Overview
Bismuth salts seem to help eliminate bacteria that cause stomach problems such as diarrhea and stomach ulcers. Bismuth salts also work like an antacid to treat problems such as indigestion. Bismuth might also speed up blood clotting.
People commonly use bismuth for travelers' diarrhea, a digestive tract infection that can lead to ulcers (Helicobacter pylori or H. pylori), and stomach ulcers. It is also used for constipation, bleeding, and many other conditions, but there is no good scientific evidence to support these other uses.
Bismuth supplements are available in many different salt forms. Bismuth nitrate is a specific form that is not legal for use in dietary supplements. Review the listing on bismuth nitrate for more details.
Uses & Effectiveness ?
Likely Effective for
- Travelers' diarrhea. Bismuth subsalicylate is effective for treating and preventing travelers' diarrhea.
Possibly Effective for
- A digestive tract infection that can lead to ulcers (Helicobacter pylori or H. pylori). Taking bismuth by mouth along with standard antibiotics might improve healing from H. pylori.
- Stomach ulcers. Taking bismuth subsalicylate by mouth, alone or with other treatments, seems to help treat and prevent stomach ulcers.
Side Effects
Bismuth is possibly unsafe when used in larger amounts due to the risk for kidney failure, and when taken long-term due to the risk of nerve damage.
Special Precautions and Warnings
Bismuth is possibly unsafe when used in larger amounts due to the risk for kidney failure, and when taken long-term due to the risk of nerve damage.
Pregnancy and breast-feeding: There isn't enough reliable information to know if bismuth is safe to use when pregnant or breast-feeding. Stay on the safe side and avoid use.
Children: Bismuth subgallate and bismuth subsalicylate are likely safe when taken by mouth short-term. Taking 200-400 mg of bismuth subgallate by mouth up to four times daily is approved by the US FDA as a deodorant drug for children at least 12 years old. Taking 1.05 grams of bismuth subsalicylate by mouth hourly as needed (no more than 4.2 grams daily) for up to 2 days is approved by the US FDA for diarrhea in children at least 12 years old. There isn't enough reliable information to know if it is safe for children to take other bismuth salts. Bismuth is possibly unsafe when taken by mouth in large amounts or long-term.
Allergy to salicylate: Many bismuth supplements contain the bismuth salt called bismuth subsalicylate. Bismuth subsalicylate breaks down in the stomach to form bismuth and salicylate. People who are sensitive to salicylate might have a serious side effect to these supplements.
Gastrointestinal (GI) conditions: Normally, almost no bismuth is absorbed by the gut. But having certain GI conditions might increase how much bismuth is absorbed. This might increase the side effects of bismuth.
Interactions ?
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with BISMUTH
Bismuth might slow blood clotting. Taking bismuth along with medications that also slow blood clotting might increase the risk of bruising and bleeding.
Aspirin interacts with BISMUTH
Many dietary supplements contain bismuth in the form of bismuth subsalicylate. When taken by mouth, bismuth subsalicylate is broken down into bismuth and salicylate. Because aspirin contains salicylate, taking bismuth with aspirin might increase the effects and side effects of aspirin.
Omeprazole (Prilosec) interacts with BISMUTH
Omeprazole increases how much bismuth the body absorbs. Taking omeprazole with bismuth might increase the effects and side effects of bismuth.
Warfarin (Coumadin) interacts with BISMUTH
Bismuth subsalicylate might decrease the effects of warfarin. People using warfarin should avoid using bismuth subsalicylate. However, this interaction is not likely to be a concern for other bismuth salts.
Moderate Interaction
Be cautious with this combination
Dosing
Addrizzo-Harris, D. J., Churg, A., and Rom, W. N. Radio-opaque punctate opacities on the chest radiograph following intravenous injection of a bismuth compound. Thorax 1997;52(3):303-304. View abstract.
Araujo Castillo, R., Pinto Valdivia, J. L., Ramirez, D., Cok Garcia, J., and Bussalleu Rivera, A. [New ultrashort scheme for helicobacter pylori infection eradication using tetracyline, furazolidone and colloidal bismuth subcitrate in dyspeptic patients with or without peptic ulceration in the National Hospital Cayetano Heredia]. Rev Gastroenterol Peru 2005;25(1):23-41. View abstract.
Bianchi Porro, G., Lazzaroni, M., and Cortvriendt, W. R. Maintenance therapy with colloidal bismuth subcitrate in duodenal ulcer disease. Digestion 1987;37 Suppl 2:47-52. View abstract.
Bingham AL, Brown RO, Dickerson RN. Inadvertent exaggerated anticoagulation following use of bismuth subsalicylate in an enterally fed patient receiving warfarin therapy. Nutr Clin Pract 2013;28(6):766-9. View abstract.
Bujanda, L., Sanchez, A., Iriondo, C., Santos, A., Cosme, A., and Munoz, C. [Comparative study of the eradication of Helicobacter pylori: ranitidine bismuth citrate versus omeprazole plus two antibiotics for seven days]. An Med Interna 2001;18(7):361-363. View abstract.
Callanan, V., Curran, A. J., Smyth, D. A., and Gormley, P. K. The influence of bismuth subgallate and adrenaline paste upon operating time and operative blood loss in tonsillectomy. J Laryngol Otol 1995;109(3):206-208. View abstract.
Carvalho, A. F., Fiorelli, L. A., Jorge, V. N., Da Silva, C. M., De Nucci, G., Ferraz, J. G., and Pedrazzoli, J. Addition of bismuth subnitrate to omeprazole plus amoxycillin improves eradication of Helicobacter pylori. Aliment Pharmacol Ther 1998;12(6):557-561. View abstract.
Cengiz, N., Uslu, Y., Gok, F., and Anarat, A. Acute renal failure after overdose of colloidal bismuth subcitrate. Pediatr Nephrol 2005;20(9):1355-1358. View abstract.
Chey, W. D., Fisher, L., Elta, G. H., Barnett, J. L., Nostrant, T., DelValle, J., Hasler, W. L., and Scheiman, J. M. Bismuth subsalicylate instead of metronidazole with lansoprazole and clarithromycin for Helicobacter pylori infection: a randomized trial. Am J Gastroenterol 1997;92(9):1483-1486. View abstract.
Code of Federal Regulations Title 21 - Foods and Drugs. Chapter 1 - Food and Drug Administration. Subchapter D - Drugs for Human Use. Part 335 Antidiarrheal drug products for over-the-counter human use. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=335.50
Code of Federal Regulations Title 21 - Foods and Drugs. Chapter 1 - Food and Drug Administration. Subchapter D - Drugs for Human Use. Part 357 Miscellaneous internal drug products for over-the-counter human use. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?cfrpart=357&showfr=1&subpartnode=21:5.0.1.1.29.5
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Addrizzo-Harris, D. J., Churg, A., and Rom, W. N. Radio-opaque punctate opacities on the chest radiograph following intravenous injection of a bismuth compound. Thorax 1997;52(3):303-304. View abstract.
Araujo Castillo, R., Pinto Valdivia, J. L., Ramirez, D., Cok Garcia, J., and Bussalleu Rivera, A. [New ultrashort scheme for helicobacter pylori infection eradication using tetracyline, furazolidone and colloidal bismuth subcitrate in dyspeptic patients with or without peptic ulceration in the National Hospital Cayetano Heredia]. Rev Gastroenterol Peru 2005;25(1):23-41. View abstract.
Araujo Castillo, R., Pinto Valdivia, J. L., Ramirez, D., Cok Garcia, J., and Bussalleu Rivera, A. [New ultrashort scheme for helicobacter pylori infection eradication using tetracyline, furazolidone and colloidal bismuth subcitrate in dyspeptic patients with or without peptic ulceration in the National Hospital Cayetano Heredia]. Rev Gastroenterol Peru 2005;25(1):23-41. View abstract.
Bianchi Porro, G., Lazzaroni, M., and Cortvriendt, W. R. Maintenance therapy with colloidal bismuth subcitrate in duodenal ulcer disease. Digestion 1987;37 Suppl 2:47-52. View abstract.
Bianchi Porro, G., Lazzaroni, M., and Cortvriendt, W. R. Maintenance therapy with colloidal bismuth subcitrate in duodenal ulcer disease. Digestion 1987;37 Suppl 2:47-52. View abstract.
Bingham AL, Brown RO, Dickerson RN. Inadvertent exaggerated anticoagulation following use of bismuth subsalicylate in an enterally fed patient receiving warfarin therapy. Nutr Clin Pract 2013;28(6):766-9. View abstract.
Bingham AL, Brown RO, Dickerson RN. Inadvertent exaggerated anticoagulation following use of bismuth subsalicylate in an enterally fed patient receiving warfarin therapy. Nutr Clin Pract 2013;28(6):766-9. View abstract.
Bujanda, L., Sanchez, A., Iriondo, C., Santos, A., Cosme, A., and Munoz, C. [Comparative study of the eradication of Helicobacter pylori: ranitidine bismuth citrate versus omeprazole plus two antibiotics for seven days]. An Med Interna 2001;18(7):361-363. View abstract.
Bujanda, L., Sanchez, A., Iriondo, C., Santos, A., Cosme, A., and Munoz, C. [Comparative study of the eradication of Helicobacter pylori: ranitidine bismuth citrate versus omeprazole plus two antibiotics for seven days]. An Med Interna 2001;18(7):361-363. View abstract.
Callanan, V., Curran, A. J., Smyth, D. A., and Gormley, P. K. The influence of bismuth subgallate and adrenaline paste upon operating time and operative blood loss in tonsillectomy. J Laryngol Otol 1995;109(3):206-208. View abstract.
Callanan, V., Curran, A. J., Smyth, D. A., and Gormley, P. K. The influence of bismuth subgallate and adrenaline paste upon operating time and operative blood loss in tonsillectomy. J Laryngol Otol 1995;109(3):206-208. View abstract.
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Carvalho, A. F., Fiorelli, L. A., Jorge, V. N., Da Silva, C. M., De Nucci, G., Ferraz, J. G., and Pedrazzoli, J. Addition of bismuth subnitrate to omeprazole plus amoxycillin improves eradication of Helicobacter pylori. Aliment Pharmacol Ther 1998;12(6):557-561. View abstract.
Carvalho, A. F., Fiorelli, L. A., Jorge, V. N., Da Silva, C. M., De Nucci, G., Ferraz, J. G., and Pedrazzoli, J. Addition of bismuth subnitrate to omeprazole plus amoxycillin improves eradication of Helicobacter pylori. Aliment Pharmacol Ther 1998;12(6):557-561. View abstract.
Cengiz, N., Uslu, Y., Gok, F., and Anarat, A. Acute renal failure after overdose of colloidal bismuth subcitrate. Pediatr Nephrol 2005;20(9):1355-1358. View abstract.
Cengiz, N., Uslu, Y., Gok, F., and Anarat, A. Acute renal failure after overdose of colloidal bismuth subcitrate. Pediatr Nephrol 2005;20(9):1355-1358. View abstract.
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Chey, W. D., Fisher, L., Elta, G. H., Barnett, J. L., Nostrant, T., DelValle, J., Hasler, W. L., and Scheiman, J. M. Bismuth subsalicylate instead of metronidazole with lansoprazole and clarithromycin for Helicobacter pylori infection: a randomized trial. Am J Gastroenterol 1997;92(9):1483-1486. View abstract.
Chey, W. D., Fisher, L., Elta, G. H., Barnett, J. L., Nostrant, T., DelValle, J., Hasler, W. L., and Scheiman, J. M. Bismuth subsalicylate instead of metronidazole with lansoprazole and clarithromycin for Helicobacter pylori infection: a randomized trial. Am J Gastroenterol 1997;92(9):1483-1486. View abstract.
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Code of Federal Regulations Title 21 - Foods and Drugs. Chapter 1 - Food and Drug Administration. Subchapter D - Drugs for Human Use. Part 335 Antidiarrheal drug products for over-the-counter human use. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=335.50
Code of Federal Regulations Title 21 - Foods and Drugs. Chapter 1 - Food and Drug Administration. Subchapter D - Drugs for Human Use. Part 335 Antidiarrheal drug products for over-the-counter human use. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=335.50
Code of Federal Regulations Title 21 - Foods and Drugs. Chapter 1 - Food and Drug Administration. Subchapter D - Drugs for Human Use. Part 357 Miscellaneous internal drug products for over-the-counter human use. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?cfrpart=357&showfr=1&subpartnode=21:5.0.1.1.29.5
Code of Federal Regulations Title 21 - Foods and Drugs. Chapter 1 - Food and Drug Administration. Subchapter D - Drugs for Human Use. Part 357 Miscellaneous internal drug products for over-the-counter human use. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?cfrpart=357&showfr=1&subpartnode=21:5.0.1.1.29.5
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