 probiotics are live bacteria that are beneficial to the human being. Probiotics should be taken on a daily basis usually about 45 minutes before your morning breakfast. I certainly would recommend taking it with either distilled water or filtered water or reverse osmosis but never with tap water. Tap water has chlorine in it and what does chlorine do? Kills bacteria. Your best best to take it about 45 minutes before breakfast. 70% of our immune system is in the gut so it behooves one to take the probiotics to have good gut health. If you're on antibiotic therapy my recommendation is about two hours after each antibiotic treatment you take a good high potency probiotic. Well if we go back many years usually it's the ones that were refrigerated with the ones that were supposed to be better. However in modern technology in today, probiotics that are refrigerated are excellent and those that are not refrigerated are also excellent. The reason being is that the manufacturers have been able to stabilize out the bacteria and also what they do is they increase the strength of the probiotic so that the date of expiration it falls within the guidelines of what the probiotic should be. Our prebiotic is food for the probiotic. Things like FOS which is fructose oleosaccharides are an excellent carbohydrate that is used as a food for the bacteria.