Akkermansia muciniphila (pasteurised) and medications.
Akkermansia muciniphila (pasteurised) is in the Distil supplement database, evidence Grade B. The page below lists every medication we have explicitly assessed it against.
Akkermansia muciniphila is a gut bacterium that lives in the protective mucus layer of the intestine, taken to support metabolic health. Lower levels of it tend to track with obesity and type 2 diabetes, and supplementing it may improve insulin sensitivity. The evidence is Grade B and genuinely emerging, and it is narrower than it is often presented. The proof-of-concept trial was an exploratory pilot in which 32 people completed, and insulin sensitivity improved clearly against placebo. Its effects on body weight and fat mass did not reach significance, and a 2025 trial in type 2 diabetes found no significant difference between the treated and placebo groups on body weight overall, with weight and blood-sugar gains showing up only in the participants who happened to start with low gut levels of the bacterium. Since we have no way to measure your baseline level, we do not recommend it for weight or fat loss. One detail matters more than the rest: use the pasteurised form, which outperformed the live bacterium in trials, at around 10 billion cells a day. It is well tolerated, with mild digestive upset the main complaint. The interaction to know is immunosuppressant medication: if you take tacrolimus, ciclosporin, sirolimus, everolimus or azathioprine, or you are otherwise immunocompromised, check with your specialist before starting any bacterial product. The pasteurised form used here lowers the usual concern, but the immune data are incomplete.
Below are the 6 documented pairs we have explicitly assessed for Akkermansia muciniphila (pasteurised): 5 amber and 1 green. The pairs cluster around 2 mechanisms: Immunosuppression caution and Gut microbiome synergy. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not listed here is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by medication, and the missing-item form at the bottom of the page routes any uncatalogued medication into our next curation pass.
Documented interactions
Last reviewed 1 June 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
Immunosuppression caution
Amber Does interact with Azathioprine?
If you take a medicine that suppresses your immune system, check with your specialist before starting any probiotic. The pasteurised (non-living) form used here lowers the usual concern, but immune data are incomplete, so a quick word with your team is the safe route.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Ciclosporin?
If you take a medicine that suppresses your immune system, check with your specialist before starting any probiotic. The pasteurised (non-living) form used here lowers the usual concern, but immune data are incomplete, so a quick word with your team is the safe route.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Everolimus?
If you take a medicine that suppresses your immune system, check with your specialist before starting any probiotic. The pasteurised (non-living) form used here lowers the usual concern, but immune data are incomplete, so a quick word with your team is the safe route.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Sirolimus?
If you take a medicine that suppresses your immune system, check with your specialist before starting any probiotic. The pasteurised (non-living) form used here lowers the usual concern, but immune data are incomplete, so a quick word with your team is the safe route.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Tacrolimus?
If you take a medicine that suppresses your immune system, check with your specialist before starting any probiotic. The pasteurised (non-living) form used here lowers the usual concern, but immune data are incomplete, so a quick word with your team is the safe route.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Gut microbiome synergy
Green Does interact with Metformin?
Akkermansia and metformin work in the same direction. Metformin itself tends to increase Akkermansia in the gut, so taking the supplement alongside it is complementary rather than a problem. No special timing is needed.
Evidence: Limited human data, from small studies or case reports, alongside a known mechanism.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope. Use the checker below to surface any medication, and submit a missing item if you take something we have not catalogued.
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How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
Read the full methodologyA full supplement review, built around you, not a generic stack.
The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
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