Interactions on record — worth a quick check against your medications. Based on 4 of 8 ingredients. Check your meds →
Dietary supplement

Lady Bugs Ingredients & Drug Interactions

by Ora

Lady Bugs label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 23, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Lady Bugs 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

Lady Bugs is a dietary supplement by Ora with 8 active ingredients. Its ingredients are commonly taken for constipation, diarrhea, high cholesterol.Based on those ingredients, 2,111 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Dietary Fiber, Lactobacillus acidophilus DDS-1, Lactobacillus crispatus UALcr-35. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Lady Bugs by Ora

Ask about any prescription or over-the-counter medication and we check it for interactions with Lady Bugs by Ora — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Lady Bugs by Ora

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 Aug 13, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

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

Why this rating?
  • The label discloses an exact amount for 2 of its 8 active ingredients.
  • “A Proprietary Probiotic Blend” is a proprietary blend — the label gives one combined amount (105 mg) without saying how much of each component you get.

Lady Bugs contains seven active probiotic and prebiotic ingredients. The main players are five Lactobacillus strains—rhamnosus GG, acidophilus DDS-1, plantarum UALp-05, crispatus UALcr-35, and reuteri UALre-16—plus a proprietary probiotic blend and inulin, a fiber that feeds the beneficial bacteria in your gut.

The rest is just capsule material (pullulan and organic Nu-MAG), which are inactive ingredients.

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: vaginal health and balanced flora.
  • We looked for evidence on: Bacterial vaginosis, Vaginal candidiasis, Urinary tract infections (UTIs), vulvovaginal health, recurrent yeast infection, vaginal dysbiosis.
  • The strongest evidence on file: Lactobacillus Acidophilus is rated "Possibly Effective" for Bacterial vaginosis (Natural Medicines).
  • Also on file: Lactobacillus Crispatus is rated "Possibly Effective" for Bacterial vaginosis.
  • Also on file: Lactobacillus Acidophilus is rated "Insufficient Reliable Evidence To Rate" for Urinary tract infections (UTIs), Vaginal candidiasis.

The evidence is mixed and depends on which strain and which condition you're interested in. Inulin is possibly effective for obesity, constipation, and diabetes.

L. acidophilus is possibly effective for irritable bowel syndrome (IBS), Helicobacter pylori infection, antibiotic-associated diarrhea, and bacterial vaginosis. L. crispatus is possibly effective for bacterial vaginosis.

For other uses listed—like L. crispatus for UTIs or preterm labor—there isn't enough reliable evidence yet to rate whether it works.

The evidence, ingredient by ingredient Black Psyllium Lactobacillus Acidophilus Lactobacillus Crispatus Inulin

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.

Probiotics in this product are generally well tolerated in healthy adults, though inulin often causes gas, bloating, and digestive cramping, especially at higher doses over 30 grams. Some probiotic strains are live organisms, and in rare cases they've been isolated in serious infections (bacteremia, sepsis, endocarditis); this risk is mainly in people with weakened immune systems or significant illness.

Inulin is likely safe in pregnancy and during breastfeeding, and L. acidophilus is possibly safe in pregnancy, though lactation data for L. acidophilus and safety data during breastfeeding for L. crispatus are limited—talk with your doctor or pharmacist if you're pregnant or nursing.

Side effects, ingredient by ingredient Black Psyllium Lactobacillus Acidophilus Lactobacillus Crispatus Inulin

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?
  • 4 of the 4 matched ingredients can interact with medications — Black Psyllium, Lactobacillus Acidophilus, Inulin, Lactobacillus Crispatus.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: diabetes medications; heart-rhythm medications; lithium.
  • For scale: 2,112 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 starting Lady Bugs, double-check with your doctor or pharmacist if you take antibiotic drugs—you'll need to space them several hours apart from this product to avoid reducing the probiotic's effectiveness. If you take antidiabetes drugs (blood sugar medications), mention this product too, since inulin theoretically raises the risk of low blood sugar, though the effect is likely small.

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.

Lady Bugs is a multi-strain probiotic with some evidence for IBS, bacterial vaginosis, antibiotic-related diarrhea, and a few other digestive and vaginal health concerns. If you take antibiotics or blood sugar medications, check the timing with your doctor or pharmacist first.

Expect possible gas and bloating, especially at the start. It's generally well tolerated in healthy people, but if you have a compromised immune system or serious illness, talk with your healthcare provider before using it.

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

Assessment coverage: 4 of 8 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 23, 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 Lady Bugs, straight from the product label.

Brand Ora
Barcode (UPC) 856720007559
Net contents 60 Capsule(s)
Market status On market
Date entered into DSLD Feb 23, 2022
DSLD ID 259890
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegan, Vegetarian, Organic, Adult Female (18 - 50 Years), 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 Lady Bugs by Ora, 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:
2 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
30
UPC/BARCODE
856720007559
IngredientAmount% DV
Dietary Fiber1 Gram(s)4%
Lactobacillus rhamnosus GG0 NP--
A Proprietary Probiotic Blend105 mg--
Inulin725 mg--
Lactobacillus acidophilus DDS-10 NP--
Lactobacillus plantarum UALp-050 NP--
Lactobacillus crispatus UALcr-350 NP--
Lactobacillus reuteri UALre-160 NP--
Lactobacillus fermentum UALf-320 NP--

Other ingredients: Pullulan, organic Nu-MAG

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

What am I? I'm a vegan probiotic blend designed for women, with probiotic strains studied for their ability to support vaginal health.

How can I help? My job is to promote optimal vaginal health while supporting a balanced flora and microbiome. A healthy balance of probiotics can offer protection against an overgrowth of opportunistic pathogens (like candida). My probiotics can improve the presence of Lactobacilli, a bacteria that usually dominates the vaginal microbiota in its normal healthy state (the right kind of lady bugs)!

Non-GMO Gluten-free Dairy-free Soy-free No artificial ingredients

Vegan

Vegan probiotic for vaginal health

Certified Vegan Vegan.org

NON GMO Project Verified Nongmoproject.org

Contains no dairy, gluten, soy, tree nuts, added sugars, nor artificial colors, flavors, sweeteners or preservatives.

Certified Organic by QCS

Formula

The lineup includes L. rhamnosus GG and L. crispatus as well as an organic prebiotic (Jerusalem Artichoke Inulin) to help fuel these probiotics.

16 billion probiotics 6 Strains 1 month supply

FDA Statement of Identity

Women's Probiotic & Prebiotic Supplement

Seals/Symbols

Certified Vegan Vegan.org NON GMO Project Verified Nongmoproject.org

Suggested/Recommended/Usage/Directions

Suggested use: Take 2 capsules per day before or during meals.

Brand IP Statement(s)

Nu-MAG is a registered trademark of Ribus, Inc. DDS is a trademark of UAS Laboratories LLC and used under license

Storage

Storage: Store in a cool, dry place.

Precautions

Warnings: Do not take if seal is broken.

Keep out of reach of children.

As with any supplement, if you are pregnant, nursing, have a medical condition or are taking medication, consult a health practitioner before use.

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

Lady Bugs by Ora label

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

Lady Bugs 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 Lady Bugs by Ora

These are the 8 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 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.

Dietary Fiber

Interacts with
2,025 drugs
1 Gram(s) per serving

Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. I...

Dietary Fiber monograph & interactions

A Proprietary Probiotic Blend

105 mg per serving

Inulin

Interacts with
86 drugs
725 mg per serving Form: Jerusalem Artichoke

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 an...

Inulin monograph & interactions

Other (inactive) ingredients: Pullulan, Organic Nu-MAG. These complete the product’s ingredient list but are not active constituents.

Interaction report

Lady Bugs by Ora Drug Interactions

Want to check YOUR meds against Lady Bugs?

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
2,111Drugs
205 Moderate 1,906 Minor

Ingredients driving the most interactions

Dietary Fiber 2,025
Lactobacillus acidophilus DDS-1 182
Lactobacillus crispatus UALcr-35 182
Inulin 86

Individual Drug Interactions

The ingredients in Lady Bugs interact with 2,111 drugs. Click any drug to see the details.

4 of the 8 ingredients in Lady Bugs interact with drugs. Each result below shows which ingredient is responsible. Dietary Fiber Lactobacillus acidophilus DDS-1 Lactobacillus crispatus UALcr-35 Inulin

Each ingredient & the kinds of drugs it affects

For each ingredient in Lady Bugs 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.

Dietary Fiber7 drug types · 2,025 drugs

Carbamazepine (Tegretol)

Theoretically, black psyllium might reduce the effects of carbamazepine and increase the risk for convulsions.
Theoretically, black psyllium might reduce carbamazepine absorption. A preliminary study using blond psyllium reported decreased carbamazepine bioavailability due to binding of the drug to psyllium, as well as reduction of available fluid in the gut for dissolution of the drug. This interaction may also occur with black psyllium.

Likelihood Probable Evidence D
Lithium

Theoretically, taking black psyllium at the same time as lithium might reduce lithium absorption.
The fiber in black psyllium might reduce lithium absorption and plasma levels. Some case reports describe a reduction in plasma lithium levels with concomitant administration of blond psyllium. This was reversed when psyllium was stopped. This interaction may also occur with black psyllium.

Likelihood Probable Evidence D
Metformin (Glucophage)

Theoretically, black psyllium might increase the therapeutic and adverse effects of metformin.
Animal research shows that concurrent consumption of blond psyllium with metformin slows and increases the absorption of metformin. This interaction may also occur with black psyllium. To avoid changes in absorption, take psyllium 30-60 minutes after metformin.

Likelihood Possible Evidence D
Olanzapine (Zyprexa)

Theoretically, taking black psyllium at the same time as olanzapine might reduce olanzapine absorption.
The fiber in black psyllium might decrease the absorption of olanzapine. A single case report describes a reduction in the effectiveness of olanzapine when it was concomitantly administered with an unspecified type of psyllium 3 grams orally twice daily. This effect was reversed when psyllium was stopped.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, taking black psyllium at the same time as digoxin might reduce digoxin absorption and decrease digoxin levels.
Psyllium might bind digoxin in the gut. However, some clinical evidence suggests that psyllium does not impact digoxin absorption.

Likelihood Unlikely Evidence B
Ethinyl Estradiol

Theoretically, taking black psyllium at the same time as ethinyl estradiol might alter levels of estradiol.
Concurrent use of blond psyllium with ethinyl estradiol results in a slight increase in the extent of ethinyl estradiol absorption and a slower rate of absorption. This is unlikely to be clinically significant.

Likelihood Unlikely Evidence D
Oral Drugs

Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.
Psyllium seems to have variable effects on drug absorption. To avoid changes in absorption, take psyllium 30-60 minutes after oral medications. Animal research shows that blond psyllium delays and increases the absorption of metformin and ethinyl estradiol. Case reports and animal research suggest that blond psyllium might reduce absorption of lithium, digoxin, olanzapine, and carbamazepine. Finally, some pharmacokinetic studies show that psyllium does not affect the absorption of levothyroxine or warfarin. Although many of these studies evaluated blond psyllium, the fiber content in black psyllium may have similar effects.

Likelihood Possible Evidence B
Dietary Fiber full monograph & interactions

Lactobacillus acidophilus DDS-11 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 DDS-1 full monograph & interactions

Lactobacillus crispatus UALcr-351 drug type · 182 drugs

Antibiotic Drugs

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

Likelihood Probable Evidence D
Lactobacillus crispatus UALcr-35 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 Lady Bugs, from the product label.

Ora

See all Ora products
Name
Ora Organic
City
San Diego
State
CA
ZipCode
92101
Phone Number
1 (858) 429-5591
Web Address
www.ora.organic
Pharmacist Counseling Corner

Lady Bugs by Ora: Common Questions

Does Lady Bugs by Ora interact with any medications?
Yes. Based on its ingredients, Lady Bugs has a known interaction with 2,111 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Lady Bugs contains 8 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 Lady Bugs if I'm on antibiotics?
You can, but timing matters. Antibiotics can kill the live bacteria in this probiotic, making it less effective. Take your antibiotic and this product several hours apart, and ask your doctor or pharmacist for the best schedule for your situation.
Will Lady Bugs give me digestive side effects?
Gas, bloating, and cramping are common, especially with inulin at higher doses. Most people tolerate probiotics well, but you may feel some digestive effects at first. These usually settle down, but if they're bothersome, talk with your pharmacist about whether to lower the dose or try again later.
Is Lady Bugs safe to take while pregnant or breastfeeding?
Inulin is likely safe in pregnancy and during breastfeeding. L. acidophilus is possibly safe in pregnancy, but lactation data for that strain and breastfeeding safety for L. crispatus are limited. Talk with your doctor or pharmacist about your individual situation before taking it.
Does Lady Bugs actually work for IBS or vaginal health?
There's evidence that L. acidophilus and L. crispatus are possibly effective for irritable bowel syndrome and bacterial vaginosis. For other uses in this product—like L. crispatus for UTIs—the evidence isn't yet strong enough to rate it either way.
What's inulin, and why is it in this probiotic?
Inulin is a soluble fiber that acts as a 'prebiotic'—it feeds the good bacteria in your gut, helping them grow and thrive. It's possibly effective on its own for obesity, constipation, and diabetes, and it works alongside the probiotics to support your microbiome.
Can I take Lady Bugs if I have a weak immune system?
The probiotic strains in this product are live organisms, and in very rare cases they've caused serious infections in people with weakened immunity or serious illness. Check with your doctor before taking this product if you have a compromised immune system, an invasive medical device, or a severe illness.

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

Not sure if Lady Bugs 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.

Lady Bugs label
Go deeper

The Full Monographs Behind Lady Bugs’s Ingredients

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

Herb & supplement monograph

Black Psyllium

Interacts with 2,025 drugs

Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. It is best known and most studied for rel...

Read the full Black Psyllium monograph → 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

Lactobacillus Crispatus

Interacts with 182 drugs

Lactobacillus crispatus is a 'good' bacterium that naturally dominates a healthy vaginal microbiome and is sold as a probiotic, mainly for vaginal and urinary health. Early research is promi...

Read the full Lactobacillus Crispatus 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

Lady Bugs'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 59 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.

Black Psyllium 18 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  4. Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.
  5. Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 1990;335:416.
  6. Vaswani SK, Hamilton RG, Valentine MD, Adkinson NF. Psyllium laxative-induced anaphylaxis, asthma, and rhinitis. Allergy 1996;51:266-8. PubMed
  7. Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. JAMA 1990;264:2534-6. DOI
  8. Kaplan MJ. Anaphylactic reaction to "Heartwise." N Engl J Med 1990;323:1072-3. DOI
  9. Nordstrom M, Melander A, Robertsson E, Steen B. Influence of wheat bran and of a bulk-forming ispaghula cathartic on the bioavailability of digoxin in geriatric in-patients. Drug Nutr Interact 1987;5:67-9..
  10. Robinson DS, Benjamin DM, McCormack JJ. Interaction of warfarin and nonsystemic gastrointestinal drugs. Clin Pharmacol Ther 1971;12:491-5. PubMed
  11. Garcia JJ, Fernandez N, Diez MJ, et al. Influence of two dietary fibers in the oral bioavailability and other pharmacokinetic parameters of ethinyloestradiol. Contraception 2000;62:253-7. PubMed
  12. Fernandez N, Lopez C, Díez R, et al. Drug interactions with the dietary fiber Plantago ovata husk. Expert Opin Drug Metab Toxicol 2012;8(11):1377-86.
  13. Semen plantaginis in: WHO Monographs on Selected Medicinal Plants, volume 1. World Health Organization, Geneva, 1999. Available at http://apps.who.int/medicinedocs/en/d/Js2200e/. Accessed November 26, 1026.
  14. Code of Federal Regulations, Title 21 (21CFR 101.17). Food labeling warning, notice, and safe handling statements. Available at www.ecfr.gov/cgi-bin/text-idx?SID=20f647d3b74161501f46564b915b4048&mc=true&node=se21.2.101_117&rgn=div8. Accessed December 3, 2
  15. Code of Federal Regulations, Title 21 (21CFR 201.319). Specific labeling requirements - water-soluble gums, hydrophilic gums, and hydrophilic mucilloids. Available at www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=201.319. Accessed Dece
  16. Diez R, Garcia JJ, Diez MJ, Sierra M, Sahagun AM, Fernandez N. Influence of Plantago ovata husk (dietary fiber) on the bioavailability and other pharmacokinetic parameters of metformin in diabetic rabbits. BMC Complement Altern Med. 2017 Jun 7;17(1):298. PubMed
  17. Chiu AC, Sherman SI. Effects of pharmacological fiber supplements on levothyroxine absorption. Thyroid. 1998;8(8):667-71. PubMed
  18. Merrick C, Madden CA, Capurso NA. A Case of Blunted Orally Disintegrating Olanzapine Effect Due to Coadministered Psyllium. J Clin Psychiatry 2021;82(2):20cr13633. PubMed

See these in context on the Black Psyllium 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 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 →

Lactobacillus Crispatus 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
  4. 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
  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. DI Pierro F, Criscuolo AA, Dei Giudici A, et al. Oral administration of Lactobacillus crispatus M247 to papillomavirus-infected women: results of a preliminary, uncontrolled, open trial. Minerva Obstet Gynecol 2021;73(5):621-631. PubMed
  8. DE Leo V, Lazzeri E, Governini L, et al. Vaginal colonization of women after oral administration of Lactobacillus crispatus strain NTCVAG04 from the human microbiota. Minerva Obstet Gynecol 2022. PubMed
  9. Dellino M, Cascardi E, Laganà AS, et al. Lactobacillus crispatus M247 oral administration: Is it really an effective strategy in the management of papillomavirus-infected women?. Infect Agent Cancer 2022;17(1):53. PubMed

See these in context on the Lactobacillus Crispatus 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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