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Supplement · Grade B

Akkermansia muciniphila (pasteurised) and medications.

Every documented pair, every citation. Below: 6 documented pairs grouped by mechanism.

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 and body composition. The evidence is Grade B and genuinely emerging: a proof-of-concept trial improved insulin sensitivity, and a 2025 trial in type 2 diabetes found weight and blood-sugar benefits that were concentrated in people who started with low gut levels of the bacterium, so the response is partly baseline-dependent. One detail is load-bearing: 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 and no significant drug interactions. Anyone significantly immunocompromised should check with their specialist first.

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

Immunosuppression caution

Amber 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.

BNF: Azathioprine

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Amber 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.

BNF: Ciclosporin

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Amber 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.

BNF: Everolimus

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Amber 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.

BNF: Sirolimus

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Amber 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.

BNF: Tacrolimus

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Gut microbiome synergy

Green Metformin

These 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.

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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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.
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How we decide

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 methodology
Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.