Indications
This is a high-count probiotic supplement providing about 45 billion live friendly bacteria per dose, usually a mix of strains such as Streptococcus thermophilus, Lactobacillus and Bifidobacterium. Some products of this type are made specially for people with chronic kidney disease (CKD), with the aim of reducing waste products (uraemic toxins) made by gut bacteria. It may also be used to support a healthy gut balance and digestion. Evidence for benefit in kidney disease is early and limited; it does not replace dialysis, diet control or prescribed kidney treatment.
How It Works
The live bacteria settle in the bowel for as long as the product is taken. Certain strains can break down nitrogen-containing waste such as urea in the gut, and compete with bacteria that produce harmful substances. This may lower the amount of these wastes that enter the blood. The bacteria also support the gut lining and digestion.
Dosage and Administration
Take as directed on the label or by your doctor, usually with a meal, swallowed whole with water. Do not open or chew capsules unless the label allows it. Avoid taking with hot drinks. People with kidney disease should use it only with their kidney doctor’s agreement. If you take an antibiotic, keep the probiotic at least 2 hours apart.
Interactions
- Antibiotics and antifungal medicines can kill the probiotic bacteria; take them at least 2 hours apart.
- Medicines that weaken the immune system, such as Tacrolimus, Cyclosporine, Mycophenolate, chemotherapy or high-dose steroids, increase the risk of infection; use only on a doctor’s advice.
Contraindications
- Severely weakened immune system, such as after a kidney or other organ transplant, during chemotherapy, or in advanced HIV, unless a doctor advises it.
- Critically ill patients, people with a central line, or acute pancreatitis.
- Allergy to any ingredient, including milk proteins if present.
Side Effects
Mild wind, bloating, stomach discomfort or a change in bowel habit may occur in the first days and usually settles.
Get urgent medical help if you develop high fever with chills, severe stomach pain, bloody diarrhoea, or signs of an allergic reaction such as swelling of the face or difficulty breathing. Very rarely, probiotic bacteria have caused blood infections in very ill people.
Pregnancy and Lactation
Common probiotic strains are generally considered safe in pregnancy and breastfeeding, as very little enters the blood. Check with your doctor before use, especially if you have kidney disease.
Precautions and Warnings
- People with CKD should not change their diet, fluid intake or medicines without their doctor’s advice.
- Check the label for added minerals such as potassium or phosphorus if you have kidney disease.
- See a doctor for diarrhoea lasting more than 2 days, or with blood, fever or dehydration.
Overdose
Taking more than recommended is unlikely to be dangerous but may cause more wind, bloating or loose stools. Seek advice if symptoms are severe.
Therapeutic Class
Probiotic food supplement.
Storage
Store below 25°C in a dry place, away from light and out of the reach of children, or in a refrigerator (2 to 8°C) if the pack says so. Keep the container tightly closed.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.