Should Ultra Levure (Saccharomyces boulardii) be taken with food?

Administration of Ultra Levure (Saccharomyces boulardii) with Food

Ultra Levure (Saccharomyces boulardii) should be taken with food to optimize its therapeutic effects and minimize potential gastrointestinal side effects.

Evidence-Based Rationale

The administration of Saccharomyces boulardii has been studied extensively in clinical settings, particularly for treating and preventing various forms of diarrhea. Based on the available evidence, taking this probiotic with food appears to be the optimal approach for several reasons:

Clinical Administration Patterns

In clinical trials demonstrating efficacy of S. boulardii, the probiotic was typically administered in one of two ways:

• Mixed with enteral nutrition through feeding tubes 1
• Given orally with meals or food 1

Multiple studies in the Critical Care journal systematic review showed that when S. boulardii was administered to critically ill patients, it was typically delivered via enteral nutrition tubes mixed with feeding solutions 1. This suggests that co-administration with nutritional intake is a standard approach in clinical settings.

Optimal Probiotic Delivery

Taking S. boulardii with food provides several advantages:

1. Enhanced survival through the GI tract: Food helps buffer stomach acid, potentially increasing the number of viable probiotic organisms reaching the intestines

2. Reduced risk of side effects: Common side effects of probiotics include gas, bloating, and abdominal discomfort, which may be minimized when taken with food

3. Improved compliance: Taking the medication with meals establishes a consistent routine for patients

Timing Considerations for Special Situations

For patients taking antibiotics, specific timing recommendations apply:

• Take S. boulardii at least 2 hours apart from antibiotics 2
• For antibiotic-associated diarrhea prevention, start S. boulardii within 24-48 hours of beginning antibiotic therapy 2
• Continue for 1-2 weeks after completing the antibiotic course 2

Dosage Recommendations

The recommended therapeutic dose of S. boulardii varies by indication:

• For antibiotic-associated diarrhea: 1g daily (approximately 3×10¹⁰ CFU/day) 2
• For acute infectious diarrhea: ≥10 billion CFU/day 2

Safety Considerations

While S. boulardii is generally considered safe, there are important precautions:

1. Contraindications: S. boulardii is absolutely contraindicated in immunocompromised patients due to risk of fungemia 2, 3

2. Central venous catheters: Patients with central lines should use caution, as cases of fungemia have been reported even in non-immunocompromised patients with intravenous catheters 3, 4

3. Cross-contamination risk: Healthcare providers should be aware that S. boulardii can spread to other patients, as documented in a case where a newborn contracted S. boulardii fungemia without direct administration 4

Clinical Application

For optimal use of Ultra Levure (S. boulardii):

• Standard administration: Take with meals or immediately after eating
• Hospitalized patients: Mix with enteral nutrition when administered via feeding tubes
• Duration: Continue treatment for the full prescribed course (typically 1-3 weeks depending on indication)
• Storage: Keep at room temperature in a dry place with capsules sealed until use

By following these evidence-based recommendations, patients can maximize the therapeutic benefits of S. boulardii while minimizing potential adverse effects.