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

Pro-Easy Extra Ingredients & Drug Interactions

by Higher Nature

Pro-Easy Extra label
See full label image
Powder 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 Pro-Easy Extra 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

Pro-Easy Extra is a dietary supplement by Higher Nature with 5 active ingredients. Its ingredients are commonly taken for digestive health and regularity, diarrhea (including antibiotic-related), irritable bowel syndrome (ibs) symptoms.Based on those ingredients, 2,083 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Sunfiber, Bifidobacterium bifidum CUL-20, Bifidobacterium animalis subsp. lactis CUL34. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Pro-Easy Extra by Higher Nature

Ask about any prescription or over-the-counter medication and we check it for interactions with Pro-Easy Extra by Higher Nature — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Pro-Easy Extra by Higher Nature

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 1 of its 5 active ingredients.
  • “Blend” is a proprietary blend — the label doesn't break down how much of each component you get.

Pro-Easy Extra contains 5 active ingredients: three beneficial bacteria strains (Bifidobacterium bifidum, Bifidobacterium lactis, and Lactobacillus acidophilus), one additional probiotic strain (Streptococcus thermophilus), and a soluble fiber derived from guar gum called Sunfiber. The probiotics are meant to support your gut health, while the fiber helps with digestive regularity.

The product also contains inactive ingredients, including partially hydrolyzed guar gum and the probiotic organisms themselves listed as excipients in the inactive section.

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: gut flora support and digestive health.
  • 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: Bifidobacterium Animalis Subsp. Lactis is rated "Possibly Effective" for Constipation, Irritable bowel syndrome (IBS).

The data we hold shows that Bifidobacterium bifidum is possibly effective for IBS and respiratory tract infections, though evidence for allergies and anxiety is insufficient. Bifidobacterium lactis is possibly effective for IBS, respiratory infections, and constipation.

Lactobacillus acidophilus is possibly effective for IBS, H. pylori-related issues, antibiotic-associated diarrhea, and bacterial vaginosis, though it appears ineffective for atopic conditions. Streptococcus thermophilus lacks sufficient evidence for the conditions listed.

Sunfiber (guar gum) is possibly effective for high blood pressure, high cholesterol, IBS, and constipation. Overall, the product's strongest support is for IBS and digestive comfort, though evidence varies by ingredient.

The evidence, ingredient by ingredient Bifidobacterium Bifidum Bifidobacterium Animalis Subsp. Lactis Lactobacillus Acidophilus Streptococcus Thermophilus Guar Gum

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 5 of the 5 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 5 of 5.
  • General safety write-ups exist for 5 of 5.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

The probiotic strains are generally well tolerated in healthy people, but those with weakened immune systems should be cautious—rarely, probiotics can cause serious infections in critically ill or immunocompromised patients. Common side effects from probiotics include bloating, flatulence, and diarrhea; a rare case of vomiting and fever was reported with B. bifidum in combination with another probiotic.

Guar gum can cause abdominal cramping, bloating, diarrhea, flatulence, and heartburn, especially when starting out; these can be reduced by beginning with a small dose and increasing gradually. Critically, guar gum must be taken with plenty of water—inadequate fluid intake can cause severe blockage of the esophagus or small bowel.

For pregnancy, Bifidobacterium bifidum and Lactobacillus acidophilus are rated possibly safe, as is Streptococcus thermophilus; data on Bifidobacterium lactis in pregnancy is not on file. Guar gum in pregnancy is possibly safe, though concentrated supplement use hasn't been well studied.

Check with your doctor or pharmacist before use during pregnancy or breastfeeding.

Side effects, ingredient by ingredient Bifidobacterium Bifidum Bifidobacterium Animalis Subsp. Lactis Lactobacillus Acidophilus Streptococcus Thermophilus Guar Gum

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 5 matched ingredients can interact with medications — Lactobacillus Acidophilus, Bifidobacterium Animalis Subsp. Lactis, Guar Gum, Bifidobacterium Bifidum.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: heart-rhythm medications.
  • For scale: 2,084 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Pro-Easy Extra, double-check with your pharmacist if you're on antibiotics (Moderate—they may reduce the effectiveness of the probiotics and vice versa), any oral medications broadly (Moderate—guar gum can lower absorption), penicillin, metformin, birth control pills with ethinyl estradiol, or digoxin. The guar gum's interaction with general oral drugs is the widest concern; separate it from your other medications by 30–60 minutes.

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.

Pro-Easy Extra may help with IBS, digestive regularity, and respiratory health, but the guar gum interacts with many oral medications—you'll need to time it carefully. If you take antibiotics, metformin, penicillin, birth control pills, digoxin, or a long list of other medications, talk to your pharmacist before starting this product.

Anyone with a weakened immune system should check with their doctor first.

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

Assessment coverage: 5 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 22, 2021.

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 Pro-Easy Extra, straight from the product label.

Brand Higher Nature
Barcode (UPC) 5031013108600
Net contents 37.5 Gram(s) Powder
Market status On market
Date entered into DSLD Apr 22, 2021
DSLD ID 246051
Product type Other Combinations
Supplement form Powder
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Children 4 or More Years of Age, Vegan, Vegetarian, Adult (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 Pro-Easy Extra by Higher Nature, 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:
0.25 tsp
Maximum serving Sizes:
0.5 tsp
UPC/BARCODE
5031013108600
IngredientAmount% DV
Blend0 NP--
Bifidobacterium bifidum CUL-200 NP--
Bifidobacterium animalis subsp. lactis CUL340 NP--
Lactobacillus acidophilus CUL600 NP--
Streptococcus thermophilus CUL680 NP--
Sunfiber1.2 Gram(s)--

Other ingredients: partially hydrolyzed Guar Gum, Lactobacillus acidophilus, Bifidobacterium bifidum, Bifidobacterium animalis lactis, Streptococcus thermophilus

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

Free from: Artificial colours, flavourings or preservatives, corn, dairy products, gluten, lactose, maize, salt, soya, starch, wheat, yeast.

Vegetarian and vegan

General Statements

Everyday Essentials

This product has not been tested on animals

Formula

Multi-strain bacteria with Sunfiber

Live bacteria Optimal benefit

5 billion live organisms per daily dose

High strength, multi-strain formula With Sunfiber soluble prebiotic fibre – perfect for supporting gut flora and adding all important fibre to the diet 5 billion live cultures per serving

FDA Statement of Identity

Food Supplement

Suggested/Recommended/Usage/Directions

Directions: Adults take 1/2 tsp a day (children 3 and over 1/4 tsp).

Precautions

Do not exceed recommended daily intake. Food supplements should not be used as a substitute for a varied and balanced diet and healthy lifestyle.

Storage: Store in a cool, dry place out of reach of children.

Storage

Storage: Store in a cool, dry place out of reach of children. No need for refrigeration.

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

See for yourself

Pro-Easy Extra by Higher Nature label

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

Pro-Easy Extra 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 Pro-Easy Extra by Higher Nature

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

Serving size0.25 tsp Dosage formPowder 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.

Sunfiber

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

Guar gum is a soluble, gel-forming fiber from the guar bean that may modestly help with cholesterol, blood sugar, and bowel regularity. It is generall...

Sunfiber monograph & interactions

Other (inactive) ingredients: Partially hydrolyzed Guar Gum, Lactobacillus acidophilus, Bifidobacterium bifidum, Bifidobacterium animalis lactis, Streptococcus thermophilus. These complete the product’s ingredient list but are not active constituents.

Interaction report

Pro-Easy Extra by Higher Nature Drug Interactions

Want to check YOUR meds against Pro-Easy Extra?

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
2,083Drugs
2,083 Moderate

Ingredients driving the most interactions

Sunfiber 2,025
Bifidobacterium bifidum CUL-20 182
Bifidobacterium animalis subsp. lactis CUL34 182
Lactobacillus acidophilus CUL60 182

Individual Drug Interactions

The ingredients in Pro-Easy Extra interact with 2,083 drugs. Click any drug to see the details.

4 of the 5 ingredients in Pro-Easy Extra interact with drugs. Each result below shows which ingredient is responsible. Sunfiber Bifidobacterium bifidum CUL-20 Bifidobacterium animalis subsp. lactis CUL34 Lactobacillus acidophilus CUL60

Each ingredient & the kinds of drugs it affects

For each ingredient in Pro-Easy Extra 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.

Sunfiber5 drug types · 2,025 drugs

Ethinyl Estradiol

Theoretically, guar gum might reduce the absorption of ethinyl estradiol, potentially decreasing its effectiveness.
Animal research shows that taking guar gum with ethinyl estradiol decreases ethinyl estradiol absorption. However, this effect has not been reported in humans.

Likelihood Possible Evidence D
Metformin (Glucophage)

Guar gum might reduce the absorption of metformin, potentially decreasing its effectiveness.
A small study in healthy volunteers shows that guar gum reduces the absorption rate of metformin.

Likelihood Probable Evidence B
Oral Drugs

Guar gum might reduce the absorption of some oral drugs, potentially decreasing their effectiveness.
Clinical research shows that guar gum reduces or slows absorption of medications such as penicillin and metformin. To avoid changes in absorption, take guar gum 30-60 minutes after oral medications.

Likelihood Possible Evidence B
Penicillin

Guar gum might reduce the absorption of penicillin, potentially decreasing its effectiveness.
A small clinical study in healthy volunteers shows that taking guar gum with penicillin results in decreased penicillin absorption and reduced penicillin levels.

Likelihood Probable Evidence B
Digoxin (Lanoxin)

Guar gum might slow digoxin absorption, but it does not seem to impact how much digoxin is absorbed overall.
Two small studies in healthy volunteers show no change in the overall extent of digoxin absorption, although early absorption was slowed, when taken with guar gum.

Likelihood Possible Evidence B
Sunfiber full monograph & interactions

Bifidobacterium bifidum CUL-201 drug type · 182 drugs

Antibiotic Drugs

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

Likelihood Probable Evidence D
Bifidobacterium bifidum CUL-20 full monograph & interactions

Bifidobacterium animalis subsp. lactis CUL341 drug type · 182 drugs

Antibiotic Drugs

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

Likelihood Probable Evidence D
Bifidobacterium animalis subsp. lactis CUL34 full monograph & interactions

Lactobacillus acidophilus CUL601 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 CUL60 full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Pro-Easy Extra, from the product label.

Higher Nature

See all Higher Nature products
Name
Higher Nature Ltd
Street Address
10 Discovery Way
City
Horam, East Sussex
ZipCode
TN21 0GE
Web Address
highernature.com
Pharmacist Counseling Corner

Pro-Easy Extra by Higher Nature: Common Questions

Does Pro-Easy Extra by Higher Nature interact with any medications?
Yes. Based on its ingredients, Pro-Easy Extra has a known interaction with 2,083 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Pro-Easy Extra contains 5 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this if I'm on antibiotics?
Not at the same time. The antibiotic will kill the live probiotic organisms, so separate them by at least a few hours. Ask your pharmacist for specific timing based on your antibiotic.
Will this help my IBS?
The three main probiotic strains and the guar gum fiber are all possibly effective for IBS, so it may help. Results vary by person, though, so give it time and talk to your doctor if you don't see improvement.
What are the main side effects?
The most common are bloating, gas, and diarrhea—typical when probiotics and fiber are introduced. Start with a small dose and increase gradually to minimize these. Guar gum specifically requires plenty of water to prevent blockage.
Is this safe during pregnancy?
The safety data is limited. Two of the probiotic strains are rated possibly safe in pregnancy, but evidence on the others and on supplement-dose guar gum is not well studied. Talk to your doctor or midwife before use.
Can I take this with my birth control pill?
The guar gum in this product may reduce how well your birth control is absorbed. Take the supplement 30–60 minutes after your pill, and ask your pharmacist to confirm this won't affect protection.
What is Sunfiber and why is it in here?
Sunfiber is a soluble fiber made from guar gum. It's included to support digestive health and regularity; it's possibly effective for constipation and IBS alongside the probiotics.

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

Not sure if Pro-Easy Extra 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.

Pro-Easy Extra label
Go deeper

The Full Monographs Behind Pro-Easy Extra’s Ingredients

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

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 Animalis Subsp. Lactis

Interacts with 182 drugs

Bifidobacterium animalis subsp. lactis is a well-studied probiotic bacterium commonly added to supplements and yogurts to support digestion and gut health. It appears generally safe for most...

Read the full Bifidobacterium Animalis Subsp. Lactis 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

Streptococcus Thermophilus

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

Read the full Streptococcus Thermophilus monograph → Herb & supplement monograph

Guar Gum

Interacts with 2,025 drugs

Guar gum is a soluble, gel-forming fiber from the guar bean that may modestly help with cholesterol, blood sugar, and bowel regularity. It is generally safe in food amounts, but concentrated...

Read the full Guar Gum monograph →
Sources

Sources & How We Checked

Pro-Easy Extra'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 77 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 →

Bifidobacterium Animalis Subsp. Lactis 8 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Phuapradit P, Varavithya W, Vathanophas K, et al. Reduction of rotavirus infection in children receiving bifidobacteria-supplemented formula. J Med Assoc Thai 1999;82:S43-8.
  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. 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
  5. Taipale TJ, Pienihäkkinen K, Isolauri E, Jokela JT, Söderling EM. Bifidobacterium animalis subsp. lactis BB-12 in reducing the risk of infections in early childhood. Pediatr Res. 2016;79(1-1):65-9. PubMed
  6. Amat-Bou M, Garcia-Ribera S, Climent E, et al. Effects of Bifidobacterium animalis Subsp. lactis (BPL1) supplementation in children and adolescents with prader-willi syndrome: A randomized crossover trial. Nutrients. 2020;12(10):3123. PubMed
  7. Mäkelä SM, Forssten SD, Kailajärvi M, et al. Effects of Bifidobacterium animalis ssp. lactis 420 on gastrointestinal inflammation induced by a nonsteroidal anti-inflammatory drug: A randomized, placebo-controlled, double-blind clinical trial. Br J Clin Ph
  8. Wildt S, Munck LK, Vinter-Jensen L, et al. Probiotic treatment of collagenous colitis: a randomized, double-blind, placebo-controlled trial with Lactobacillus acidophilus and Bifidobacterium animalis subsp. Lactis. Inflamm Bowel Dis 2006;12(5):395-401. PubMed

See these in context on the Bifidobacterium Animalis Subsp. Lactis 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 →

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
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  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 →

Guar Gum 26 references
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  4. Lagier F, Cartier A, Somer J, et al. Occupational asthma caused by guar gum. J Allergy Clin Immunol 1990;85:785-90.
  5. Lewis JH. Esophageal and small bowel obstruction from guar gum-containing diet pills: analysis of 26 cases reported to the FDA. Am J Gastroenterol 1992;87:1424-8.
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  7. Superko HR, Haskell WL, Sawrey-Kubicek L, Farquhar JW. Effects of solid and liquid guar gum on plasma cholesterol and triglyceride concentrations in moderate hypercholesterolemia. Am J Cardiol 1988;62:51-5. PubMed
  8. 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
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  10. Chuang LM, Jou TS, Yang WS, et al. Therapeutic effect of guar gum in patients with non-insulin-dependent diabetes mellitus. J Formos Med Assoc 1992;91:15-9.
  11. Ebeling P, Yki-Jarvinen H, Aro A, et al. Glucose and lipid metabolism and insulin sensitivity in type 1 diabetes: the effect of guar gum. Am J Clin Nutr 1988;48:98-103. PubMed
  12. Scheen AJ. Clinical pharmacokinetics of metformin. Clin Pharmacokinet 1996;30:359-71. PubMed
  13. Knopp RH, Superko HR, Davidson M, et al. Long-term blood cholesterol-lowering effects of a dietary fiber supplement. Am J Prev Med 1999;17:18-23. PubMed
  14. Patrick PG, Gohman SM, Marx SC, et al. Effect of supplements of partially hydrolyzed guar gum on the occurrence of constipation and use of laxative agents. J Am Diet Assoc 1998;98:912-4. PubMed
  15. Osterlund P, Ruotsalainen T, Korpela R, et al. Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study. Br J Cancer 2007;97:1028-34. PubMed
  16. Lembcke B, Hasler K, Kramer P, et al. Plasma digoxin concentrations during administration of dietary fibre (guar gum) in man. Z Gastroenterol 1982;20;164-7.
  17. Riikonen, S., Savonius, H., Gylling, H., Nikkila, K., Tuomi, A. M., and Miettinen, T. A. Oral guar gum, a gel-forming dietary fiber relieves pruritus in intrahepatic cholestasis of pregnancy. Acta Obstet.Gynecol.Scand. 2000;79(4):260-264. DOI
  18. Kovacs, E. M., Westerterp-Plantenga, M. S., Saris, W. H., Goossens, I., Geurten, P., and Brouns, F. The effect of addition of modified guar gum to a low-energy semisolid meal on appetite and body weight loss. Int.J.Obes.Relat Metab Disord. 2001;25(3):307 PubMed
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  20. Landin, K., Holm, G., Tengborn, L., and Smith, U. Guar gum improves insulin sensitivity, blood lipids, blood pressure, and fibrinolysis in healthy men. Am.J.Clin.Nutr. 1992;56(6):1061-1065. PubMed
  21. Cicero, A. F., Derosa, G., Manca, M., Bove, M., Borghi, C., and Gaddi, A. V. Different effect of psyllium and guar dietary supplementation on blood pressure control in hypertensive overweight patients: a six-month, randomized clinical trial. Clin.Exp.Hyp PubMed
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  23. Salenius JP, Harju E, Jokela H, et al. Long term effects of guar gum on lipid metabolism after carotid endarterectomy. BMJ 1-14-1995;310:95-96. PubMed
  24. Gylling, H., Riikonen, S., Nikkila, K., Savonius, H., and Miettinen, T. A. Oral guar gum treatment of intrahepatic cholestasis and pruritus in pregnant women: effects on serum cholestanol and other non-cholesterol sterols. Eur.J.Clin.Invest 1998;28(5):35 PubMed
  25. Brillantino A, Iacobellis F, Izzo G, et al. Maintenance therapy with partially hydrolyzed guar gum in the conservative treatment of chronic anal fissure: results of a prospective, randomized study. Biomed Res Int 2014;2014:964942. PubMed
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See these in context on the Guar Gum 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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