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Lactobacillus

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Are there any interactions with medications?



Antibiotic drugs
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Antibiotics are used to reduce harmful bacteria in the body. Antibiotics can also reduce friendly bacteria in the body. Lactobacillus is a type of friendly bacteria. Taking antibiotics along with Lactobacillus can reduce the effectiveness of Lactobacillus. To avoid this interaction, take Lactobacillus products at least 2 hours before or after antibiotics.



Medications that decrease the immune system (Immunosuppressants)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

Lactobacillus contains live bacteria and yeast. The immune system usually controls bacteria and yeast in the body to prevent infections. Medications that decrease the immune system can increase your chances of getting sick from bacteria and yeast. Taking Lactobacillus along with medications that decrease the immune system might increase the chances of getting sick.

Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.

Dosing considerations for Lactobacillus.

The strength of Lactobacillus products is usually indicated by the number of living organisms per capsule. Typical doses range from 1 to 10 billion living organisms taken daily in 3-4 divided doses.

The following doses have been studied in scientific research:

ADULTS:

BY MOUTH:
  • For hayfever: At least 2 billion Lactobacillus paracasei daily for 7 weeks has been used along with 10 mg of loratadine once daily for 5 weeks.
  • For preventing diarrhea caused by antibiotics: A specific beverage (Actimel, Danone) containing Lactobacillus casei, Lactobacillus bulgaricus, and Streptococcus thermophilus (Actimel, Danone) 97 mL has been taken twice daily. Also, a combination of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12, a total of 2 billion live cells, has been taken twice daily for 14 days.
  • For eczema (atopic dermatitis): A specific strain of Lactobacillus rhamnosus, Lactobacillus GG (Culturelle), has been used. Also, 100 million CFU of Lactobacillus reuteri has been used daily starting at week 36 of pregnancy until delivery.
  • For a condition associated with an increased risk for developing allergic reactions (atopic disease): Ten to 20 billion CFU of Lactobacillus GG has been used daily for 2-4 weeks before delivery.
  • For treating vaginal infections caused by bacteria (bacterial vaginosis): 150 mL of yogurt containing Lactobacillus acidophilus has been used daily for 2 months.
  • For preventing diarrhea due to cancer treatment (chemotherapy): Ten to 20 billion CFU of a specific strain of Lactobacillus rhamnosus, Lactobacillus GG, has been used daily in two divided doses during 24 weeks of chemotherapy.
  • For Helicobacter pylori (H pylori) infection: A yogurt containing one billion CFU Lactobacillus gasseri has been used twice daily for 4 to 8 weeks alone or with antibiotics. A specific product (Lacteol Fort, Bruschettini s.r.l., Genoa, Italy) containing Lactobacillus acidophilus has been taken three times daily for 10 days along with antibiotics. Other combinations of Lactobacillus strains and antibiotics have also been used.
  • For high cholesterol: A mixture of three strains of Lactobacillus plantarum containing a total daily dose of 1.2 billion live cells has been used for 12 weeks. Also, specific yogurt or specific capsules containing 2.9 to 50 billion live cells of Lactobacillus reuteri (strain NCIMB 30242; Cardioviva, Micropharma Limited) have been used daily for 6 to 9 weeks.
  • For irritable bowel syndrome (IBS): A specific product containing 10 billion organisms of Lactobacillus acidophilus (Lacteol Fort) has been used daily for 6 weeks. Also, a specific beverage containing Lactobacillus plantarum (ProViva, Skanemejerier, Sweden) has been taken in doses of 125-200 mL once or twice daily, or capsules containing 10 billion CFU Lactobacillus plantarum once daily, for 4 weeks.
  • For inflamed mouth sores from cancer treatment (oral mucositis): Lozenges containing Lactobacillus brevis have been dissolved in the mouth every 2-3 hours up to six times daily during chemotherapy and continuing until one week after.
  • Inflammation of an artificial rectum surgically created in people with inflammatory bowel disease (pouchitis): A combination probiotic containing, Lactobacillus, Bifidobacterium, and Streptococcus species (VSL#3), has been taken twice daily for up to one year. A specific formulation (Trilac, Allergon AB, Angelholm, Sweden) containing Lactobacillus acidophilus, Lactobacillus bulgaricus, and Bifidobacterium bifidum, has been taken in doses of two capsules three times daily for 9 months.
  • For rheumatoid arthritis: One hundred million CFU of Lactobacillus casei have been used daily for 8 weeks.
  • For traveler's diarrhea: Two billion CFU of a specific strain of Lactobacillus rhamnosus, Lactobacillus GG, has been used daily, starting two days before traveling and continuing until the end of the trip.
  • For a bowel condition called ulcerative colitis: A specific product (Profermin, Nordisk Rebalance), containing 100 million colony forming units (CFUs)/mL of the specific probiotic strain Lactobacillus plantarum has been taken twice daily for 8 weeks. Also, 3 grams of another combination probiotic containing Lactobacillus, Bifidobacterium, and Streptococcus (VSL#3) has been used twice daily for maintenance therapy.
APPLIED INSIDE THE VAGINA:
  • For treating vaginal infections caused by bacteria: One to two vaginal tablets (Gynoflor, Medinova, Switzerland) daily containing living Lactobacillus acidophilus (10 million colon-forming units/tablet) and 0.3 mg estriol for 6 days. Intravaginal suppositories containing 100 million to 1 billion colony forming units of Lactobacillus acidophilus (Vivag, Pharma Vinci A/S, Denmark) given twice daily for 6 days has also been used.
CHILDREN:

BY MOUTH:
  • For children with rotaviral diarrhea: Five to 10 billion live Lactobacillus GG in a solution that replaces lost water has been used. Also, 10 to100 billion live Lactobacillus reuteri daily for up to 5 days has been used. Lower doses might not be as effective.
  • For hayfever: Ten billion cells of Lactobacillus johnsonii, has been taken once daily for 12 weeks along with 5 mg of levocetirizine in children 7-12 years-old.
  • For preventing diarrhea caused by antibiotics: While taking antibiotics, 10-20 billion live organisms of a strain of Lactobacillus rhamnosus, Lactobacillus GG (Culturelle), has been taken once daily or 20 billion organisms twice daily.
  • For eczema (atopic dermatitis): Five billion CFU of Lactobacillus sakei has been used twice daily for 12 weeks. Also, 100 million CFU of Lactobacillus reuteri daily from birth to 12 months has been used. Fifty billion CFU of Lactobacillus plantarum has been used twice daily for 12 weeks in children aged 1 to 13 years.
  • For a condition associated with an increased risk for developing allergic reactions (atopic disease): Ten to 20 billion CFU of Lactobacillus GG has been used daily for the first three to six months of life.
  • For diarrhea: Six billion CFU of a specific strain of Lactobacillus rhamnosus, Lactobacillus GG, has been used twice daily in infants while hospitalized. Also, 37 billion CFU of Lactobacillus GG has been used daily, 6 days weekly, for 15 months in children 6 to 24 months-old.
  • For Helicobacter pylori (H pylori) infection: A combination of 94 billion CFU Lactobacillus acidophilus and 8.6 billion CFU Bifidobacterium bifidum have been used together with an antibiotic daily for 2 weeks, followed by the probiotics alone for an additional 4 weeks.
  • For colic in babies: One hudred million CFU of Lactobacillus reuteri (Probiotic Drops, BioGaia AB) has been used daily for up to 90 days in breast-fed and formula-fed infants.
  • For lung infections: Milk products containing 1 million to 5 billion CFU of various Lactobacillus strains have been used.
  • For traveler's diarrhea: Two billion CFU of a specific strain of Lactobacillus rhamnosus, Lactobacillus GG, has been used daily, starting two days before traveling and continuing until the end of the trip.
  • For a bowel condition called ulcerative colitis: A combination probiotic containing 450 billion to 1800 billion bacteria, including Lactobacillus, Bifidobacterium, and Streptococcus (VSL#3), has been used daily in children with moderate-to-severe ulcerative colitis.

Therapeutic Research Faculty copyright

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