Meta Information
ID:saccharomyces-boulardii
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-25T18:50:05.062584+00:00
Model
claude-sonnet-4.6-wave15-stub-rebuild
Interactions
Target id:
/class/antifungal-agents
Target name:
Systemic Antifungals (Reduce Probiotic Effect)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Systemic antifungal agents (fluconazole, itraconazole) may inactivate Saccharomyces boulardii.
Actionable advice:
This is best used with caution, and it is a good idea to monitor for clinical effect; dose adjustment or monitoring may be required.
Validation status:
validated_via_monograph
Evidence tier:
tier_c
Evidence basis:
non_natmed_monograph_verbatim
Evidence anchors:
Exact phrase from label:
ANTIFUNGALS Interaction Rating Minor Be watchful with this combination.
Label source:
NatMed Professional Monograph: Saccharomyces boulardii
Action type:
adjust_with_prescriber
Target id:
/condition/immunocompromised
Target name:
Immunocompromised Patients (Fungemia Risk)
Severity:
major
Interaction type:
contraindication
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Avoid use in immunocompromised patients due to fungemia risk.
Actionable advice:
This combination should be avoided; if unavoidable, it should be managed under specialist supervision with intensive monitoring.
Validation status:
validated_via_monograph
Evidence tier:
tier_c
Evidence basis:
non_natmed_monograph_verbatim
Evidence anchors:
Exact phrase from label:
nonpathogenic organism, there have been numerous cases of fungemia following its use, primarily in immunocompromised
Label source:
NatMed Professional Monograph: Saccharomyces boulardii
Action type:
avoid
Target id:
/condition/critically-ill
Target name:
Critically Ill / Central Catheter
Severity:
major
Interaction type:
contraindication
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Avoid in critically ill patients and those with central venous catheters; fungemia cases reported.
Actionable advice:
This combination should be avoided; if unavoidable, it should be managed under specialist supervision with intensive monitoring.
Validation status:
validated_via_monograph
Evidence tier:
tier_c
Evidence basis:
non_natmed_monograph_verbatim
Evidence anchors:
Exact phrase from label:
A small clinical study in critically ill patients shows that administering S.
Label source:
NatMed Professional Monograph: Saccharomyces boulardii
Action type:
avoid
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Limited safety data; use only if benefits clearly outweigh risks.
Actionable advice:
Use should be avoided during pregnancy unless the benefit clearly outweighs the risk, and it is worth discussing with a prescriber.
Validation status:
validated_via_monograph
Evidence tier:
tier_c
Evidence basis:
non_natmed_monograph_verbatim
Evidence anchors:
Exact phrase from label:
PREGNANCY AND LACTATION: Insufficient reliable information available; avoid using.
Label source:
NatMed Professional Monograph: Saccharomyces boulardii
Action type:
avoid
Target id:
/condition/lactation
Target name:
Lactation
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Limited data; topical/intestinal exposure may be acceptable but discuss with provider.
Actionable advice:
It is important to talk to a prescriber about risk/benefit before nursing; alternatives or temporary cessation may be warranted.
Validation status:
validated_via_monograph
Evidence tier:
tier_c
Evidence basis:
non_natmed_monograph_verbatim
Evidence anchors:
Exact phrase from label:
PREGNANCY AND LACTATION: Insufficient reliable information available; avoid using.
Label source:
NatMed Professional Monograph: Saccharomyces boulardii
Action type:
informational_none
Target id:
/adverse/fungemia
Target name:
Fungemia / Bloodstream Infection
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
S. boulardii fungemia and bloodstream infection have been reported, primarily in ICU patients.
Actionable advice:
This combination should be avoided; if unavoidable, it should be managed under specialist supervision with intensive monitoring.
Validation status:
validated_via_monograph
Evidence tier:
tier_c
Evidence basis:
non_natmed_monograph_verbatim
Evidence anchors:
Exact phrase from label:
Admission to the ICU and extended length of stay increase the risk of developing Saccharomyces fungemia (107604).
Label source:
NatMed Professional Monograph: Saccharomyces boulardii
Action type:
avoid
Target id:
/condition/yeast-allergy
Target name:
Yeast Allergy/Hypersensitivity
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Avoid in patients with known yeast hypersensitivity.
Actionable advice:
This is best used with caution, and it is a good idea to monitor for clinical effect; dose adjustment or monitoring may be required.
Validation status:
validated_via_monograph
Evidence tier:
tier_c
Evidence basis:
non_natmed_monograph_verbatim
Evidence anchors:
Exact phrase from label:
less YEAST ALLERGY Theoretically, patients with yeast allergy can be allergic to products containing Saccharomyces boulardii (4363); use with caution.
Label source:
NatMed Professional Monograph: Saccharomyces boulardii
Action type:
adjust_with_prescriber
Target id:
/class/cns-depressants
Target name:
CNS Depressants
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
General caution when combined with other active therapeutic agents.
Actionable advice:
It is important to talk to a physician before combining this with other medications.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Generic placeholder row: the text is non-specific ('general caution') and there is no established CNS-depressant interaction for this agent. No validatable interaction claim - marked unvalidatable (candidate for removal).
Action type:
informational_none
Target id:
/dietary/hot-foods-beverages
Target name:
Hot Foods or Beverages
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Saccharomyces boulardii is a live micro-organism. High temperatures (above ~43°C / 110°F) kill the live cells, rendering the supplement inactive.
Actionable advice:
Saccharomyces boulardii should never be mixed with hot foods or drinks (coffee, tea, soup); it should be taken with cool or room-temperature liquid or food.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Exact phrase from label:
heating at high temperatures such as those used in blanching, canning, or 'stir-fry' cooking is unthinkable for probiotics because temperatures are above 80°C, which would kill the cells.
Label source:
Primary literature: https://pmc.ncbi.nlm.nih.gov/articles/PMC3948641/
Action type:
avoid