Supplement·Interactions·Reviewed June 9, 2026
Probiotics interactions.
Probiotics has 61 documented interactions in the NutriStack database: 1 to avoid or watch closely, 22 that need timing or caution, and 38 that work synergistically. The full list, with what each pairing does, is below.
In short
Probiotics at a glance.
A quick, data-grounded summary. The full table is below.
Probiotics has 61 documented interactions in the NutriStack database: 1 to avoid or watch closely, 22 that need timing or caution, and 38 that work synergistically. The full list, with what each pairing does, is below.
Interactions
Everything that interacts with probiotics.
Every supplement and medication in the NutriStack database with a documented interaction with this substance, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| Berberine | Conflict | Berberine has significant antimicrobial properties and can reduce beneficial gut bacteria populations. Taking berberine with probiotics may reduce... details → |
| Azathioprine | Caution | Live probiotics rarely cause bacteremia or fungemia in severely immunosuppressed patients. |
| Famciclovir | Caution | Famciclovir is generally well tolerated and, unlike antibacterial agents, does not disrupt the gut microbiome, so it does not kill probiotic... |
| KPV | Caution | Probiotics can change gut symptoms while KPV claims target gut inflammation, making response hard to interpret. |
| Mycophenolate Mofetil | Caution | Live probiotics rarely cause invasive infection in severely immunosuppressed patients. |
| Valganciclovir | Caution | Valganciclovir is used heavily in immunosuppressed populations such as solid-organ and stem-cell transplant recipients, and it can deepen immune... |
| Ampicillin | Timing Sensitive | Ampicillin can suppress or kill bacterial probiotic organisms if taken at the same time, although selected probiotics may lower... |
| Cefdinir | Timing Sensitive | Cefdinir can suppress or kill bacterial probiotic organisms if taken at the same time, although selected probiotics may lower antibiotic-associated... |
| Cefixime | Timing Sensitive | Cefixime can suppress or kill bacterial probiotic organisms if taken at the same time, although selected probiotics may lower antibiotic-associated... |
| Cefpodoxime | Timing Sensitive | Cefpodoxime can suppress or kill bacterial probiotic organisms if taken at the same time, although selected probiotics may lower... |
| Cefuroxime | Timing Sensitive | Cefuroxime can suppress or kill bacterial probiotic organisms if taken at the same time, although selected probiotics may lower... |
| Dicloxacillin | Timing Sensitive | Dicloxacillin can suppress or kill bacterial probiotic organisms if taken at the same time, although selected probiotics may lower... |
| Digestive Enzymes | Timing Sensitive | Both support gut health but work best at different times. Digestive enzymes work with meals; probiotics prefer an empty stomach or before meals. |
| Erythromycin | Timing Sensitive | Erythromycin can suppress or kill bacterial probiotic organisms if taken at the same time, although selected probiotics may lower... |
| Fosfomycin | Timing Sensitive | Fosfomycin can suppress or kill bacterial probiotic organisms if taken at the same time, although selected probiotics may lower... |
| Iron | Timing Sensitive | Iron supplements can disrupt gut microbiome composition. However, certain probiotic strains may actually enhance iron absorption. |
| Iron Bisglycinate | Timing Sensitive | Iron Bisglycinate supplements can disrupt gut microbiome composition. However, certain probiotic strains may actually enhance iron bisglycinate... |
| Larazotide Acetate | Timing Sensitive | Probiotics can alter GI symptoms and make it harder to judge larazotide response. |
| Minocycline | Timing Sensitive | Minocycline is a broad-spectrum antibiotic that can kill the live bacterial cultures in probiotic supplements taken at the same time, reducing the... |
| Nystatin | Timing Sensitive | Oral nystatin can reduce viability of yeast-containing probiotics such as Saccharomyces boulardii when taken together. |
| Penicillin V Potassium | Timing Sensitive | Penicillin V Potassium can suppress or kill bacterial probiotic organisms if taken at the same time, although selected probiotics may lower... |
| Tetracycline | Timing Sensitive | Tetracycline is a broad-spectrum antibiotic that can kill the live bacteria in probiotic supplements taken at the same time, reducing the viability... |
| Vancomycin | Timing Sensitive | Vancomycin can suppress or kill bacterial probiotic organisms if taken at the same time, although selected probiotics may lower... |
| Amoxicillin | Synergy | Probiotic supplementation during amoxicillin therapy reduces antibiotic-associated diarrhea and helps preserve gut microbiome diversity. Although... details → |
| Amoxicillin-Clavulanate | Synergy | Amoxicillin-clavulanate has notably higher rates of antibiotic-associated diarrhea than plain amoxicillin, largely due to the clavulanate component.... details → |
| Azithromycin | Synergy | Probiotic supplementation during azithromycin therapy reduces antibiotic-associated diarrhea and helps preserve gut microbiome diversity, which can... details → |
| Beta-Glucan | Synergy | Beta-glucans and probiotics may support complementary gut-immune pathways. |
| Bifidobacterium infantis 35624 | Synergy | Additional probiotic strains may complement 35624 but can increase gas and obscure which strain helps. |
| Bifidobacterium longum BB536 | Synergy | Combining BB536 with other probiotic strains may broaden microbiome effects but can increase gas or make attribution difficult. |
| Ceftriaxone | Synergy | Probiotic supplementation during ceftriaxone therapy reduces antibiotic-associated diarrhea and helps preserve gut microbiome diversity. This is... details → |
| Cephalexin | Synergy | Probiotic supplementation during cephalexin therapy reduces antibiotic-associated diarrhea and helps preserve gut microbiome diversity disrupted by... details → |
| Ciprofloxacin | Synergy | Probiotic supplementation during ciprofloxacin therapy reduces the incidence of antibiotic-associated diarrhea by restoring colonization resistance... details → |
| Clarithromycin | Synergy | Probiotic supplementation during clarithromycin therapy, including during H. pylori triple therapy, reduces antibiotic-associated diarrhea and... details → |
| Clindamycin | Synergy | Clindamycin is one of the highest-risk antibiotics for C. difficile-associated colitis. Probiotic supplementation during clindamycin therapy reduces... details → |
| Colostrum | Synergy | Colostrum and probiotics may work together to support gut barrier integrity and a healthy microbiome, with colostrum providing prebiotic and immune... |
| D-Mannose | Synergy | D-mannose prevents E. coli adhesion to uroepithelium; probiotics support gut and urogenital flora that resists pathogen colonization. |
| Doxycycline | Synergy | Probiotic supplementation during doxycycline therapy reduces antibiotic-associated diarrhea and helps preserve gut microbiome diversity disrupted by... details → |
| Fructooligosaccharides (FOS) | Synergy | FOS can act as a prebiotic substrate for probiotic organisms and resident bifidobacteria. |
| Galactooligosaccharides (GOS) | Synergy | GOS can feed bifidobacteria and may complement probiotic supplements. |
| Inulin | Synergy | Inulin can feed bifidobacteria and may complement probiotic organisms. |
| L-Glutamine | Synergy | L-glutamine fuels intestinal cells and supports the gut barrier, complementing the way probiotics strengthen the mucosal lining. |
| Lactobacillus acidophilus NCFM | Synergy | NCFM is often used with other probiotic strains such as bifidobacteria, but efficacy is formulation-specific. |
| Lactobacillus plantarum 299v | Synergy | Combining probiotic strains may broaden effects but can also increase gas or make response attribution difficult. |
| Lactoferrin | Synergy | Both may support gut and mucosal immune defenses. |
| Lactulose | Synergy | Lactulose and probiotics both target gut-derived ammonia pathways in hepatic encephalopathy. Trials and meta-analyses show probiotics can improve... details → |
| Levofloxacin | Synergy | Probiotic supplementation during levofloxacin therapy reduces the incidence of antibiotic-associated diarrhea and helps preserve gut microbiome... details → |
| Mesalamine | Synergy | Multi-strain probiotics have been studied as add-ons to 5-ASA therapy, including mesalamine, in ulcerative colitis. Trials of VSL#3-type... details → |
| Metronidazole | Synergy | Probiotic supplementation during metronidazole therapy reduces antibiotic-associated diarrhea and helps preserve gut microbiome diversity. This is... details → |
| Nitrofurantoin | Synergy | Probiotic supplementation during nitrofurantoin therapy reduces antibiotic-associated diarrhea and helps preserve gut microbiome diversity.... details → |
| Omeprazole | Synergy | Omeprazole shifts the gut microbiome and roughly doubles the risk of Clostridioides difficile and small intestinal bacterial overgrowth. A 2017... details → |
| Pantoprazole | Synergy | Pantoprazole shifts gut microbiota and increases the risk of C. difficile-associated diarrhea and small intestinal bacterial overgrowth. A Cochrane... details → |
| Partially Hydrolyzed Guar Gum (Sunfiber) | Synergy | PHGG can act as a fermentable substrate for beneficial bacteria and may complement probiotic use. |
| Peppermint Oil (Enteric-Coated) | Synergy | Probiotics and peppermint oil may both support IBS symptoms through different mechanisms. |
| Psyllium Husk | Synergy | Psyllium is a partially fermentable fiber that can feed beneficial bacteria, acting as a synbiotic that supports probiotic colonization and... |
| Saccharomyces Boulardii | Synergy | Adding the probiotic yeast Saccharomyces boulardii to bacterial probiotics broadens coverage and is particularly effective for preventing... |
| Sodium Butyrate | Synergy | Butyrate is an end-product of microbial fermentation, and certain probiotic and prebiotic-fed commensal species are butyrate producers. Supplemental... |
| Terbinafine | Synergy | Oral terbinafine treats fungal infections but its mycobiome and microbiome impact in humans is incompletely characterized, and antifungal exposure... |
| Trimethoprim-Sulfamethoxazole | Synergy | Probiotic supplementation during trimethoprim-sulfamethoxazole therapy reduces antibiotic-associated diarrhea and helps preserve gut microbiome... details → |
| Turkey Tail | Synergy | Turkey tail polysaccharopeptide (PSP) acts as a prebiotic that favorably shifts gut microbiota composition, complementing the live bacteria... |
| Vitamin D3 | Synergy | Vitamin D supports the gut immune barrier. Probiotics modulate the microbiome. Together they support gut-immune axis health. |
| Whey Protein | Synergy | Probiotics may improve GI tolerance in some users, though direct performance synergy is limited. |
Go deeper
The full probiotics profile.
Benefits, dosing by goal, forms, and the cited evidence for this supplement.
FAQ
Common probiotics questions.
Quick answers drawn from the table above.
What interacts with Probiotics?
In the NutriStack database, Probiotics has 61 documented interactions with other supplements and medications. The most notable include Berberine, Azathioprine, Famciclovir, KPV, and Mycophenolate Mofetil.
What should you not take with Probiotics?
Probiotics is flagged against 1 substance in the database, including Berberine. Review these with a clinician before combining, especially alongside prescription medications.
What works well with Probiotics?
Probiotics pairs synergistically with Amoxicillin, Amoxicillin-Clavulanate, Azithromycin, Beta-Glucan, and Bifidobacterium infantis 35624 in the NutriStack database. Synergy still depends on dose and timing; open any pair for the detail.
Can you take Probiotics with Berberine?
NutriStack classifies the Probiotics and Berberine pairing as conflict: Berberine has significant antimicrobial properties and can reduce beneficial gut bacteria populations. Taking berberine with probiotics may reduce probiotic viability.... Separate berberine and probiotics by at least 2-3 hours. Take probiotics at a different meal than berberine. Consider spore-based probiotics which...
Check your whole stack
See how probiotics fits your routine.
NutriStack screens your full stack for interactions and timing conflicts, and updates the moment you change it.