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Drug Interactions between Probiotic Formula and sulfamethoxazole / trimethoprim

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

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Interactions between your drugs

Moderate

sulfamethoxazole lactobacillus acidophilus

Applies to: sulfamethoxazole / trimethoprim and Probiotic Formula (bifidobacterium infantis / lactobacillus acidophilus)

ADJUST DOSING INTERVAL: Coadministration of oral probiotic preparations with oral antibiotics may reduce the efficacy of the probiotic. It has been theorized that concomitant antibiotics may kill the live organisms found in lactobacillus-, bacillus coagulans-, and bifidobacteria-containing oral probiotic preparations. However, the clinical significance of the interaction has not been established.

MANAGEMENT: Although data are limited, it may be prudent to advise patients to take oral probiotics at least 1 to 2 hours before or after an oral antibiotic.

References (3)
  1. Clarion Brands, Inc. (2020) Florajen Probiotics. https://www.florajen.com/products/florajen-women
  2. Xiao JZ, Takahashi S, Odamaki T, Yaeshima T, iwatsuki k (2010) "Antibiotic susceptibility of bifidobacterial strains distributed in the Japanese market." Biosci Biotechnol Biochem, 74, p. 336-42
  3. dwyer a (2024) Taking probiotics with antibiotics https://www.optibacprobiotics.com/learning-lab/in-depth/general-health/probiotics-with-antibiotics
Moderate

sulfamethoxazole bifidobacterium infantis

Applies to: sulfamethoxazole / trimethoprim and Probiotic Formula (bifidobacterium infantis / lactobacillus acidophilus)

ADJUST DOSING INTERVAL: Coadministration of oral probiotic preparations with oral antibiotics may reduce the efficacy of the probiotic. It has been theorized that concomitant antibiotics may kill the live organisms found in lactobacillus-, bacillus coagulans-, and bifidobacteria-containing oral probiotic preparations. However, the clinical significance of the interaction has not been established.

MANAGEMENT: Although data are limited, it may be prudent to advise patients to take oral probiotics at least 1 to 2 hours before or after an oral antibiotic.

References (3)
  1. Clarion Brands, Inc. (2020) Florajen Probiotics. https://www.florajen.com/products/florajen-women
  2. Xiao JZ, Takahashi S, Odamaki T, Yaeshima T, iwatsuki k (2010) "Antibiotic susceptibility of bifidobacterial strains distributed in the Japanese market." Biosci Biotechnol Biochem, 74, p. 336-42
  3. dwyer a (2024) Taking probiotics with antibiotics https://www.optibacprobiotics.com/learning-lab/in-depth/general-health/probiotics-with-antibiotics
Moderate

trimethoprim lactobacillus acidophilus

Applies to: sulfamethoxazole / trimethoprim and Probiotic Formula (bifidobacterium infantis / lactobacillus acidophilus)

ADJUST DOSING INTERVAL: Coadministration of oral probiotic preparations with oral antibiotics may reduce the efficacy of the probiotic. It has been theorized that concomitant antibiotics may kill the live organisms found in lactobacillus-, bacillus coagulans-, and bifidobacteria-containing oral probiotic preparations. However, the clinical significance of the interaction has not been established.

MANAGEMENT: Although data are limited, it may be prudent to advise patients to take oral probiotics at least 1 to 2 hours before or after an oral antibiotic.

References (3)
  1. Clarion Brands, Inc. (2020) Florajen Probiotics. https://www.florajen.com/products/florajen-women
  2. Xiao JZ, Takahashi S, Odamaki T, Yaeshima T, iwatsuki k (2010) "Antibiotic susceptibility of bifidobacterial strains distributed in the Japanese market." Biosci Biotechnol Biochem, 74, p. 336-42
  3. dwyer a (2024) Taking probiotics with antibiotics https://www.optibacprobiotics.com/learning-lab/in-depth/general-health/probiotics-with-antibiotics
Moderate

trimethoprim bifidobacterium infantis

Applies to: sulfamethoxazole / trimethoprim and Probiotic Formula (bifidobacterium infantis / lactobacillus acidophilus)

ADJUST DOSING INTERVAL: Coadministration of oral probiotic preparations with oral antibiotics may reduce the efficacy of the probiotic. It has been theorized that concomitant antibiotics may kill the live organisms found in lactobacillus-, bacillus coagulans-, and bifidobacteria-containing oral probiotic preparations. However, the clinical significance of the interaction has not been established.

MANAGEMENT: Although data are limited, it may be prudent to advise patients to take oral probiotics at least 1 to 2 hours before or after an oral antibiotic.

References (3)
  1. Clarion Brands, Inc. (2020) Florajen Probiotics. https://www.florajen.com/products/florajen-women
  2. Xiao JZ, Takahashi S, Odamaki T, Yaeshima T, iwatsuki k (2010) "Antibiotic susceptibility of bifidobacterial strains distributed in the Japanese market." Biosci Biotechnol Biochem, 74, p. 336-42
  3. dwyer a (2024) Taking probiotics with antibiotics https://www.optibacprobiotics.com/learning-lab/in-depth/general-health/probiotics-with-antibiotics

Drug and food interactions

Moderate

sulfamethoxazole food

Applies to: sulfamethoxazole / trimethoprim

MONITOR: Two cases have been reported in which patients on sulfamethoxazole-trimethoprim therapy, after consuming beer, reported flushing, heart palpitations, dyspnea, headache, and nausea (disulfiram - alcohol type reactions). First-generation sulfonylureas have been reported to cause facial flushing when administered with alcohol by inhibiting acetaldehyde dehydrogenase and subsequently causing acetaldehyde accumulation. Since sulfamethoxazole is chemically related to first-generation sulfonylureas, a disulfiram-like reaction with products containing sulfamethoxazole is theoretically possible. However, pharmacokinetic/pharmacodynamic data are lacking and in addition, the two reported cases cannot be clearly attributed to the concomitant use of sulfamethoxazole-trimethoprim and alcohol.

MANAGEMENT: Patients should be alerted to the potential for this interaction and although the risk for this interaction is minimal, caution is recommended while taking sulfamethoxazole-trimethoprim concomitantly with alcohol.

References (2)
  1. Heelon MW, White M (1998) "Disulfiram-cotrimoxazole reaction." Pharmacotherapy, 18, p. 869-70
  2. Mergenhagen KA, Wattengel BA, Skelly MK, Clark CM, Russo TA (2020) "Fact versus fiction: a review of the evidence behind alcohol and antibiotic interactions." Antimicrob Agents Chemother, 64, e02167-19

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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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