(lak toe ba SIL us)
- Lactobacillus acidophilus
- Lactobacillus bifidus
- Lactobacillus bulgaricus
- Lactobacillus casei
- Lactobacillus paracasei
- Lactobacillus plantarum
- Lactobacillus reuteri
- Lactobacillus rhamnosus GG
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Advanced Probiotic: L. acidophilus, L. casei, L. delbrueckii, and L. rhamnosus GG 10 billion live cultures [also includes Bifidobacterium lactis, and B. longum]
Culturelle: L. rhamnosus GG 10 billion colony-forming units
Dofus: L. acidophilus and L. bifidus 10:1 ratio [beet root powder base]
Flora-Q: L. acidophilus and L. paracasei ≥8 billion colony-forming units [also contains Bifidobacterium and S. thermophilus] [DSC]
100: L. acidophilus 1 billion colony-forming units [milk, soy, and yeast free; rice derived]
600: L. acidophilus 6 billion colony-forming units [milk, soy, and yeast free; rice derived]
100: L. bifidus 1 billion colony-forming units [milk, soy, and yeast free; rice derived]
600: L. bifidus 6 billion colony-forming units [milk, soy, and yeast free; rice derived]
Lacto-Pectin: L. acidophilus, L. casei, L. plantarum, L. rhamnosus, Bifidobacterium breve, and B. longum 20 billion colony-forming units
100: L. acidophilus, L. bifidus, and L. bulgaricus 1 billion colony-forming units [milk, soy and yeast free; rice derived]
600: L. acidophilus, L. bifidus, and L. bulgaricus 6 billion colony-forming units [milk, soy and yeast free; rice derived]
Megadophilus, Superdophilus: L. acidophilus 2 billion units [available in dairy based or dairy free formulations]
Prodigen: L. acidophilus 42 billion colony-forming units and Bifidobacterium lactis 39 billion colony-forming units
RisaQuad: L. acidophilus and L. paracasei 8 billion colony-forming units [also includes Bifidobacterium and Streptococcus thermophilus]
RisaQuad-2: L. acidophilus and L. paracasei 16 billion colony-forming units [gluten free; also includes Bifidobacterium and Streptococcus thermophilus]
Visbiome: L. acidophilus, L. plantarum, L. paracasei, L. bulgaricus, Bifidobacterium breve, B. longum, B. infantis, and Streptococcus thermophilus112 billion live cells [gluten free; contains lactose, milk protein]
VSL #3: L. acidophilus, L. plantarum, L. paracasei, L. bulgaricus, Bifidobacterium breve, B. longum, B. infantis, and Streptococcus thermophilus 112 billion live cells [gluten free]
Risa-Bid: L. acidophilus and L. bulgaricus [also contains Bifidobacterium bifidum and Streptococcus thermophilus]
Floranex: L. acidophilus and L. bulgaricus 100 million live cells per 1 g packet (12s) [contains milk, sodium 5 mg/packet, soy]
Lactinex: L. acidophilus and L. bulgaricus 100 million live cells per 1 g packet (12s) [gluten free; contains calcium 5 mg/packet, lactose 380 mg/packet, potassium 20 mg/packet, sodium 5 mg/packet, sucrose 34 mg/packet, whey, evaporated milk, and soy peptone]
Lacto-TriBlend: L. acidophilus, L. bifidus, and L. bulgaricus 10 billion colony-forming units per ¼ teaspoon (60 g) [milk, soy, and yeast free; rice derived]
Megadophilus, Superdophilus: L. acidophilus 2 billion units per half-teaspoon (49 g, 70 g, 84 g, 126 g) [available in dairy based or dairy free (garbanzo bean) formulations]
MoreDophilus: L. acidophilus 12.4 billion units per teaspoon (30 g, 120 g) [dairy free, yeast free; soy and carrot derived]
Visbiome: L. acidophilus, L. plantarum, L. paracasei, L. bulgaricus 450 billion live cells per packet (30s) [gluten free; contains lactose, milk protein; also contains Bifidobacterium breve, B. longum, B. infantis, and Streptococcus thermophilus; lemon flavor and unflavored]
VSL #3: L. acidophilus, L. plantarum, L. paracasei, L. bulgaricus 450 billion live cells per sachet (10s, 30s) [gluten free; also contains Bifidobacterium breve, B. longum, B. infantis, and Streptococcus thermophilus; lemon cream flavor and unflavored]
VSL #3-DS: L. acidophilus, L. plantarum, L. paracasei, L. bulgaricus 900 billion live cells per packet (20s,) [gluten free; also contains Bifidobacterium breve, B. longum, B. infantis, and Streptococcus thermophilus]
Floranex: L. acidophilus and L. bulgaricus 1 million colony-forming units [contains lactose, nonfat dried milk, whey]
Kala: L. acidophilus 200 million units [dairy free, yeast free; soy based]
Tablet, chewable, Oral:
Dialyvite Probiotic: L. acidophilus and Bifidobacterium lactis 10 billion cells [orange cream flavor]
Lactinex: L. acidophilus and L. bulgaricus 1 million live cells [gluten free; contains calcium 5.2 mg/4 tablets, lactose 960 mg/4 tablets, potassium 20 mg/4 tablets, sodium 5.6 mg/4 tablets, and sucrose 500 sucrose/4 tablets; contains whey, evaporated milk, and soy peptone]
Pedia-Lax Probiotic Yums: L. reuteri 100 million organisms [dye free, gluten free, sugar free; contains milk protein; strawberry flavor]
ReZyst IM: L. acidophilus and Bifidobacterium 150 mg [3 billion lives cells; berry flavor] [DSC]
Generic: L. acidophilus 90 mg and L. bifidus 25 mg (100s) [provides 1 billion organisms/wafer at time of manufacture]
Brand Names: U.S.
- Advanced Probiotic [OTC]
- Culturelle [OTC]
- Dialyvite Probiotic [OTC]
- Dofus [OTC]
- Flora-Q [OTC] [DSC]
- Floranex [OTC]
- Kala [OTC]
- Lactinex [OTC]
- Lacto-Bifidus [OTC]
- Lacto-Key [OTC]
- Lacto-Pectin [OTC]
- Lacto-TriBlend [OTC]
- Megadophilus [OTC]
- MoreDophilus [OTC]
- Pedia-Lax Probiotic Yums [OTC]
- ReZyst IM [DSC]
- Risa-Bid [OTC]
- RisaQuad [OTC]
- RisaQuad-2 [OTC]
- Superdophilus [OTC]
- Visbiome [OTC]
- VSL #3 [OTC]
- VSL #3-DS
- Dietary Supplement
Helps re-establish normal intestinal flora; suppresses the growth of potentially pathogenic microorganisms by producing lactic acid which favors the establishment of an aciduric flora.
Local, primarily colon
Use: Labeled Indications
Dietary supplement: Probiotic to promote normal bacterial flora of the intestinal tract; probiotic supplement for breastfed or partially breastfed infants experiencing excessive crying, colic, and fussiness (Gerber Soothe Colic only).
Visbiome: Dietary management of pouchitis, ulcerative colitis, and irritable bowel syndrome.
VSL#3: Dietary management of an ileal pouch or ulcerative colitis.
OTC labeling: When used for self-medication, do not use if sensitive to milk protein (product specific).
Dietary supplement/medical food: Oral: Dosing varies by manufacturer; consult product labeling.
Acidophilus products: 2 capsules 2 to 4 times daily or 1 to 2 wafers 2 to 4 times daily
Culturelle Digestive Health capsule and chewable tablet: 1 capsule or chewable tablet once daily; may increase chewable tablet to twice daily to alleviate digestive distress or during travel
Floranex: 4 tablets 3 to 4 times daily
Flora-Q: 1 capsule once daily
Lactinex: 1 packet or 4 tablets 3 to 4 times daily
Irritable bowel syndrome: 2 to 4 capsules or ½ to 1 packet per day
Pouchitis: 2 to 4 packets/day
Ulcerative colitis (active): 4 to 8 packets/day
Ulcerative colitis (maintenance): 4 to 8 capsules or 1 to 2 packets per day
VSL #3: 1 to 8 packets or 2 to 8 capsules/day
VSL #3-DS: 1 to 4 packets/day
Refer to adult dosing.
Dietary Supplement: Note: Product formulations and labeling for use in pediatric patients may vary among available formulations; consult product labeling.
Culturelle (Lactobacillus rhamnosus GG): Oral:
Kids Packets: Lactobacillus rhamnosus GG 5 billion CFU/packet: Children <3 years: 1 packet once or twice daily
Kids Chewables: Lactobacillus rhamnosus GG 5 billion CFU/tablet: Children ≥3 years and Adolescents: 1 tablet once or twice daily
Digestive Health Capsule: Lactobacillus rhamnosus GG 10 billion CFU/capsule: Children and Adolescents: 1 capsule daily
Digestive Health Chewable: Lactobacillus rhamnosus GG 10 billion CFU/tablet: Children ≥3 years and Adolescents: 1 tablet once or twice daily
Gerber Soothe Probiotic Colic Drops: Lactobacillus reuteri 20 million CFU/drop: Infants: 5 drops once daily
Acidophilus products: Administer with water or milk during a meal.
Culturelle: Do not add to warm or hot foods or beverages. Capsules may be opened and mixed in a cool beverage or sprinkled onto baby food or applesauce. Mix entire contents of packet into cool food or drink until dissolved.
Floranex: May follow administration with milk, fruit juice, or water.
Flora-Q: Administer with or without food.
Lactinex: Tablets may be chewed or swallowed; may follow with milk, fruit juice, or water. Granules may be added to cereal, food, or milk.
Visbiome: Unflavored powder packet or contents of capsule may be sprinkled on cold food or into cold noncarbonated beverages. Flavored packet may be mixed with cold noncarbonated beverage.
VSL #3, VSL #3-DS: Powder may be mixed in any noncarbonated beverage or mixed with any food such as yogurt, ice cream, or apple sauce.
Some products may contain lactose, potassium, and/or sodium.
Store at room temperature; keep away from direct sunlight and protect from extreme heat; some preparations may need to be refrigerated; consult individual product labeling.
Visbiome: Store refrigerated at 4°C to 8°C (39°F to 46°F). May be stored at room temperature for up to 1 week.
There are no known significant interactions.
Frequency not defined.
Gastrointestinal: Bloating (intestinal), flatulence
• Immunocompromised patients: Use dietary supplements containing live bacteria or yeast with caution in immunocompromised patients. A fatal case of GI mucormycosis caused by the mold Rhizopus oryzae has been previously reported in a premature infant administered a dietary supplement containing 3 species of live bacteria (FDA Safety Information 2014).
Dosage form specific issues:
• Interchangeability: Significant differences may exist from one preparation compared to another with respect to biologic activity and composition.
• Lactose: Some products may contain lactose; use with caution in patients with lactose intolerance.
• Dietary supplement: Probiotics are classified as dietary supplements; therefore, there are no safety reviews or approved therapeutic indications by the FDA. There is no conclusive evidence to support widespread use in the treatment of diarrhea.
What is this drug used for?
• It is used to keep the normal balance of bacteria in the gastrointestinal (GI) tract.
Frequently reported side effects of this drug
• Passing gas
• Loss of appetite
• Abdominal cramps
• Dry mouth
Other side effects of this drug: Talk with your doctor right away if you have any of these signs of:
• Increased thirst
• Change in amount of urine passed
• Muscle pain
• Bone pain
• Severe loss of strength and energy
• Weight loss
• Signs of a significant reaction like wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat.
Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.
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