Major interaction on record — check this product against your medications before combining. Based on 11 of 16 ingredients. Check your meds →
Dietary supplement

Vital Flora Advanced Biome Probiotic Ingredients & Drug Interactions

by Brenda Watson's Vital Planet

Vital Flora Advanced Biome Probiotic label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 30, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Vital Flora Advanced Biome 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: Major

Vital Flora Advanced Biome Probiotic is a dietary supplement by Brenda Watson's Vital Planet with 16 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, 2,177 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Guar Gum, Acacia Fiber, Cranberry. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Vital Flora Advanced Biome Probiotic by Brenda Watson's Vital Planet

Ask about any prescription or over-the-counter medication and we check it for interactions with Vital Flora Advanced Biome Probiotic by Brenda Watson's Vital Planet — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Vital Flora Advanced Biome Probiotic by Brenda Watson's Vital Planet

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

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

Why this rating?
  • The label discloses an exact amount for 0 of its 31 active ingredients.
  • “Total Probiotic Cultures” is listed as a grouped ingredient — the label doesn't break down how much of each component you get.
  • “Advanced Biome Proprietary Probiotic Blend” is a proprietary blend — the label gives one combined amount (405 mg) without saying how much of each component you get.
  • “Total Lacto Probiotic Cultures” is listed as a grouped ingredient — the label doesn't break down how much of each component you get.

Vital Flora Advanced Biome Probiotic contains 31 ingredients, of which the active components are probiotic cultures—live beneficial bacteria including Lactobacillus species (acidophilus, casei, rhamnosus, brevis, reuteri, salivarius, fermentum, gasseri, helveticus, and bulgaricus) and potato starch—along with fibers from guar gum, apple, pea, acacia, and chicory root. It also includes Jerusalem artichoke, cassava, blue agave, and organic potato as supporting ingredients.

The inactive ingredients are hypromellose, gellan gum, and water—these are the capsule material and binders that hold everything together.

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 system health.
  • We looked for evidence on: Abdominal pain, Antibiotic-associated diarrhea, Aspirin-associated gastric damage, Atopic disease, Bacterial vaginosis, Celiac disease — and 4 related terms.
  • The strongest evidence on file: Lactobacillus Acidophilus is rated "Possibly Effective" for Antibiotic-associated diarrhea (Natural Medicines).
  • Also on file: Lactobacillus Acidophilus is rated "Possibly Effective" for Bacterial vaginosis.
  • Also on file: Guar Gum is rated "Possibly Effective" for Constipation.

The evidence for most ingredients in this product is limited. Guar gum is possibly effective for high blood pressure, high cholesterol, and irritable bowel syndrome.

Apple fiber, chicory, and cassava all have insufficient evidence for their claimed uses in our data. Cranberry is possibly effective for urinary tract infections but shows insufficient evidence for other conditions.

Of the probiotics, Lactobacillus acidophilus is possibly effective for irritable bowel syndrome, H. pylori infection, antibiotic-associated diarrhea, and bacterial vaginosis, though it's marked possibly ineffective for atopic disease. The other Lactobacillus species show insufficient evidence for their claimed benefits.

The evidence, ingredient by ingredient Bifidobacterium Bifidum Bifidobacterium Breve Bifidobacterium Longum Guar Gum Apple Cranberry Chicory Gum Arabic

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 17 of the 17 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 17 of 17.
  • General safety write-ups exist for 17 of 17.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Guar gum is generally well tolerated but must be taken with plenty of water to prevent choking or blockage—a rare but serious risk. Common side effects include bloating, gas, diarrhea, and abdominal pain, which can be minimized by starting with small doses.

Apple fiber is well tolerated in normal food amounts; people with allergies to apples or related fruits (peach, pear, plum, apricot, almond, strawberry) should avoid it due to rare risk of severe allergic reactions. Cranberry is generally well tolerated; gastrointestinal upset and diarrhea are possible with large doses.

Chicory may cause gas and bloating and can trigger allergies in sensitive people. Cassava, if properly cooked, is generally fine as food, but raw or poorly processed cassava carries risk of cyanide poisoning.

Potato is safe as food when cooked normally, but green or sprouted potatoes contain natural toxins that can cause sweating, nausea, vomiting, diarrhea, and in severe cases paralysis. The probiotic bacteria are generally well tolerated but carry a theoretical risk of infection in severely immunocompromised patients.

Side effects, ingredient by ingredient Bifidobacterium Bifidum Bifidobacterium Breve Bifidobacterium Longum Guar Gum Apple Cranberry Chicory Gum Arabic

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 16 of the 17 matched ingredients can interact with medications — Chicory, Gum Arabic, Apple, Lactobacillus Acidophilus, Potato, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications; heart-rhythm medications; lithium.
  • For scale: 2,178 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.

Major concern: OATP substrate drugs (like fexofenadine, atenolol, aliskiren)—apple fiber can sharply reduce their blood levels and effectiveness. Moderate concerns: antibiotic drugs (penicillin and all others—space them 2 hours apart from this product), antidiabetes drugs and metformin specifically, birth control pills containing ethinyl estradiol, blood pressure medications, blood thinners (warfarin), cholesterol drugs (atorvastatin, nifedipine), lithium, and thyroid hormone replacement.

Minor concern: digoxin. If you're on any of these, check with your pharmacist before starting.

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. Major medication interactions have been identified, and safety information is well characterized.

This is a multi-ingredient probiotic meant to support digestive health, but it has multiple medication interactions you need to check first—especially if you take antibiotics, blood pressure drugs, cholesterol medications, blood thinners, diabetes drugs, or birth control pills. If you take any prescription medications, run them through the checker on this page before you start.

Talk with your pharmacist or doctor about timing and any concerns about your specific medications.

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

Assessment coverage: 18 of 31 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 24, 2023.

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 Vital Flora Advanced Biome Probiotic , straight from the product label.

Brand Brenda Watson's Vital Planet
Barcode (UPC) 850964006651
Net contents 30 Delayed Release Vegetable Capsule(s)
Market status On market
Date entered into DSLD Oct 24, 2023
DSLD ID 292771
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Gluten Free, Sugar 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 Vital Flora Advanced Biome Probiotic by Brenda Watson's Vital Planet, 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
UPC/BARCODE
850964006651
IngredientAmount% DV
Jerusalem Artichoke0 NP--
Guar Gum0 NP--
Apple Fiber0 NP--
Pea Fiber0 NP--
Cranberry0 NP--
Chicory0 NP--
Acacia Fiber0 NP--
Cassava0 NP--
Total Probiotic Cultures0 NP--
Blue Agave0 NP--
Advanced Biome Proprietary Probiotic Blend405 mg--
organic Potato0 NP--
Total Lacto Probiotic Cultures0 NP--
Lactobacillus plantarum0 NP--
Lactobacillus paracasei0 NP--
Lactobacillus acidophilus0 NP--
Lactobacillus casei0 NP--
Lactobacillus rhamnosus0 NP--
Lactobacillus brevis0 NP--
Lactobacillus reuteri0 NP--
Lactobacillus salivarius0 NP--
Lactobacillus fermentum0 NP--
Lactobacillus gasseri0 NP--
Lactobacillus bulgaricus0 NP--
Lactobacillus helveticus0 NP--
Lactobacillus delbrueckii0 NP--
Lactobacillus crispatus VP-600 NP--
Lactobacillus johnsonii VP-550 NP--
Lactobacillus sakei VP-810 NP--
Total Bifido Probiotic Cultures0 NP--
Bifidobacterium animalis lactis0 NP--
Bifidobacterium bifidum0 NP--
Bifidobacterium breve0 NP--
Bifidobacterium longum0 NP--
Bifidobacterium longum infantis0 NP--
Organic Prebiotic and Fiber Blend150 mg--

Other ingredients: Hypromellose, Gellan Gum, Water

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.
Formula

100 Billion Live Cultures 100 Strains of Probiotics Advanced Biome Probiotic +10 prebiotics

Diversity is the key to Advanced Biome Our bodies naturally contain many different types of good bacteria so we formulated Vital Flora Advanced Biome with a diverse blend of 100 strains. The increased potency and balanced ratio of Bifido to Lacto strains provide more advanced support for overall immune and digestive health We also added 10 plant-based prebiotics to help feed the diversity of good bacteria in our gut.

What to look for in a probiotic 100 Billion Live Cultures Formulated with 100 billion live probiotic cultures in every capsule, Vital Flora contains the potency that you want for your most critical needs. 100 Diverse Probiotic Strains A healthy gut contains a highly diverse balance of good microbes. Vital Flora contains multiple strains of Lacto and Bifido bacteria to more closely mirror the natural diversity of the human gut. 10 Types of Prebiotics Prebiotics are special types of fiber from plants that help feed beneficial bacteria in the digestive tract. Vital Flora contains a blend of 10 organic prebiotic sources. Delayed Release Capsules Taken any time of day, with or without food, Vital Flora's delayed release capsules help ensure more probiotics reach the intestinal tract where you want them.

Formulation

Digestive + Immune

Non GMO Gluten Free

Contains no GMOs, yeast, wheat, gluten, tree nuts, salt, shellfish, sugar, animal products, binders, fillers, or artificial ingredients.

Quality & Purity Guaranteed

Assembled in a facility in the USA that is GMP (Good Manufacturing Practices)

General Statements

Family business

Family Owned & Operated Meet the creator of vital flora I've devoted my life to helping people balance their digestive system and achieve vibrant health. I believe overall good health begins with a healthy gut. Brenda Watson Digestive Care Expert Founder of Vital Planet NY Times Bestselling Author

Free Product Specialist Support Line Call toll-free: 1-866-787-9001 At Vital Planet, we're always here to help! If you have questions or want additional information on any of our products, talk to one of our product specialists who will be happy to guide you on your journey to vibrant health.

FDA Statement of Identity

Probiotic Supplement

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.

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.

Suggested/Recommended/Usage/Directions

Directions: For best results, adults take one (1) capsule daily with or without food.

Precautions

Contains traces of dairy. May contain traces of soy from fermentation ingredients.

Keep out of reach of children.

Consult your healthcare professional before using this or any product if you are pregnant, nursing, or under medical supervision.

Tamper evident: Do not use if safety seal on bottle is broken or missing.

Storage

Store at 41 degrees F (5 degrees C) or below. Keep refrigerated.

Seals/Symbols

Assembled in USA Assembled in a facility in the USA that is GMP (Good Manufacturing Practices)

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

See for yourself

Vital Flora Advanced Biome Probiotic by Brenda Watson's Vital Planet label

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

Vital Flora Advanced Biome 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 Vital Flora Advanced Biome Probiotic by Brenda Watson's Vital Planet

These are the 16 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.

Advanced Biome Proprietary Probiotic Blend

405 mg per serving
  • › Total Probiotic Cultures

Total Bifido Probiotic Cultures

0 NP per serving

Organic Prebiotic and Fiber Blend

150 mg per serving

Other (inactive) ingredients: Hypromellose, Gellan Gum, Water. These complete the product’s ingredient list but are not active constituents.

Interaction report

Vital Flora Advanced Biome Probiotic by Brenda Watson's Vital Planet Drug Interactions

Want to check YOUR meds against Vital Flora Advanced Biome 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
2,177Drugs
47 Major 2,121 Moderate 9 Minor

Ingredients driving the most interactions

Guar Gum 2,025
Acacia Fiber 2,022
Cranberry 712
Apple Fiber 300
Bifidobacterium bifidum 182

Individual Drug Interactions

The ingredients in Vital Flora Advanced Biome Probiotic interact with 2,177 drugs. Click any drug to see the details.

10 of the 16 ingredients in Vital Flora Advanced Biome Probiotic interact with drugs. Each result below shows which ingredient is responsible. Guar Gum Acacia Fiber Cranberry Apple Fiber Bifidobacterium bifidum Bifidobacterium breve Bifidobacterium longum Chicory Cassava organic Potato

Each ingredient & the kinds of drugs it affects

For each ingredient in Vital Flora Advanced Biome Probiotic with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Guar Gum5 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
Guar Gum full monograph & interactions

Acacia Fiber2 drug types · 2,022 drugs

Amoxicillin (Amoxil, Trimox)

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

Likelihood Probable Evidence B
Oral Drugs

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

Likelihood Possible Evidence B
Acacia Fiber full monograph & interactions

Cranberry6 drug types · 712 drugs

Atorvastatin (Lipitor)

Theoretically, cranberry might increase levels and adverse effects of atorvastatin.
In one case report, a patient taking atorvastatin experienced upper back pain, rhabdomyolysis, and abnormal liver function after drinking cranberry juice 16 ounces daily for 2 weeks. Theoretically, this may have been caused by inhibition of cytochrome P450 3A4 (CYP3A4) enzymes by cranberry juice, as atorvastatin is a CYP3A4 substrate. Creatinine kinase and liver enzymes normalized within 2 weeks of stopping cranberry juice. Patients taking atorvastatin should avoid large quantities of cranberry juice.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
A case of upper back pain, rhabdomyolysis, and abnormal liver function has been reported for a patient taking atorvastatin, a CYP3A4 substrate, in combination with cranberry juice 16 ounces daily for 2 weeks. Creatinine kinase and liver enzymes normalized within 2 weeks of stopping cranberry juice. Also, animal research suggests that cranberry juice, administered intraduodenally 30 minutes prior to nifedipine, a CYP3A4 substrate, inhibits nifedipine metabolism and increases the area under the concentration-time curve by 1.6-fold compared to control.

Likelihood Possible Evidence D
Nifedipine (Procardia)

Theoretically, cranberry might increase the levels and adverse effects of nifedipine.
Animal research suggests that cranberry juice, administered intraduodenally 30 minutes prior to nifedipine treatment, inhibits nifedipine metabolism and increases the area under the concentration-time curve by 1.6-fold compared to control. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, cranberry might increase the levels and adverse effects of warfarin. However, research is conflicting.
There is contradictory evidence about the effect of cranberry juice on warfarin. Case reports have linked cranberry juice consumption to increases in the international normalized ratio (INR) in patients taking warfarin, resulting in severe spontaneous bleeding and excessive postoperative bleeding. Daily consumption of cranberry sauce for one week has also been linked to an increase in INR in one case report. In a small study in healthy young males, taking a high dose of 3 grams of cranberry juice concentrate capsules, equivalent to 57 grams of fruit daily, for 2 weeks produced a 30% increase in the area under the INR-time curve after a single 25-mg dose of warfarin. However, 3 very small clinical studies in patients stabilized on warfarin reported that cranberry juice 250 mL once or twice daily for 7 days (27% cranberry juice or pure cranberry juice) or 240 mL once daily for 14 days does not significantly increase INR or affect plasma warfarin levels. The reasons for these discrepant findings are unclear. It is possible that the form and dose of cranberry may play a role, as cranberry extracts and juices contain different constituents. Additionally, an in vitro study evaluating 5 different cranberry juices found varying effects, with only a cranberry concentrate, and not diluted cranberry juices, inhibiting CYP2C9. However, this concentrate did not inhibit CYP2C9 activity in humans.

Likelihood Possible Evidence B
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates. However, research is conflicting.
There is contradictory evidence about the effect of cranberry on CYP2C9 enzymes. In vitro evidence suggests that flavonoids in cranberry inhibit CYP2C9 enzymes. However, clinical research shows that cranberry juice does not significantly affect the levels, metabolism, or elimination of the CYP2C9 substrates flurbiprofen or diclofenac. Also, in patients stabilized on warfarin, drinking cranberry juice 250 mL daily for 7 days does not significantly increase the anticoagulant activity of warfarin, a CYP2C9 substrate. Additional pharmacokinetic research shows that cranberry juice does not increase peak plasma concentrations or area under the concentration-time curve of warfarin.

Likelihood Unlikely Evidence B
Diclofenac (Voltaren, Others)

Theoretically, cranberry might modestly increase the levels and adverse effects of diclofenac.
In vitro evidence suggests that cranberry juice inhibits diclofenac metabolism by human liver microsomes. However, drinking cranberry juice does not seem to affect diclofenac metabolism in humans.

Likelihood Unlikely Evidence B
Cranberry full monograph & interactions

Apple Fiber7 drug types · 300 drugs

Organic Anion-Transporting Polypeptide Substrates (Oatp)

Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Research shows that consuming apple juice inhibits OATP, which reduces bioavailability of oral drugs that are substrates of OATP. Fexofenadine, atenolol, and aliskiren are substrates of OATP. Clinical research shows that coadministration of apple juice decreases bioavailability of fexofenadine by up to 78%, aliskiren by 63%, and atenolol by up to 82%. These effects appear to increase with larger quantities of apple juice. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.

Likelihood Likely Evidence B
Aliskiren (Tekturna, Rasilez)

Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of aliskiren.
Pharmacokinetic research shows that coadministration of apple juice 200 mL along with aliskiren 150 mg decreases the bioavailability of aliskiren by 63%. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.

Likelihood Probable Evidence B
Antidiabetes Drugs

Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Clinical research suggests that consuming apples or drinking apple juice can raise blood glucose levels, with the effects of drinking apple juice being more significant than consuming apples.

Likelihood Possible Evidence D
Antihypertensive Drugs

Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Some clinical evidence suggests that consuming apple and cherry juice can increase blood pressure in elderly patients.

Likelihood Probable Evidence B
Atenolol (Tenormin)

Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of atenolol.
Pharmacokinetic research shows that coadministration of apple juice 600-1200 mL decreases levels of atenolol by 58% to 82% in a dose-dependent manner. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.

Likelihood Probable Evidence B
Fexofenadine (Allegra)

Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of fexofenadine.
Pharmacokinetic research shows that coadministration of apple juice 400-1200 mL along with fexofenadine 60-120 mg decreases bioavailability of fexofenadine by up to 78%. Coadministration with smaller quantities of apple juice (150 mL or less) does not appear to affect the bioavailability of fexofenadine. Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction.

Likelihood Likely Evidence B
Lithium

There is some concern that concomitant consumption of apple juice might decrease oral absorption and blood levels of lithium.
In one case report, a patient had an undetectable serum lithium level when lithium citrate was administered with apple juice. When lithium was administered with an alternative beverage, the lithium level became detectable and the patient demonstrated clinical improvement.

Likelihood Possible Evidence D
Apple Fiber full monograph & interactions

Bifidobacterium bifidum1 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 full monograph & interactions

Bifidobacterium breve1 drug type · 182 drugs

Antibiotic Drugs

Theoretically, taking Bifidobacterium breve with antibiotic drugs might decrease the effectiveness of B. breve.
Since B. breve 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. breve preparations by at least 2 hours.

Likelihood Probable Evidence D
Bifidobacterium breve full monograph & interactions

Bifidobacterium longum1 drug type · 182 drugs

Antibiotic Drugs

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

Likelihood Probable Evidence D
Bifidobacterium longum full monograph & interactions

Chicory1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, chicory might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal and in vitro research shows that chicory extracts have antidiabetic effects.

Likelihood Possible Evidence D
Chicory full monograph & interactions

Cassava1 drug type · 16 drugs

Thyroid Hormone

Evidence from human and animal research suggests that cassava root has marked antithyroid effects, particularly if poorly processed or if consumed as part of a protein-deficient diet. Also, clinical research shows that consuming boiled cassava leaves 200 grams twice daily for 9 days significantly reduces levels of the thyroid hormones triiodothyronine and thyroxine. Theoretically, cassava may alter thyroid function, reduce thyroid hormone levels, and interfere with thyroid hormone-replacement therapy.

Likelihood Possible Evidence D
Cassava full monograph & interactions

organic Potato2 drug types · 7 drugs

Succinylcholine

In humans, consuming potatoes prior to preoperative fasting prolongs the duration of the succinylcholine-induced neuromuscular block and slows recovery from anesthesia. This interaction is possibly related to inhibition of the butyrylcholinesterase enzyme by potato glycoalkaloids.

Likelihood Probable Evidence B
Thrombolytic Drugs

Theoretically, concomitant use of potato may enhance the effects of thrombolytic drugs. A carboxypeptidase inhibitor isolated from potato tubers may have inhibitory effects on thrombin-activatable thrombolysis inhibitor, and thereby enhance the activity of thrombolytic agents.

Likelihood Possible Evidence D
organic Potato full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Vital Flora Advanced Biome Probiotic , from the product label.

Brenda Watson's Vital Planet

See all Brenda Watson's Vital Planet products
Name
Vital Planet
Street Address
133 Candy Ln.
City
Palm Harbor
State
FL
ZipCode
34683
Phone Number
800.938.8482
Web Address
VitalPlanet.com
Pharmacist Counseling Corner

Vital Flora Advanced Biome Probiotic by Brenda Watson's Vital Planet: Common Questions

Does Vital Flora Advanced Biome Probiotic by Brenda Watson's Vital Planet interact with any medications?
Yes. Based on its ingredients, Vital Flora Advanced Biome Probiotic has a known interaction with 2,177 medications, including 47 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Vital Flora Advanced Biome Probiotic contains 16 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 probiotic while I'm on antibiotics?
Not at the same time. Three of the Lactobacillus strains in this product (acidophilus, gasseri, and helveticus) can be killed by antibiotics, making the probiotic less effective. Separate them by at least 2 hours—take your antibiotic, then take the probiotic later, or vice versa. Check with your pharmacist about the best timing for your specific antibiotic.
Will this probiotic make my blood pressure medication less effective?
It's possible. Apple fiber in this product may interfere with how your body absorbs certain blood pressure drugs like atenolol or aliskiren—potentially reducing their effectiveness by up to 80%. If you take a blood pressure medication, verify the exact name with your pharmacist and check it against our interaction tool on this page.
Is this safe to take while pregnant?
It depends on the ingredient. Guar gum and cassava are possibly unsafe in pregnancy, and chicory may stimulate the uterus, so the product is not recommended during pregnancy. Lactobacillus acidophilus is possibly safe. Talk with your doctor or pharmacist before using this product while pregnant.
What does the guar gum in this product do?
Guar gum is a fiber that may help with high cholesterol, high blood pressure, and irritable bowel syndrome. However, it can slow the absorption of some oral medications, so take any prescriptions 30–60 minutes away from this supplement.
Can I take this with my diabetes medication?
Potentially not at the same time. Guar gum and apple fiber may interfere with how your body absorbs or processes blood sugar control. Check the exact name of your medication with your pharmacist using our interaction tool before you start.
Are there any fillers in this product?
Yes. The inactive ingredients are hypromellose (capsule material), gellan gum (a binder), and water.

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

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Vital Flora Advanced Biome Probiotic label
Go deeper

The Full Monographs Behind Vital Flora Advanced Biome Probiotic ’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 Breve

Interacts with 182 drugs

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

Read the full Bifidobacterium Breve monograph → Herb & supplement monograph

Bifidobacterium Longum

Interacts with 182 drugs

Bifidobacterium longum is a 'friendly' bacterium found naturally in the human gut and used as a probiotic. It is generally well tolerated and is most studied for digestive issues, though evi...

Read the full Bifidobacterium Longum monograph → Herb & supplement monograph

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 → Herb & supplement monograph

Apple

Interacts with 300 drugs

Apples are a nutritious whole food that provides fiber, vitamins, and antioxidant plant compounds, and eating them regularly fits well into a healthy diet. While research suggests apples may...

Read the full Apple monograph → Herb & supplement monograph

Cranberry

Interacts with 712 drugs

Cranberry is best known for helping to prevent repeated urinary tract infections (UTIs) in some people, and the evidence here is moderate but mixed. It is not a reliable treatment for an act...

Read the full Cranberry monograph → Herb & supplement monograph

Chicory

Interacts with 86 drugs

Chicory is best known as a caffeine-free coffee substitute and as a source of inulin, a soluble prebiotic fiber that may support digestion and regularity. Strong human evidence for most othe...

Read the full Chicory monograph → Herb & supplement monograph

Gum Arabic

Interacts with 2,022 drugs

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

Read the full Gum Arabic monograph → Herb & supplement monograph

Cassava

Interacts with 16 drugs

Cassava is a starchy root vegetable that feeds millions of people worldwide, but it must be properly cooked or processed because the raw plant contains compounds that release cyanide. As a s...

Read the full Cassava monograph → Herb & supplement monograph

Agave

Agave is a succulent plant best known as the source of agave nectar, a popular sweetener, and the base for tequila and mezcal. While it has a long history of folk use for digestion, skin car...

Read the full Agave monograph → Herb & supplement monograph

Potato

Interacts with 7 drugs

Potato is a common food, and as a supplement it is mostly used in folk remedies such as raw potato juice for stomach upset or as a topical poultice. Solid scientific evidence for these uses...

Read the full Potato monograph →
Sources

Sources & How We Checked

Vital Flora Advanced Biome 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 235 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.

Guar Gum 26 references
  1. Gin H, Orgerie MB, Aubertin J. The influence of Guar gum on absorption of metformin from the gut in healthy volunteers. Horm Metab Res 1989;21:81-3.
  2. Huupponen R, Seppala P, Iisalo E. Effect of guar gum, a fibre preparation, on digoxin and penicillin absorption in man. Eur J Clin Pharmacol 1984;26:279-81. PubMed
  3. Malo JL, Cartier A, L'Archeveque J, et al. Prevalence of occupational asthma and immunologic sensitization to guar gum among employees at a carpet-manufacturing plant. J Allergy Clin Immunol 1990;86:562-9. PubMed
  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.
  6. Vuorinen-Markkola H, Sinisalo M, Koivisto VA. Guar gum in insulin-dependent diabetes: effects on glycemic control and serum lipoproteins. Am J Clin Nutr 1992;56:1056-1060. PubMed
  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
  9. Groop PH, Aro A, Stenman S, Groop L. Long-term effects of guar gum in subjects with non-insulin-dependent diabetes mellitus. Am J Clin Nutr 1993;58:513-8. PubMed
  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
  19. Halama, W. H. and Mauldin, J. L. Distal esophageal obstruction due to a guar gum preparation (Cal-Ban 3000). South.Med.J. 1992;85(6):642-645. PubMed
  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
  22. Simons LA, Gayst S, Balasubramaniam S, Ruys J. Long-term treatment of hypercholesterolaemia with a new palatable formulation of guar gum. Atherosclerosis 1982;45:101-108. PubMed
  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
  26. Polymeros D, Beintaris I, Gaglia A, et al. Partially hydrolyzed guar gum accelerates colonic transit time and improves symptoms in adults with chronic constipation. Dig Dis Sci 2014;59(9):2207-14. PubMed

See these in context on the Guar Gum monograph →

Apple 16 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.
  3. Rodriguez J, Crespo JF, Lopez-Rubio A, et al. Clinical cross-reactivity among foods of the Rosaceae family. J Allergy Clin Immunol 2000;106:183-189. PubMed
  4. Greenblatt DJ. Analysis of drug interactions involving fruit beverages and organic anion-transporting polypeptides. J Clin Pharmacol 2009;49:1403-7. PubMed
  5. Bailey DG. Fruit juice inhibition of uptake transport: a new type of food-drug interaction. Br J Clin Pharmacol 2010;70:645-55. PubMed
  6. Kamath AV, Yao M, Zhang Y, Chong S. Effect of fruit juices on the oral bioavailability of fexofenadine in rats. J Pharm Sci 2005;94:233-9. PubMed
  7. Tapaninen T, Neuvonen PJ, Niemi M. Orange and apple juice greatly reduce the plasma concentrations of the OATP2B1 substrate aliskiren. Br J Clin Pharmacol 2011;71:718-26. PubMed
  8. Jeon H, Jang IJ, Lee S, et al. Apple juice greatly reduces systemic exposure to atenolol. Br J Clin Pharmacol 2012 May 11. doi: 10.1111/j.1365-2125.2012.04324.x. [Epub ahead of print]. PubMed
  9. Visvanathan, R., Chen, R., Horowitz, M., and Chapman, I. Blood pressure responses in healthy older people to 50 g carbohydrate drinks with differing glycaemic effects. Br J Nutr 2004;92(2):335-340. PubMed
  10. Asp, N. G., Agardh, C. D., Ahren, B., Dencker, I., Johansson, C. G., Lundquist, I., Nyman, M., Sartor, G., and Schersten, B. Dietary fibre in type II diabetes. Acta Med Scand Suppl 1981;656:47-50. PubMed
  11. Akamine Y, Miura M, Komori H, et al. Effects of one-time apple juice ingestion on the pharmacokinetics of fexofenadine enantiomers. Eur J Clin Pharmacol. 2014 Sep;70(9):1087-95. PubMed
  12. Luo J, Imai H, Ohyama T, et al. The Pharmacokinetic Exposure to Fexofenadine is Volume-Dependently Reduced in Healthy Subjects Following Oral Administration With Apple Juice. Clin Transl Sci. 2016 Aug;9(4):201-6. PubMed
  13. Tsiougkos N, Vovolis V. Repeated anaphylactic episodes to orange and apple. Eur Ann Allergy Clin Immunol. 2013 May;45(3):113-5.
  14. Rubido S, García-Caballero L, Abeleira MT, Limeres J, García M, Diz P. Effect of chewing an apple on dental plaque removal and on salivary bacterial viability. PLoS One. 2018;13(7):e0199812. PubMed
  15. Krishnasamy S, Lomer MCE, Marciani L, et al. Processing apples to puree or juice speeds gastric emptying and reduces postprandial intestinal volumes and satiety in healthy adults. J Nutr 2020;150(11):2890-9. PubMed
  16. Awan S, Abelleira A, Khehra L, Hieber R. Undetectable serum lithium concentrations after coadministration of liquid lithium citrate and apple juice: A case report. Ment Health Clin. 2021;11(1):27-30. PubMed

See these in context on the Apple monograph →

Cranberry 33 references
  1. Anon. Possible interaction between warfarin and cranberry juice. Current Problems in Pharmacovigilance 2003;29:8. PubMed
  2. Greenblatt DJ, von Moltke LL, Perloff ES, et al. Interaction of flurbiprofen with cranberry juice, grape juice, tea, and fluconazole: in vitro and clinical studies. Clin Pharmacol Ther 2006;79:125-33. PubMed
  3. Hodek P, Trefil P, Stiborova M. Flavonoids-potent and versatile biologically active compounds interacting with cytochromes P450. Chem Biol Interact 2002;139:1-21.. PubMed
  4. Grant P. Warfarin and cranberry juice: An interaction? J Heart Valve Dis 2004;13:25-6.
  5. Suvarna R, Pirmohamed M, Henderson L. Possible interaction between warfarin and cranberry juice. BMJ 2003;327:1454. PubMed
  6. Li Z, Seeram NP, Carpenter CL, et al. Cranberry does not affect prothrombin time in male subjects on warfarin. J Am Diet Assoc 2006;106:2057-61. PubMed
  7. Lilja JJ, Backman JT, Neuvonen PJ. Effects of daily ingestion of cranberry juice on the pharmacokinetics of warfarin, tizanidine, and midazolam - probes of CYP2C9, CYP1A2 and CYP3A4. Clin Pharmacol The 2007:81:833-9. PubMed
  8. Wing DA, Rumney PJ, Preslicka CW, Chung JH. Daily cranberry juice for the prevention of asymptomatic bacteriuria in pregnancy: a randomized, controlled pilot study. J Urol 2008;180:1367-72. PubMed
  9. Mohammed Abdul MI, Jiang X, Williams KM, et al. Pharmacodynamic interaction of warfarin with cranberry but not with garlic in healthy subjects. Br J Pharmacol 2008;154:1691-700. PubMed
  10. McMurdo MET, Argo I, Phillips G, et al. Cranberry or trimethoprim for the prevention of recurrently urinary tract infections? A randomized controlled trial in older women. J Antimicrob Chemother 2009;63:389-95.
  11. Mergenhagen KA, Sherman O. Elevated International Normalized Ratio after concurrent ingestion of cranberry sauce and warfarin. Am J Health-Syst Pharm 2008;65:2113-6. PubMed
  12. Ansell J, McDonough M, Zhao Y, et al. The absence of an interaction between warfarin and cranberry juice: a randomized, double-blind trial. J Clin Pharmacol 2009;49:824-30. PubMed
  13. Haber SL, Cauthon KA, Raney EC. Cranberry and warfarin interaction: a case report and review of the literature. Consult Pharm 2012;27:58-65. PubMed
  14. Hamann GL, Campbell JD, George CM. Warfarin-cranberry juice interaction. Ann Pharmacother 2011;45:e17. PubMed
  15. Roberts D, Flanagan P. Case report: Cranberry juice and warfarin. Home Healthc Nurse 2011;29:92-7.
  16. Garcia-Calatayud, S., Larreina Cordoba, J. J., and Lozano De La Torre MJ. [Severe cranberry juice poisoning]. An.Esp.Pediatr. 2002;56(1):72-73.
  17. Patel, D. A., Gillespie, B., Sobel, J. D., Leaman, D., Nyirjesy, P., Weitz, M. V., and Foxman, B. Risk factors for recurrent vulvovaginal candidiasis in women receiving maintenance antifungal therapy: results of a prospective cohort study. Am J Obstet.Gy PubMed
  18. Isele, H. [Fatal bleeding under warfarin plus cranberry juice. Is it due to salicylic acid?]. MMW.Fortschr.Med 3-11-2004;146(11):13.
  19. Linsenmeyer, T. A., Harrison, B., Oakley, A., Kirshblum, S., Stock, J. A., and Millis, S. R. Evaluation of cranberry supplement for reduction of urinary tract infections in individuals with neurogenic bladders secondary to spinal cord injury. A prospecti
  20. McMurdo, M. E., Bissett, L. Y., Price, R. J., Phillips, G., and Crombie, I. K. Does ingestion of cranberry juice reduce symptomatic urinary tract infections in older people in hospital? A double-blind, placebo-controlled trial. Age Ageing 2005;34(3):256- PubMed
  21. Sylvan, L. and Justice, N. P. Possible interaction between warfarin and cranberry juice. Am Fam.Physician 9-15-2005;72(6):1000.
  22. Niklasson, A. and Andren, L. [Interaction between Waran and cranberry juice]. Lakartidningen 3-15-2006;103(11):853-854.
  23. Rindone, J. P. and Murphy, T. W. Warfarin-cranberry juice interaction resulting in profound hypoprothrombinemia and bleeding. Am J Ther 2006;13(3):283-284. PubMed
  24. Uesawa, Y. and Mohri, K. Effects of cranberry juice on nifedipine pharmacokinetics in rats. J Pharm Pharmacol 2006;58(8):1067-1072. PubMed
  25. Valentova, K., Stejskal, D., Bednar, P., Vostalova, J., Cihalik, C., Vecerova, R., Koukalova, D., Kolar, M., Reichenbach, R., Sknouril, L., Ulrichova, J., and Simanek, V. Biosafety, antioxidant status, and metabolites in urine after consumption of dried
  26. Royer, D. J., George, J. N., and Terrell, D. R. Thrombocytopenia as an adverse effect of complementary and alternative medicines, herbal remedies, nutritional supplements, foods, and beverages. Eur J Haematol 2010;84(5):421-429. PubMed
  27. Stapleton, A. E., Dziura, J., Hooton, T. M., Cox, M. E., Yarova-Yarovaya, Y., Chen, S., and Gupta, K. Recurrent urinary tract infection and urinary Escherichia coli in women ingesting cranberry juice daily: a randomized controlled trial. Mayo.Clin.Proc. PubMed
  28. Doad GJ, Kabange W. Cranberry juice, atorvastatin and back pain. J Med Assoc Ga 2014;103(1):14.
  29. Griffiths AP, Beddall A, Pegler S. Fatal haemopericardium and gastrointestinal haemorrhage due to possible interaction of cranberry juice with warfarin. J R Soc Promot Health 2008;128(6):324-6. PubMed
  30. Mellen CK, Ford M, Rindone JP. Effect of high-dose cranberry juice on the pharmacodynamics of warfarin in patients. Br J Clin Pharmacol 2010;70(1):139-42. PubMed
  31. Ushijima K, Tsuruoka S, Tsuda H, Hasegawa G, Obi Y, Kaneda T, Takahashi M, Maekawa T, Sasaki T, Koshimizu TA, Fujimura A. Cranberry juice suppressed the diclofenac metabolism by human liver microsomes, but not in healthy human subjects. Br J Clin Pharmaco PubMed
  32. Ngo N, Brantley SJ, Carrizosa DR, et al. The warfarin-cranberry juice interaction revisited: A systematic in vitro-in vivo evaluation. J Exp Pharmacol. 2010;2010(2):83-91.
  33. Williams G, Stothart CI, Hahn D, Stephens JH, Craig JC, Hodson EM. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev 2023;11(11):CD001321. PubMed

See these in context on the Cranberry 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 →

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 →

Cassava 30 references
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  5. Osman BA, Ng ML, Bakar AA, Khalid BA. The effect of cassava leave intake on thyroid hormone and urinary iodine. East Afr Med J 1993;70(5):314-5.
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  7. Geelhoed GW. Metabolic maladaptation: individual and social consequences of medical intervention in correcting endemic hypothyroidism. Nutrition 1999;15(11-12):908-32. DOI
  8. Biassoni P, Ravera G, Bertocchi J, et al. Influence of dietary habits on thyroid status of a nomadic people, the Bororo shepherds, roaming a central African region affected by severe iodine deficiency. Eur J Endocrinol 1998;138(6):681-5. PubMed
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  10. Delange F. [The role of goitrogenic factors distinct from iodine deficiency in the etiology of goiter]. Ann Endocrinol (Paris) 1988;49(4-5):302-5.
  11. Assan R, Assan D, Thiebaut MF, et al. [Diabetogenic tropical pancreatitis]. Diabete Metab 1988;14(3):299-312.
  12. Balakrishnan V, Unnikrishnan AG, Thomas V, et al. Chronic pancreatitis. A prospective nationwide study of 1,086 subjects from India. JOP 2008;9(5):593-600.
  13. Cliff J, Lundqvist P, Martensson J, et al. Association of high cyanide and low sulphur intake in cassava-induced spastic paraparesis. Lancet 1985;2(8466):1211-3. PubMed
  14. Paula Cardoso A, Ernesto M, Nicala D, et al. Combination of cassava flour cyanide and urinary thiocyanate measurements of school children in Mozambique. Int J Food Sci Nutr 2004;55(3):183-90. PubMed
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  19. Olusanya O, Olanrewaju DM, Oluwole FA. Studies on the effectiveness, safety and acceptability of fluids from local foodstuffs in the prevention and management of dehydration caused by diarrhoea in children. J Trop Pediatr 1994;40(6):360-4. PubMed
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  23. Cardoso AP, Mirione E, Ernesto M, et al. Processing of cassava roots to remove cyanogens. Journal of Food Composition and Analysis 2005;18(5):451-60. DOI
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  26. Rosa ML, Falcão PM, Yokoo EM, et al. Brazil's staple food and incident diabetes. Nutrition. 2014 Mar;30(3):365-8. Epub 2013 Oct 2. PubMed
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  28. Boivin MJ, Okitundu D, Makila-Mabe Bumoko G, et al. Neuropsychological effects of konzo: a neuromotor disease associated with poorly processed cassava. Pediatrics. 2013 Apr;131(4):e1231-9. Epub 2013 Mar 25. PubMed
  29. Antolin-Amerigo D, Rodriguez-Rodriguez M, Barbarroja-Escudero J, Postigo Resa I, Uribe-Etxebarría MC, Alvarez-Mon M. Hypersensitivity to cassava: an allergen-based assessment. J Investig Allergol Clin Immunol. 2012;22(5):385-6.
  30. Santos KS, Galvao CE, Gadermaier G, et al. Allergic reactions to manioc (Manihot esculenta Crantz): identification of novel allergens with potential involvement in latex-fruit syndrome. J Allergy Clin Immunol. 2011 Dec;128(6):1367-9. Epub 2011 Aug 19. PubMed

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Agave 8 references
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  2. Brenner S, Landau M, Goldberg I. Contact dermatitis with systemic symptoms from Agave americana. Dermatology 1998;196(4):408-411.
  3. High WA. Agave contact dermatitis. Am J Contact Dermat 2003;14(4):213-214. DOI
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  5. Ricks MR, Vogel PS, Elston DM, et al. Purpuric agave dermatitis. J Am Acad Dermatol 1999;40(2 Pt 2):356-358. PubMed
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  8. Cherpelis BS, Fenske NA. Purpuric irritant contact dermatitis induced by Agave americana. Cutis 2000;66(4):287-8.

See these in context on the Agave monograph →

Potato 15 references
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  2. Klement P, Liao P, Bajzar L. A novel approach to arterial thrombolysis. Blood 1999;94:2735-43. DOI
  3. Redlitz A, Nicolini FA, Malycky JL, et al. Inducible carboxypeptidase activity. A role in clot lysis in vivo. Circulation 1996;93:1328-30. PubMed
  4. Larsson SC, Wolk A. Potato consumption and risk of cardiovascular disease: 2 prospective cohort studies. Am J Clin Nutr. 2016;104(5):1245-1252. PubMed
  5. Vinson JA, Demkosky CA, Navarre DA, Smyda MA. High-antioxidant potatoes: acute in vivo antioxidant source and hypotensive agent in humans after supplementation to hypertensive subjects. J Agric Food Chem. 2012;60(27):6749-54. PubMed
  6. Bestas A, Goksu H, Erhan OL. The effect of preoperative consumption of potatoes on succinylcholine-induced block and recovery from anesthesia. J Clin Monit Comput. 2013;27(6):609-12. PubMed
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  8. Mensinga TT, Sips AJ, Rompelberg CJ, et al. Potato glycoalkaloids and adverse effects in humans: an ascending dose study. Regul Toxicol Pharmacol. 2005;41(1):66-72. PubMed
  9. Darooghegi Mofrad M, Milajerdi A, Sheikhi A, Azadbakht L. Potato consumption and risk of all cause, cancer and cardiovascular mortality: a systematic review and dose-response meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr. 2020;60(7): PubMed
  10. Elefterova-Florova EV, Popova DN, Andreeva RV. An unusual and rare case of food-dependent exercise-induced anaphylaxis caused by ingestion of potatoes. Folia Med (Plovdiv). 2018;60(3):479-82. PubMed
  11. Schwingshackl L, Schwedhelm C, Hoffmann G, Boeing H. Potatoes and risk of chronic disease: a systematic review and dose-response meta-analysis. Eur J Nutr. 2019;58(6):2243-51. PubMed
  12. Tsang C, Smail NF, Almoosawi S, McDougall GJM, Al-Dujaili EAS. Antioxidant rich potato improves arterial stiffness in healthy adults. Plant Foods Hum Nutr. 2018;73(3):203-8. PubMed
  13. Stone MS, Martin BR, Weaver CM. Short-Term RCT of Increased Dietary Potassium from Potato or Potassium Gluconate: Effect on Blood Pressure, Microcirculation, and Potassium and Sodium Retention in Pre-Hypertensive-to-Hypertensive Adults. Nutrients 2021;13( PubMed
  14. Darooghegi Mofrad M, Mozaffari H, Askari MR, et al. Potato Consumption and Risk of Site-Specific Cancers in Adults: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies. Adv Nutr. 2021 Oct 1;12(5):1705-22. PubMed
  15. Yiannakou I, Pickering RT, Yuan M, Singer MR, Moore LL. Potato consumption is not associated with cardiometabolic health outcomes in Framingham Offspring Study adults. J Nutr Sci. 2022 Sep 2;11:e73. PubMed

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Lactobacillus Acidophilus 15 references
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  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 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 Helveticus 2 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

See these in context on the Lactobacillus Helveticus monograph →

Lactobacillus Delbrueckii 9 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Rossi F, Amadoro C, Gasperi M, Colavita G. Lactobacilli infection case reports in the last three years and safety implications. Nutrients. 2022;14(6):1178. PubMed
  3. Ranchal P, Gupta R, Goldberg R, A Lobo S, Pascual A, El Khoury MY. Penicillin-sensitive Lactobacillus jensenii bacteremia. Am J Ther 2021;28(2):e250-e252. PubMed
  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. Neonakis IK, Skamagkas I, Stafylaki D, Maraki S. Lactobacillus delbrueckii urinary tract infection in a male patient: a case report. Germs 2022;12(2):304-307. PubMed
  8. Maillet F, Passeron A, Podglajen I, Ranque B, Pouchot J. Lactobacillus delbrueckii urinary tract infection in a male patient. Med Mal Infect 2019;49(3):226-228. PubMed
  9. Darbro BW, Petroelje BK, Doern GV. Lactobacillus delbrueckii as the cause of urinary tract infection. J Clin Microbiol 2009;47(1):275-7.

See these in context on the Lactobacillus Delbrueckii 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 →

Lactobacillus Johnsonii 2 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

See these in context on the Lactobacillus Johnsonii monograph →

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 Breve 9 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Xiao JZ, Takahashi S, Odamaki T, et al. Antibiotic susceptibility of bifidobacterial strains distributed in the Japanese market. Biosci Biotechnol Biochem. 2010;74(2):336-42. PubMed
  3. Pruccoli G, Silvestro E, Pace Napoleone C, Aidala E, Garazzino S, Scolfaro C. Are probiotics safe? Bifidobacterium bacteremia in a child with severe heart failure. Infez Med. 2019;27(2):175-178.
  4. Ohishi A, Takahashi S, Ito Y, et al. Bifidobacterium septicemia associated with postoperative probiotic therapy in a neonate with omphalocele. J Pediatr. 2010;156(4):679-81. PubMed
  5. Sakurai Y, Watanabe T, Miura Y, et al. Clinical and bacteriologic characteristics of six cases of Bifidobacterium breve bacteremia due to probiotic administration in the neonatal intensive care unit. Pediatr Infect Dis J 2022;41(1):62-65. PubMed
  6. Esaiassen E, Hjerde E, Cavanagh JP, Simonsen GS, Klingenberg C; Norwegian Study Group on Invasive Bifidobacterial Infections. Bifidobacterium bacteremia: Clinical characteristics and a genomic approach to assess pathogenicity. J Clin Microbiol. 2017;55(7) PubMed
  7. Wakabayashi Y, Nakayama S, Yamamoto A, et al. First case of necrotizing fasciitis and bacteremia caused by Bifidobacteriumbreve. Anaerobe 2022;76:102613.
  8. Takeda Y, Ota K, Kondo A, et al. A case of necrotizing fasciitis caused by Bifidobacterium breve. IDCases 2022;31:e01667. PubMed
  9. Suwantarat N, Romagnoli M, Wakefield T, Carroll KC. Ventriculoperitoneal shunt infection caused by Bifidobacterium breve. Anaerobe 2014;28:1-3. PubMed

See these in context on the Bifidobacterium Breve monograph →

Bifidobacterium Longum 21 references
  1. Ha GY, Yang CH, Kim H, Chong Y. Case of sepsis caused by Bifidobacterium longum. J Clin Microbiol 1999;37:1227-8.
  2. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  3. Xiao JZ, Takahashi S, Odamaki T, et al. Antibiotic susceptibility of bifidobacterial strains distributed in the Japanese market. Biosci Biotechnol Biochem. 2010;74(2):336-42. PubMed
  4. Rautava S, Kainonen E, Salminen S, Isolauri E. Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant. J Allergy Clin Immunol. 2012;130(6):1355-60. PubMed
  5. Pruccoli G, Silvestro E, Pace Napoleone C, Aidala E, Garazzino S, Scolfaro C. Are probiotics safe? Bifidobacterium bacteremia in a child with severe heart failure. Infez Med. 2019;27(2):175-178.
  6. Pellonperä O, Vahlberg T, Mokkala K, et al. Weight gain and body composition during pregnancy: a randomised pilot trial with probiotics and/or fish oil. Br J Nutr. 2020 Nov 4:1-11. PubMed
  7. Pellonperä O, Mokkala K, Houttu N, et al. Efficacy of fish oil and/or probiotic intervention on the incidence of gestational diabetes mellitus in an at-risk group of overweight and obese women: A randomized, placebo-controlled, double-blind clinical trial PubMed
  8. Shahriari A, Karimi E, Shahriari M, Aslani N, Khooshideh M, Arab A. The effect of probiotic supplementation on the risk of gestational diabetes mellitus among high-risk pregnant women: A parallel double-blind, randomized, placebo-controlled clinical trial PubMed
  9. Esaiassen E, Hjerde E, Cavanagh JP, Simonsen GS, Klingenberg C; Norwegian Study Group on Invasive Bifidobacterial Infections. Bifidobacterium bacteremia: Clinical characteristics and a genomic approach to assess pathogenicity. J Clin Microbiol. 2017;55(7) PubMed
  10. Enomoto T, Sowa M, Nishimori K, et al. Effects of bifidobacterial supplementation to pregnant women and infants in the prevention of allergy development in infants and on fecal microbiota. Allergol Int 2014;63(4):575-85. PubMed
  11. US Food and Drug Administration (FDA). Dear Healthcare Provider Letter: Warning Regarding Use of Probiotics in Preterm Infants. September 2023. Available at: https://www.fda.gov/media/172606/download?attachment. Accessed November 1, 2023.
  12. Pillai A, Tan J, Paquette V, Panczuk J. Does probiotic bacteremia in premature infants impact clinically relevant outcomes? A case report and updated review of literature. Clin Nutr ESPEN. 2020;39:255-259. PubMed
  13. Sabaté JM, Iglicki F. Effect of Bifidobacterium longum 35624 on disease severity and quality of life in patients with irritable bowel syndrome. World J Gastroenterol 2022;28(7):732-744.
  14. Malaguarnera M, Greco F, Barone G, Gargante MP, Malaguarnera M, Toscano MA. Bifidobacterium longum with fructo-oligosaccharide (FOS) treatment in minimal hepatic encephalopathy: a randomized, double-blind, placebo-controlled study. Dig Dis Sci 2007;52(11) PubMed
  15. Zbinden A, Zbinden R, Berger C, Arlettaz R. Case series of Bifidobacterium longum bacteremia in three preterm infants on probiotic therapy. Neonatology 2015;107(1):56-9.
  16. Tamaki H, Nakase H, Inoue S, et al. Efficacy of probiotic treatment with Bifidobacterium longum 536 for induction of remission in active ulcerative colitis: A randomized, double-blinded, placebo-controlled multicenter trial. Dig Endosc 2016;28(1):67-74.
  17. Bertelli C, Pillonel T, Torregrossa A, et al. Bifidobacterium longum bacteremia in preterm infants receiving probiotics. Clin Infect Dis 2015;60(6):924-7. PubMed
  18. Esaiassen E, Cavanagh P, Hjerde E, Simonsen GS, Støen R, Klingenberg C. Bifidobacterium longum subspecies infantis bacteremia in 3 extremely preterm infants receiving probiotics. Emerg Infect Dis 2016;22(9):1664-6.
  19. Tena D, Losa C, Medina MJ, Sáez-Nieto JA. Peritonitis caused by Bifidobacterium longum: case report and literature review. Anaerobe 2014;27:27-30. PubMed
  20. Sangkanjanavanich S, Pradubpongsa P, Mitthamsiri W, Sangasapaviliya A, Boonpiyathad T. Bifidobacterium infantis 35624 efficacy in patients with uncontrolled asthma: A randomized placebo-controlled trial. Ann Allergy Asthma Immunol 2022;129(6):790-792. PubMed
  21. Wilson HL, Ong CW. Bifidobacterium longum vertebrodiscitis in a patient with cirrhosis and prostate cancer. Anaerobe 2017;47:47-50. PubMed

See these in context on the Bifidobacterium Longum monograph →

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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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