General

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

Pronunciation:
sak-a-roe-mye-seez boo-lar-dee

Trade Name(s)

• Brewer's yeast
• probiotics

Ther. Class.

antidiarrheals

anti irritable bowel syndrome agents

Common Uses

• Treatment and prevention of diarrhea.
• Irritable bowel syndrome.

Action

Nonpathogenic yeast used to colonize the GI tract.

Therapeutic Effect(s):

Reduced number of bowel movements.

Pharmacokinetics

Absorption: Unknown.

Distribution: Unknown.

Metabolism and Excretion: Unknown.

Half-life: Unknown.

TIME/ACTION PROFILE

Contraindication/Precautions

Contraindicated in:

• Hypersensitivity to yeast.

Use Cautiously in:

• Immunocompromised patients (↑ risk of fungemia);
• OB:   Safety not established in pregnancy;
• Lactation:  Safety not established in breastfeeding;
• Pedi:   Safety and effectiveness not established in children.

Adverse Reactions/Side Effects

F and E: ↑ thirst

GI: bloating, constipation, flatulence

Misc: fungemia

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Natural Drug Interaction

 Antifungals  may ↓ effectiveness.

Natural-Natural:

•  Oregano oil,  garlic, or  berberine  may ↓ effectiveness.
• May cause overstimulation in autoimmune-prone individuals if consumed with  echinacea or  elderberry .

Route/Dosage

PO (Adults): 250–500 mg 2–4 times daily.

Availability

Capsules: 250 mg^OTC

Powder: ^OTC

Assessment

• Assess for abdominal distention, presence of bowel sounds, and usual pattern of bowel function.
• Assess color, consistency, and amount of stool produced.

Lab Test Considerations:

Monitor CBC periodically during therapy.

Implementation

• PO Administer with or without food.
• Administer ≥1 hr before and 2 hr after antifungal agents.
• Capsules can be swallowed whole or opened and mixed with liquids or soft foods. Avoid hot foods and beverages.
• Dissolve powder in water, juice, or milk.

Patient/Family Teaching

• Explain purpose and side effects of herb to patient.
• Advise patient to consult with health care provider before using any herbal supplement especially when taken concurrently with Rx or OTC medications or vitamins.
• Advise patient to take as directed. Administer herb early in the course of antibiotic treatment for antibiotic-associated diarrhea.
• Rep:  Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected or if breastfeeding before using this herb.

Evaluation/Desired Outcomes

Reduced number of bowel movements.