Is Saccharomyces boulardii Safe with Tacrolimus?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Saccharomyces boulardii is CONTRAINDICATED in patients receiving tacrolimus or other immunosuppressants post-transplant. Do not initiate this supplement without explicit approval from the transplant care team. If GI support is needed, discuss bacterium-based probiotic alternatives with demonstrated safety profiles in immunosuppressed patients.
Why this interaction occurs
Tacrolimus causes profound T-cell suppression, severely compromising the ability to contain yeast organisms. Multiple published case reports and case series document Saccharomyces boulardii fungemia and sepsis in immunocompromised patients, including organ transplant recipients. The risk of life-threatening disseminated fungal infection outweighs any potential benefit.
Evidence
Evidence level: strong.
Reported safety data
The FDA’s adverse event reporting system (FAERS) has received 130,929 reports mentioning Tacrolimus. This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the Tacrolimus + supplement combination on this page.
FAERS reports are voluntary and cannot prove that a drug caused an event. Do not use report counts to assess the safety of this specific drug-supplement pair.
Frequently asked questions
Related interactions
All Saccharomyces boulardii interactions → · All Tacrolimus interactions →
Already checked this one — check your whole list
Educational only — not medical advice.
Always confirm with your doctor or pharmacist.