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Drug Interactions between brewer's yeast and Hecoria

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

tacrolimus brewer's yeast

Applies to: Hecoria (tacrolimus) and brewer's yeast

MONITOR: Probiotic use during immunosuppressant or intense antineoplastic therapy may theoretically increase the risk of infections from the live microorganisms contained in probiotic products. Patients may be immunosuppressed if they have recently received or are receiving alkylating agents, antimetabolites, radiation, some antirheumatic agents, high dosages of corticosteroids or adrenocorticotropic agents, or long-term topical or inhaled corticosteroids. Although probiotics are generally considered safe, with minimal to low pathogenicity, infections such as bacteremia and endocarditis with various strains commonly found in probiotics (e.g., lactobacilli, bifidobacteria, Bacillus subtilis) have been rarely reported, primarily in critically ill patients or patients with significant underlying medical conditions such as malignancy, organ transplantation, AIDS, valvular heart disease, diabetes mellitus, recent surgery, or compromised immune system. Lactobacillus bacteremia has also been reported following endoscopy. In addition, cases of lactobacillus pneumonia and liver abscess, as well as Saccharomyces fungemia, pneumonia, liver abscess, peritonitis and vaginitis, have been described in the medical literature.

MANAGEMENT: Caution is advised when probiotics are used during immunosuppressant or intense antineoplastic therapy. It may be advisable to avoid using probiotics, particularly products containing saccharomyces boulardii, in patients who are significantly immunosuppressed unless benefits are anticipated to outweigh the potential risk of infection.

References

  1. Salminen MK, Rautelin H, Tynkkynen S, et al. "Lactobacillus bacteremia, clinical significance, and patient outcome, with special focus on probiotic L. rhamnosus GG." Clin Infect Dis 38 (2004): 62-9
  2. Salminen MK, Tynkkynen S, Rautelin H, et al. "Lactobacillus bacteremia during a rapid increase in probiotic use of Lactobacillus rhamnosus GG in Finland." Clin Infect Dis 35 (2002): 1155-60
  3. Rautio M, Jousimies-Somer H, Kauma H, et al. "Liver abscess due to a Lactobacillus rhamnosus strain indistinguishable from L. rhamnosus strain GG." Clin Infect Dis 28 (1999): 1159-60
  4. Schlegel L, Lemerle S, Geslin P "Lactobacillus species as opportunistic pathogens in immunocompromised patients." Eur J Clin Microbiol Infect Dis 17 (1998): 887-8
  5. Saxelin M, Chuang NH, Chassy B, et al. "Lactobacilli and bacteremia in southern Finland, 1989-1992" Clin Infect Dis 22 (1996): 564-6
  6. Husni RN, Gordon SM, Washington JA, Longworth DL "Lactobacillus bacteremia and endocarditis: review of 45 cases." Clin Infect Dis 25 (1997): 1048-55
  7. Oggioni MR, Pozzi G, Valensin PE, Galieni P, Bigazzi C "Recurrent septicemia in an immunocompromised patient due to probiotic strains of Bacillus subtilis." J Clin Microbiol 36 (1998): 325-6
  8. Mackay AD, Taylor MB, Kibbler CC, Hamilton-Miller JM "Lactobacillus endocarditis caused by a probiotic organism." Clin Microbiol Infect 5 (1999): 290-2
  9. Borriello SP, Hammes WP, Holzapfel W, et al. "Safety of probiotics that contain lactobacilli or bifidobacteria." Clin Infect Dis 36 (2003): 775-80
  10. Lolis N, Veldekis D, Moraitou H, et al. "Saccharomyces boulardii fungaemia in an intensive care unit patient treated with caspofungin." Crit Care 12 (2008): epub
  11. Boyle RJ, Robins-Browne RM, Tang ML "Probiotic use in clinical practice: what are the risks?" Am J Clin Nutr 83 (2006): 1256-64
  12. Pruccoli G, Silvestro E, Napoleone CP, Aidala E, Garazzino S, Scolfaro C "Are probiotics safe? Bifidobacterium bacteremia in a child with severe heart failure. https://www.researchgate.net/publication/333853508_Are_probiotics_safe_Bifidobacterium_bacteremia_in_a_child_with_severe_heart_failure" (2024):
View all 12 references

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Drug and food interactions

Moderate

tacrolimus food

Applies to: Hecoria (tacrolimus)

ADJUST DOSING INTERVAL: Consumption of food has led to a 27% decrease in the bioavailability of orally administered tacrolimus.

MANAGEMENT: Tacrolimus should be administered at least one hour before or two hours after meals.

GENERALLY AVOID: Grapefruit juice has been reported to increase tacrolimus trough concentrations. Data are limited, but inhibition of the CYP450 enzyme system appears to be involved.

MANAGEMENT: The clinician may want to recommend that the patient avoid ingesting large amounts of grapefruit juice while taking tacrolimus.

References

  1. "Product Information. Prograf (tacrolimus)." Fujisawa PROD (2001):
  2. Hooks MA "Tacrolimus, a new immunosuppressant--a review of the literature." Ann Pharmacother 28 (1994): 501-11

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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