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.
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
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,
|Depletion or interference
|Side effect reduction/prevention
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
Interactions with Herbs
Sarsaparilla (Smilax spp.)
Sarsaparilla may increase the absorption of digitalis and bismuth, increasing the chance of
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.
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,