I was prescribed Floramax (probiotic containing lactic acid bacteria and bifidobacteria) capsules to be taken twice daily for 15 days, but I accidentally left one set outside the fridge, should I discard the remaining 2 capsules or continue with the entire strip of 10 capsules?

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Discard the Capsules Left Outside the Fridge

You should discard the 2 remaining capsules from the strip that was left outside the refrigerator and purchase a new strip to complete your prescribed 15-day course. Freeze-dried probiotic bacteria are highly sensitive to storage conditions, and improper storage significantly compromises their viability and therapeutic effectiveness.

Why Storage Conditions Are Critical for Probiotics

Manufacturing and storage conditions—including temperature, humidity, and pH—are critical determinants of probiotic bacterial survival, growth, and viability, which directly impact clinical outcomes. 1 When probiotics containing lactic acid bacteria and bifidobacteria are stored outside recommended conditions (refrigeration), the live bacterial count drops substantially, leaving you with predominantly dead bacteria that cannot provide the intended therapeutic benefit.

The Problem with Dead Bacteria

  • Dead bacteria are inevitably present in all probiotic products from manufacturing, but proper refrigeration minimizes further bacterial death during storage. 1
  • When stored improperly, the ratio of dead-to-live bacteria increases dramatically, rendering the product ineffective even though it may look unchanged. 1
  • The label only reports colony-forming units (CFU) of live bacteria at manufacture—it doesn't account for viability loss from improper storage. 1

Completing Your Treatment Course

For general gastrointestinal support with Lactobacillus acidophilus and Bifidobacterium species, the standard dosing is 10⁹ to 10¹⁰ CFU per day, and completing the full prescribed duration is important for therapeutic benefit. 2

What You Should Do:

  • Discard the improperly stored capsules immediately to avoid consuming an ineffective product. 3
  • Purchase a new strip and continue taking the capsules twice daily (after breakfast and dinner) as originally prescribed. 2
  • Store all probiotic capsules in the refrigerator at all times to maintain bacterial viability. 1
  • Complete the full 15-day course even though you've had an interruption—the duration matters for establishing beneficial effects on your gut microbiota. 2, 4

Common Pitfalls to Avoid

  • Never assume probiotics are stable at room temperature unless explicitly labeled as shelf-stable. Freeze-dried formulations typically require refrigeration. 1
  • Don't try to "make up" for lost doses by taking extra capsules—stick to the prescribed twice-daily dosing. 2
  • Don't open or crush the capsules to try to salvage them, as this can destroy the protective coating and further reduce bacterial viability. 5
  • Keep probiotics away from heat, moisture, and direct sunlight, all of which accelerate bacterial death. 1

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Probiotic Dosing Guidelines for Lactobacillus acidophilus and Bifidobacterium

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Administration of Probiotics for Various Conditions

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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