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Probiotics play a crucial role in modulating prostaglandin E2 (PGE2), an anti-inflammatory prostanoid that inhibits the secretion of pro-inflammatory cytokines, such as IL-1 and TNF-, by macrophages (174)

For most people, these effects tend to diminish over time as the body develops tolerance to the medication

Excipients such as sorbitol, mannitol (sugar alcohols), lactose (in those with intolerance), and various binding agents or fillers may contribute to gastrointestinal symptoms

Chronic or heavy alcohol consumption increases CYP2E1 activity, which in turn elevates NAPQI formation from acetaminophen metabolism

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Once reconstituted, vial should be used by one person to avoid contamination