Usage
This combination of Lactobacillus species is primarily used as a probiotic supplement to support gastrointestinal health. While individual strains have shown promise in specific conditions, the combination itself doesn’t have FDA-approved indications for treating diseases. It’s often used to alleviate symptoms of irritable bowel syndrome (IBS), restore gut flora after antibiotic use, and prevent or manage antibiotic-associated diarrhea. They do not fall under a specific pharmacological classification like antibiotics or analgesics. Instead, they are classified as probiotics or dietary supplements.
These probiotics work by colonizing the gut and competing with harmful bacteria. They may also modulate the immune system, strengthen the intestinal barrier, and produce beneficial substances like short-chain fatty acids.
Alternate Names
This combination does not have a specific international nonproprietary name (INN). It is generally referred to as a multi-strain probiotic or a combination of Lactobacillus species. Brand names vary depending on the manufacturer and formulation. Biopro is an example of a commercially-available product containing a larger combination of probiotic strains including Lactobacillus plantarum, Lactobacillus salivarius, and Lactobacillus brevis.
How It Works
Pharmacodynamics: Lactobacillus species primarily exert their effects within the gastrointestinal tract. They produce lactic acid, which lowers the pH of the gut, creating an unfavorable environment for the growth of many pathogenic bacteria. Some strains also produce bacteriocins, which are antimicrobial peptides that can directly inhibit the growth of specific bacteria.
Pharmacokinetics: Orally administered probiotics must survive the acidic environment of the stomach to reach the intestines. They are not absorbed systemically in significant amounts. They colonize the gut lumen and reproduce, but are eventually eliminated through the feces. Specific details on the pharmacokinetics of each individual strain are not routinely studied.
Mode of Action: Lactobacillus species compete with pathogenic bacteria for nutrients and adhesion sites in the gut. This competitive exclusion helps prevent the overgrowth of harmful bacteria. Some strains can also enhance the intestinal barrier function and modulate immune responses by interacting with host cells in the gut mucosa. There are not any direct enzyme inhibitions, receptor bindings, or neurotransmitter modulations.
Elimination: Probiotics are not absorbed systemically; therefore, they are eliminated from the body primarily through fecal excretion.
Dosage
Dosage recommendations can vary depending on the specific product formulation and the individual patient. Consulting a healthcare professional for personalized dosage recommendations is essential.
Standard Dosage
Since this combination is a supplement and not a pharmaceutical drug, there is no officially standardized dosage. A common recommendation for general probiotic use is 1-10 billion colony-forming units (CFUs) per day. However, this may not apply to specific combinations of Lactobacillus species and you should refer to the product label or consult your doctor for dosage advice.
Adults:
- Refer to product-specific recommendations.
Children:
- Consult a pediatrician before giving probiotics to children. Dosage recommendations can depend on the child’s age and health condition.
Special Cases:
- Elderly Patients: Generally, no dosage adjustments are needed.
- Patients with Renal Impairment: No specific adjustments are needed.
- Patients with Hepatic Dysfunction: No specific adjustments are needed.
- Patients with Comorbid Conditions: Consult a physician for individualized recommendations.
Clinical Use Cases
There aren’t specific clinical dosages recommended for the combination of Lactobacillus brevis, Lactobacillus plantarum, and Lactobacillus salivarius in medical settings. However, individual Lactobacillus species have been studied in specific clinical contexts: some strains have been used to reduce the incidence of ventilator-associated pneumonia in ICU patients, for example, but there is no standardized dosage.
Dosage Adjustments
Follow healthcare professional’s guidance.
Side Effects
Common Side Effects
Mild and transient gastrointestinal issues, such as bloating, gas, or mild abdominal discomfort, may occur, particularly at the beginning of probiotic therapy.
Rare but Serious Side Effects
In rare cases, especially in immunocompromised individuals, probiotics have been associated with systemic infections.
Long-Term Effects
Limited data exists on long-term adverse effects of probiotic usage.
Adverse Drug Reactions (ADR)
Clinically significant adverse reactions to probiotics are rare. However, any unusual symptoms following probiotic use should be reported to a doctor.
Contraindications
Individuals with severely compromised immune systems, those with central venous catheters, or those with short bowel syndrome should consult a physician before using probiotics.
Drug Interactions
There are limited data on significant drug interactions with the Lactobacillus strains. However, concurrent use of antibiotics can reduce the effectiveness of probiotics. It’s recommended to separate the administration of antibiotics and probiotics by a few hours.
Pregnancy and Breastfeeding
Probiotics are generally considered safe during pregnancy and breastfeeding. However, consulting a healthcare professional before taking any supplement, including probiotics, during these periods is always recommended.
Drug Profile Summary
- Mechanism of Action: Competitive exclusion of pathogenic bacteria, lactic acid production, modulation of the immune system, enhancement of intestinal barrier function.
- Side Effects: Generally well-tolerated; mild gastrointestinal symptoms possible.
- Contraindications: Immunocompromised individuals, patients with central venous catheters, short bowel syndrome. Consult a physician before use.
- Drug Interactions: Antibiotics may reduce probiotic effectiveness.
- Pregnancy & Breastfeeding: Generally safe, but consult a healthcare professional before use.
- Dosage: Product specific, but typically 1 to 10 billion CFUs daily.
- Monitoring Parameters: Monitor for resolution of gastrointestinal symptoms if used for IBS or similar conditions.
Popular Combinations
Lactobacillus species are often combined with other probiotic strains, including Bifidobacterium species and Streptococcus thermophilus, for synergistic effects. Additionally, some products incorporate prebiotics, such as inulin or fructooligosaccharides, to provide nourishment for the probiotic bacteria.
Precautions
Consult a healthcare professional for personalized advice. No specific precautions related to menstruation apply.
FAQs
Q1: What is the recommended dosage for Lactobacillus Brevis + Lactobacillus Plantarum + Lactobacillus Salivarius?
A: Consult a healthcare professional or refer to the specific product labeling.
Q2: Can probiotics treat infections directly?
A: Probiotics are not considered a treatment for infections. They can support the immune system and gut health, which may indirectly contribute to the body’s natural defense mechanisms.
Q3: Are there any food interactions with probiotics?
A: No known specific food interactions exist.
Q4: Can I take probiotics with other medications?
A: Generally, yes. However, taking probiotics at the same time as antibiotics may reduce their efficacy. It’s best to separate their administration by a few hours.
Q5: How long should I take probiotics?
A: The duration of probiotic use can vary depending on the individual and the reason for use. Consult a healthcare professional for guidance.
Q6: Can I give probiotics to my child?
A: Consult a pediatrician for recommendations specific to your child’s age and health condition.
Q7: Are there any long-term side effects of taking probiotics?
A: Long-term side effects of probiotic use are largely unknown. More research is needed in this area.
Q8: Can probiotics be used in patients with allergies?
A: Patients with allergies, particularly to dairy or soy (as some probiotics are cultured in these media), should carefully check the product ingredients.
Q9: Are probiotics helpful for all types of IBS?
A: While studies show promise, not all individuals with IBS benefit from probiotics. Moreover, different strains may be more effective for specific IBS subtypes.
