What is the recommended dosage and treatment duration for Florajen (Lactobacillus acidophilus) Acidophilus Oral Capsule?

Florajen Acidophilus Oral Capsule Dosing

For general digestive health and antibiotic-associated diarrhea prevention in adults, administer one capsule containing 10-20 billion CFU once or twice daily, continued throughout the entire course of antibiotic therapy and optionally for 1-2 weeks after completion. 1

Standard Dosing Regimens

For Antibiotic-Associated Diarrhea Prevention

• Dose: 10-20 billion CFU daily, divided into 1-2 doses 1
• Duration: Throughout entire antibiotic course, with consideration for continuing 1-2 weeks post-antibiotics 1
• Timing: Start at the beginning of antibiotic therapy 1
• Evidence: Multi-strain Lactobacillus formulations reduce C. difficile-associated diarrhea risk by 65-78% compared to placebo 1

For Functional Bowel Disorders

• Dose: 2 × 10¹¹ CFU per day (divided into twice daily dosing) 2
• Duration: 8 weeks minimum for symptom improvement 2
• Evidence: This dosing significantly improved abdominal bloating at 4 weeks (p=0.009) and 8 weeks (p<0.01) in functional bowel disorder patients 2

For Functional Constipation

• Dose: 3-8 billion CFU once daily 3
• Duration: 30 days minimum 3
• Evidence: Improvement in stool frequency and quality observed within the first week of treatment 3

Administration Guidelines

Route and Method

• Oral capsules are the preferred delivery method, as novel encapsulation technology (such as Probiotic Pearls™) significantly improves gastrointestinal survival and fecal recovery compared to conventional gelatin capsules 4
• Encapsulated formulations show 3.11 log CFU/g higher persistence 7 days after supplementation ends compared to standard capsules (p=0.05) 4

Optimal Formulation

• Multi-strain combinations are more effective than single strains 1
• Recommended combinations include:
  • L. acidophilus + L. casei (two-strain): 78% risk reduction for C. difficile 1
  • L. acidophilus + L. delbrueckii bulgaricus + B. bifidum (three-strain): 65% risk reduction 1
  • Four-strain combinations: 72% risk reduction 1

Critical Contraindications

Probiotics are absolutely contraindicated in immunocompromised patients due to risk of bacteremia or fungemia. 1, 5

High-Risk Populations Requiring Caution

• Severely ill patients may be at higher risk of adverse events 1
• Patients with central venous catheters 1
• Those with compromised intestinal barrier function 1

Clinical Context for Use

When to Prioritize Probiotic Therapy

• High-risk patients for C. difficile infection: elderly, prolonged hospitalization, severe underlying illness, or previous C. difficile infection 1
• During antibiotic therapy: Particularly with clindamycin or broad-spectrum antibiotics 1
• Functional bowel disorders: When bloating is a predominant symptom 2

Evidence Quality Considerations

• The overall quality of evidence supporting probiotic use is rated as low to moderate 1
• Effects are strain-specific and disease-specific—not all probiotics are equally effective 1
• Benefits are primarily observed in high-risk populations (>15% baseline C. difficile risk), with no significant effects in low-risk outpatient settings 1

Storage and Viability

• Optimal temperature range: 28°C to 37°C (82.4°F to 98.6°F) for L. paracasei survival 6
• Refrigeration is typically recommended for most Lactobacillus formulations to maintain CFU counts, though specific storage requirements vary by product formulation 4

Common Pitfalls to Avoid

• Do not use probiotics as monotherapy for established C. difficile infection—limited data supports this approach 1
• Do not assume all probiotic products are equivalent—efficacy is strain-specific 1
• Do not continue indefinitely without reassessment—most evidence supports 4-8 week courses for specific indications 2, 3
• Do not administer to immunocompromised patients without careful risk-benefit analysis 1