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Lactobacillus

IN THIS ARTICLE

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: Moderate 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:

BY MOUTH:
  • For children with rotaviral diarrhea: 5 to 10 billion live Lactobacillus GG in a solution that replaces lost water.
  • For treating babies and children with diarrhea:
    • 10 to 100 billion live Lactobacillus reuteri daily for up to 5 days. Lower doses may not be effective.
    • Also, combination of Lactobacillus rhamnosus and Lactobacillus reuteri, 10 billion live cells of each strain, twice daily for 5 days.
  • For preventing antibiotic-associated diarrhea in children: A specific strain of Lactobacillus rhamnosus, Lactobacillus GG (Culturelle) containing 20 billion live organisms daily has been used during treatment with antibiotics. A specific beverage containing Lactobacillus casei, Lactobacillus bulgaricus, and Streptococcus thermophilus (Actimel, Danone) 97 mL twice daily also has been used.
  • For preventing diarrhea in infants and children ages 1 to 36 months:
    • 6 billion live Lactobacillus GG twice daily.
    • A fermented milk product containing a specific Lactobacillus casei strain DN-114 001 (DanActive, Dannon) in doses of 100 grams, 125 grams, or 250 grams daily has also been used.
  • For preventing and shortening the duration of diarrhea in newborns within the first year of life in rural areas of developing countries: 100 million live Lactobacillus sporogenes have been given daily for one year.
  • For preventing respiratory infections in children attending day-care centers: 260 mL milk with 500,000 to 1 million colony-forming units of Lactobacillus GG per mL. A milk product containing 5 billion colony forming units each of Lactobacillus acidophilus and Bifidobacterium (HOWARU Protect, Danisco) in 120 mL of milk twice a day has also been used. A milk product containing Lactobacillus 5 billion colony forming units in 120 mL of milk twice a day has also been used.
  • For treating recurrent diarrhea caused by Clostridium difficile: 1.25 billion live Lactobacillus GG in two divided doses for 2 weeks.
  • For ulcerative colitis: a combination product containing living freeze-dried bacteria species including lactobacillus, bifidobacteria, and streptococcus (VSL#3) 3 grams twice daily has been used for maintenance therapy.
  • For patients with active mild-to-moderate ulcerative colitis: VSL#3 three grams once or twice daily in combination with conventional treatment.
  • For children with moderate-to-severe ulcerative colitis: VSL#3 450-1800 billion bacteria once a day in combination with mesalamine.
  • For preventing traveler's diarrhea: Lactobacillus GG, 2 billion organisms daily.
  • For diarrhea due to chemotherapy: a specific strain of Lactobacillus rhamnosus, Lactobacillus GG (Culturelle) containing 10-20 billion live organisms daily.
  • For atopic dermatitis: a specific strain of Lactobacillus rhamnosus, Lactobacillus GG (Culturelle). Lactobacillus reuteri 100 million live bacteria daily, or Lactobacillus sakei 5 billion live bacteria twice daily have also been used.
  • For irritable bowel syndrome (IBS): 10 billion heat-killed Lactobacillus acidophilus (Lacteol Fort) twice daily for 6 weeks. A specific lactobacillus combination probiotic containing viable lyophilized bacteria species including lactobacillus, bifidobacteria, and streptococcus (VSL#3) containing 450 billion viable lyophilized bacteria twice daily. A specific beverage containing Lactobacillus plantarum 299v (ProViva, Skanemejerier, Sweden) taken twice daily.
  • For preventing the common cold in adults: a mixture of Lactobacillus plantarum and Lactobacillus paracasei, 1 billion live bacteria daily.
  • For colic in babies: A specific Lactobacillus reuteri product (Probiotic Drops, BioGaia AB) 100 million CFUs once daily 30 minutes after a feeding.
  • For preventing the serious gut condition called necrotizing enterocolitis (NEC) in babies born prematurely: Lactobacillus rhamnosus GG 6 billion live bacteria daily.
  • For preventing serious lung infections in adults on ventilators: Lactobacillus rhamnosus GG (Amerifit Brands Nutrition), 2 billion live bacteria twice daily.
APPLIED INSIDE THE VAGINA:
  • For treating vaginal infections caused by bacteria:
    • 1-2 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.
    • Vaginal capsules containing Lactobacillus gasseri and Lactobacillus rhamnosus, 100 million to 1 billion colony-forming units of each strain per capsule (EcoVag Vaginal Capsules, Bifodan A/S, Denmark), following usual treatment, for 10 days in three menstrual cycles following the infection has also been used.

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