Bismuth Subsalicylate Also indexed as: Bismatrol, BSS, Pepto-Bismol
Bismuth subsalicylate is a nonprescription drug used to relieve indigestion without constipation, nausea, and abdominal cramps. It is also used to control diarrhea and traveler’s diarrhea. Bismuth subsalicylate is used together with prescription antibiotics and stomach acid-blocking drugs to treat gastric and duodenal ulcers associated with Helicobacter pylori infection.
Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.
 Avoid: Adverse interaction—Avoid these supplements when taking this medication because taking them together may cause undesirable or dangerous results. | Salicylate-containing herbs* such as meadowsweet, poplar, willow, and wintergreen Sarsaparilla |
| Depletion or interference | None known |
| Side effect reduction/prevention | None known |
| Supportive interaction | None known |
| Reduced drug absorption/bioavailability | None known |
An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
Interactions with Herbs
Sarsaparilla (Smilax spp.)
Sarsaparilla may increase the absorption of digitalis and bismuth, increasing the chance of toxicity.1
Salicylate-containing herbs
Bismuth subsalicylate contains salicylates. Various herbs including meadowsweet (Filipendula ulmaria), poplar (Populus tremuloides),willow (Salix alba), and wintergreen (Gaultheria procumbens) contain salicylates as well. Though similar to aspirin, plant salicylates have been shown to have different actions in test tube studies.2 Furthermore, salicylates are poorly absorbed and likely do not build up to levels sufficient to cause negative interactions that aspirin might.3 No reports have been published of negative interactions between salicylate-containing plants and aspirin or aspirin-containing drugs.4 Therefore concerns about combining salicylate-containing herbs remain theoretical, and the risk of causing problems appears to be low.
References (To view, roll mouse over the "References" heading; to hide, click on the heading)
1. Bradley PR (ed). British Herbal Compendium, vol 1. Bournemouth, Dorset, UK: British Herbal Medicine Association, 1992, 194–6.
2. Wichtl M, Bisset NG, eds. Herbal Drugs and Phytopharmaceuticals. Stuttgart: Medpharm GmBH Scientific Publishers.
3. Janssen PL, Katan MB, van Staveren WA, et al. Acetylsalicylate and salicylates in foods. Cancer Lett 1997:114(1–2):163–4.
4. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. (1997) American Herbal Product Association’s Botanical Safety Handbook. Boca Raton, FL: CRC Press, 1997, 154–5.
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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2009.