Lactobacillus Rhamnosus

Usage

Lacticaseibacillus rhamnosus, formerly known as Lactobacillus rhamnosus, is a probiotic bacterium used primarily for gastrointestinal health. It’s indicated for conditions like antibiotic-associated diarrhea, traveler’s diarrhea, irritable bowel syndrome (IBS), and eczema (atopic dermatitis), particularly in children. While it is also used for other conditions like hay fever, colic, and stomach pain, evidence for these uses is not as strong. Its pharmacological classification is as a probiotic. The mechanism of action involves adhering to the intestinal wall, producing lactic acid which creates an unfavorable environment for harmful bacteria, enhancing gut barrier function, modulating the immune system, and potentially producing antimicrobial substances.

Alternate Names

Lacticaseibacillus rhamnosus was previously classified as Lactobacillus rhamnosus. A common strain is Lactobacillus rhamnosus GG (ATCC 53103), often abbreviated as LGG. Culturelle is a popular brand name. Other brand names may exist depending on the manufacturer and the specific formulation.

How It Works

Pharmacodynamics: L. rhamnosus exerts its effects by competitively excluding pathogenic bacteria in the gut lumen. It adheres to the intestinal mucosa, forming a barrier against pathogen adhesion. L. rhamnosus also produces lactic acid, which lowers intestinal pH, inhibiting the growth of certain pathogenic bacteria. It can stimulate the immune system by modulating cytokine production and enhancing the function of immune cells. Certain strains, like LGG, may produce antimicrobial substances like bacteriocins, further combating pathogens.

Pharmacokinetics: L. rhamnosus, when administered orally, survives transit through the stomach due to its acid tolerance. It adheres to the intestinal wall and colonizes the gut. It is not absorbed into the bloodstream in significant quantities. Elimination primarily occurs through the gastrointestinal tract via fecal excretion. Specific metabolic pathways or CYP enzyme interactions are not typically relevant to its mechanism of action.

Mode of Action: L. rhamnosus doesn’t typically involve receptor binding, enzyme inhibition, or neurotransmitter modulation in the way traditional drugs do. Its primary action is through ecological competition with pathogenic bacteria, modulation of the gut microenvironment, and immune system stimulation.

Dosage

Standard Dosage

Adults:

• General health: 1 capsule (10-20 billion CFU) daily.
• Antibiotic-associated diarrhea: 1 capsule (10 billion CFU) twice daily throughout antibiotic therapy and for one week following.
• Traveler’s diarrhea: 1 capsule (10 billion CFU) twice daily, starting 2-3 days before travel and continuing throughout.

Children:

• 1/2 - 1 capsule daily (or 1-10 billion CFU per day orally divided three to four times a day), opened and mixed into a cool drink or food.

Special Cases:

• Elderly Patients: 10-20 billion CFU daily for general health, potentially higher for specific conditions (20-50 billion CFU). Consult with a healthcare professional.
• Patients with Renal Impairment: No specific adjustments have been established.
• Patients with Hepatic Dysfunction: No specific adjustments have been established.
• Patients with Comorbid Conditions: Patients with compromised immune systems (e.g., HIV/AIDS, cancer) or taking immunosuppressants should avoid L. rhamnosus.

Clinical Use Cases

Lactobacillus Rhamnosus is not typically used in the clinical settings listed (intubation, surgical procedures, mechanical ventilation, ICU, emergency situations). Its use focuses on the prevention or treatment of specific gastrointestinal conditions.

Dosage Adjustments

Dosing can be adjusted based on individual patient needs and the specific condition being treated. Always consult with a healthcare professional to determine appropriate dosage.

Side Effects

Common Side Effects

Bloating, gas.

Rare but Serious Side Effects

Infection in immunocompromised individuals.

Long-Term Effects

No specific long-term adverse effects have been identified with normal usage.

Adverse Drug Reactions (ADR)

Severe allergic reactions (rare).

Contraindications

Immunocompromised individuals, individuals taking immunosuppressants.

Drug Interactions

Antibiotics may reduce the effectiveness of L. rhamnosus. It’s best to take probiotics at least 2 hours before or after antibiotics. Limited information is available regarding other drug interactions.

Pregnancy and Breastfeeding

L. rhamnosus is generally considered safe during pregnancy and breastfeeding. Some studies suggest it may even offer benefits, but consult with a healthcare professional before use.

Drug Profile Summary

• Mechanism of Action: Colonizes the gut, produces lactic acid, competes with pathogens, modulates immune system.
• Side Effects: Bloating, gas (rarely infection in immunocompromised).
• Contraindications: Immunocompromised, on immunosuppressants.
• Drug Interactions: Antibiotics.
• Pregnancy & Breastfeeding: Generally considered safe.
• Dosage: Varies by age and condition; typically 10-20 billion CFU daily for adults.
• Monitoring Parameters: Monitor for improvement in targeted condition (e.g., diarrhea, eczema).

Popular Combinations

Often combined with other probiotic strains for synergistic effects.

Precautions

Screen for allergies (milk, soy), immunocompromised status. Caution in individuals with underlying medical conditions. Consult with a healthcare professional for use during pregnancy and breastfeeding.

FAQs

Q1: What is the recommended dosage for Lactobacillus Rhamnosus?

A: Varies depending on the age, health status, and intended use. Adults: 10-20 billion CFU daily for general health. Children: 1/2-1 capsule daily or 1-10 billion CFU daily. Consult healthcare provider.

Q2: Can L. rhamnosus be used in immunocompromised patients?

A: No, it’s contraindicated in immunocompromised patients and those taking immunosuppressants due to the risk of infection.

Q3: Are there any drug interactions I should be aware of?

A: Antibiotics can reduce L. rhamnosus efficacy. Administer probiotics at least two hours before or after antibiotics.

Q4: Is L. rhamnosus safe during pregnancy and breastfeeding?

A: Generally considered safe, but always consult a healthcare professional before use.

Q5: What is the mechanism of action of L. rhamnosus?

A: It competes with harmful bacteria, produces lactic acid, modulates the gut environment and stimulates the immune system.

Q6: What are the common side effects of taking L. rhamnosus?

A: Bloating and gas are the most common side effects, typically mild and transient.

Q7: Can L. rhamnosus be used to treat any medical condition?

A: While used for various conditions, it is most strongly indicated for antibiotic-associated diarrhea, IBS, and eczema, particularly in children.

Q8: How should L. rhamnosus be administered?

A: Typically taken orally in capsule form. Capsules can be opened and mixed with cold food or liquids if necessary.

Q9: Are there different strains of L. rhamnosus?

A: Yes, LGG (Lactobacillus rhamnosus GG) is a common and well-researched strain.

Q10: What is the difference between Lactobacillus and Lacticaseibacillus?

A: Lacticaseibacillus rhamnosus was formerly classified as Lactobacillus rhamnosus. The genus Lactobacillus was recently reclassified into several different genera.