Table 2.

The influence of probiotics on bioavailability of oral drugs.

Name	Probiotic	The influence on PK or pharmacological effects of the drug	Possible mechanism	Model	Ref.
Amiodarone (AMI)	E. coli strain Nissle 1917 (EcN)	The bioavailability of AMI is increased.	1.Local intestinal pH is decreased. 2.The expression of the OATP2B1 (SLCO2B1) transporter is increased.	Male Wistar rats	29
Gliclazide	Lactobacillus acidophilus, Bifidobacterium lactis, Lactobacillus rhamnosus	Gliclazide absorption in healthy rats is reduced while that is enhanced in a type 1 diabetes rat model.	1.MRP2 and MRP3 may be influenced. 2.A ‘thicker’ layer of the adherent mucous may be formed. 3.Bacterial degradation.	Healthy male Wistar rats and rats with alloxan-induced type 1 diabetes	138,139
Monoketocholic acid (co-administered with gliclazide)	Lactobacillus acidophilus, Bifidobacterium lactis, Lactobacillus rhamnosus	The bioavailability of MKC is reduced in healthy rats treated with probiotics while it remains the same in type 1 diabetes rats when taken with gliclazide together.	Presystemic metabolism of monoketocholic acid may be increased by probiotics.	Healthy male Wistar rats and rats with alloxan-induced type 1 diabetes	140
Acetaminophen	Lactobacillus reuteri K8	Acetaminophen AUC decreased after the treatment with probiotics.	1.Acetaminophen metabolism is promoted directly or via probiotics' modulation of microbial enzyme activity. 2.A decrease of the bowel transit time	Male C57BL/6 mice	141
Amlodipine	Lactobacillus plantarum IS-10506 probiotic	Amlodipine plasma concentrations are increased significantly after the treatment with probiotics.	1.The level of red blood cell (RBC) and hematocrit (HTC) is increased. 2.More ATP-binding cassette transporters are provided by probiotics.	Male New Zealand White rabbits	142
Sulfasalazine	Lactobacillus acidophilus L10, Bifidobacterium lactis B94, Streptococcus salivarius K12	1.In animal models, the metabolism of sulfasalazine is affected while the PK of sulfasalazine or sulfapyridine is not influenced. 2.Both metabolism and PK of sulfasalazine and sulfapyridine are not significantly affected in the clinical trial.	1.The transporters are not influenced in animal models. 2.The barrier function of the colonic mucosa to sulfapyridine absorption is increased in animal models. 3.In the clinical trial, higher levels of the probiotic cell-associated enzyme activity to the intestine is not provided by probiotic treatment. 4.In the clinical trial, indigenous microbial azoreductase activity is not enhanced significantly by probiotics.	1.Male Wistar rats 2.Patients with rheumatoid arthritis	60,143

AUC, the area under the curve; MKC, monoketocholic acid; PK, pharmacokinetics.