Dontaraju VS, Patel K. Lactobacillus-associated spontaneous bacterial peritonitis in a liver cirrhosis patient on probiotics. Cureus. 2020;12(12):e11896. PubMed
  3. 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
  4. 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
  5. 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
  6. 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
  7. 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.
  8. Ramos-Coria D, Canto-Losa J, Carrillo-Vázquez D, Carbajal-Morelos L, Estrada-León R, Corona-Rodarte E. Lactobacillus gasseri liver abscess and bacteremia: a case report. BMC Infect Dis 2021;21(1):518. PubMed
  9. Elikowski W, Malek-Elikowska M, Lisiecka M, Bodora A, Wisniewska K, Oko-Sarnowska Z. Lactobacillus gasseri endocarditis on the aortic valve bioprosthesis - a case report. Pol Merkur Lekarski 2017;43(257):220-223.
  10. Esquibel A, Dababneh AS, Palraj BR. Lactobacillus gasseri causing bilateral empyema. Case Rep Infect Dis 2017;2017:4895619.
  11. Tleyjeh IM, Routh J, Qutub MO, Lischer G, Liang KV, Baddour LM. Lactobacillus gasseri causing Fournier's gangrene. Scand J Infect Dis 2004;36(6-7):501-3. PubMed
  12. Dickgiesser U, Weiss N, Fritsche D. Lactobacillus gasseri as the cause of septic urinary infection. Infection 1984;12(1):14-6. PubMed

See these in context on the Lactobacillus Gasseri monograph →

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 →

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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.

© 2021 Therapeutic Research Center, LLC

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