- What other names is Bismuth known by?
- What is Bismuth?
- How does Bismuth work?
- Are there safety concerns?
- Are there any interactions with medications?
- Dosing considerations for Bismuth.
Atomic number 83, Basic Bismuth Carbonate, Basic Bismuth Gallate (BSG), Basic Bismuth Nitrate (BSN), Bi, Bismuth, Bismuth Aluminate, Bismuth Biskalcitrate, Bismuth Carbomer, Bismuth Citrate, Bismuth Gallate, Bismuth Oxynitrate, Bismuth Phosphate, Bismuth Salts, Bismuth Sodium Triglycollamate, Bismuth Subcarbonate, Bismuth Subcitrate, Bismuth Subgallate, Bismuth Subnitrate, Bismuth Subsalicylate, Bismuth-Peptide Complex (BPC, bicitropeptide), Colloidal Bismuth Subcitrate, Ranitidine Bismuth Citrate, Tripotassium Dicitrato Bismuthate.
Bismuth (Bi) is a chemical element with the atomic number 83. Supplements containing bismuth usually contain bismuth as a salt.
People take bismuth salts by mouth for inflammation of the lining of the colon (colitis), constipation, diarrhea, indigestion, Helicobacter pylori (H. pylori) infection, odor caused by an opening in the belly wall during surgery (ileostomy odor), stomach problems caused by nonsteroidal anti-inflammatory (NSAID) drugs, stomach ulcers, stomach flu, and preventing traveler's diarrhea.
People apply bismuth salt to the skin for hemorrhoids.
People use bismuth as an enema for pouchitis. This condition involves inflammation in an artificial rectum created after surgery for ulcerative colitis.
Bismuth salts are also added to cosmetics, batteries, paints, and pigment plastics in manufacturing.
Likely Effective for...
- Traveler's diarrhea. Research shows that taking bismuth subsalicylate the day before traveling and continuing until 2 days after returning home reduces the risk of traveler's diarrhea by up to 41%.
Possibly Effective for...
- Preventing ulcers caused by a bacterium called Helicobacter pylori (H. pylori). Research shows that taking bismuth by mouth three times daily for 4 weeks does not cure H. pylori infection when taken alone. However, some research shows that bismuth salts might improve healing when taken with antibiotics. But taking bismuth with antibiotics might increase the risk for side effects. Bismuth salts have also been taken in combination with antibiotics and medications that decrease stomach acid (proton pump inhibitors). Research shows that this combination might treat H. pylori infections as well as other antibiotic combination therapies. Also, this combination might work better than antibiotic combination therapies in people who have developed resistance to some of these antibiotics.
- Stomach ulcers. Early research suggests that taking a certain bismuth salt three times daily for 4 weeks is as effective as taking the drug cimetidine daily for 4 weeks at preventing stomach ulcers from recurring. Taking this bismuth salt might also improve the effects of antibiotics when used to treat stomach ulcers associated with H. pylori infection.
Insufficient Evidence to Rate Effectiveness for...
- Bleeding. Early research suggests that smearing bismuth paste that also contains adrenaline onto swabs and placing the swabs in the throat around the tonsils and adenoids for 2-3 minutes following adenoid or tonsil-removal surgery reduces operating time and bleeding. However, other research shows that bismuth paste that does not contain adrenaline doesn't affect operating or bleeding time.
- Inflammation of the lining of the colon (Colitis). Early research shows that taking a certain bismuth salt three times daily for 8 weeks decreases stool frequency in people with colitis.
- Odor caused by an opening in the belly wall during surgery (Ileostomy odor). Early research suggests that taking a bismuth salt by mouth three times daily for 1 week reduces or eliminates the odor caused by an opening in the belly wall during surgery.
- Inflammation in an artificial rectum created after surgery for ulcerative colitis (Pouchitis). Early research suggests that using an enema containing elemental bismuth mixed with a particular gel nightly for 45 days reduces pouchitis symptoms. However, other evidence suggests that using bismuth enemas does not improve symptoms of pouchitis.
- Stomach problems caused by non-steroidal anti-inflammatory (NSAID) drugs.
- Stomach flu.
- Other conditions.
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 also might speed up blood clotting.
Taking a certain bismuth salt called bismuth subgallate by mouth, short-term and as directed, is LIKELY SAFE when used to treat odor caused by an opening in the belly wall during surgery. Also, another bismuth salt called bismuth subsalicylate is LIKELY SAFE when taken by mouth short-term and as directed to treat diarrhea. These two bismuth salts are approved by the US Food and Drug Administration (FDA) to treat these conditions.
Other forms of bismuth salts are POSSIBLY SAFE when taken by mouth appropriately, short-term. Bismuth salts, including ranitidine bismuth citrate, colloidal bismuth subcitrate, and bismuth subnitrate appear to be safe when taken in doses of 400-2100 mg daily for up to 56 days.
Bismuth is POSSIBLY UNSAFE when taken by mouth in large amounts due to the risk for kidney failure, and when taken over the long-term due to the risk of nerve damage.
Special Precautions & Warnings:Pregnancy and breast-feeding: There is not enough reliable information about the safety of taking bismuth if you are 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 and as directed. 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 is not enough reliable information about the safety of taking other bismuth salts by mouth in children. Bismuth is POSSIBLY UNSAFE when taken by mouth in large amounts or over a prolonged time period.
Allergy to salicylate: Many bismuth supplements contain the bismuth salt called bismuth subsalicylate. When taken by mouth, bismuth subsalicylate breaks down in the stomach to form bismuth and salicylate. In theory, people who are sensitive to salicylate might have a serious side effect to these supplements
AspirinInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.
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.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Some medications are taken to slow blood clotting. Bismuth salts might increase how quickly blood clots. Taking bismuth salts with these medications might reduce their effects and increase the risk of blood clots. Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.
Omeprazole (Prilosec)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Omeprazole increases how much bismuth the body absorbs. Taking omeprazole with bismuth might increase the effects and side effects of bismuth.
Warfarin (Coumadin)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
There is some concern that a specific bismuth salt called bismuth subsalicylate might decrease the effects of warfarin. People using warfarin should avoid using bismuth subsalicylate. However, this interaction is not likely for other bismuth salts.
The following doses have been studied in scientific research:
By mouth:For preventing ulcers caused by a bacterium called Helicobacter pylori (H. pylori): As a triple therapy, 120 mg bismuth subcitrate, 500 mg amoxicillin, and 250 mg metronidazole four times daily for 14 days have been used. As a bismuth quadruple therapy (BQT), 240-1680 mg of bismuth salts daily, 400-1500 mg of metronidazole daily, 1500-2000 mg of tetracycline daily, and a medication that decreases stomach acid (proton pump inhibitor) for a total of 7 to 14 days have been used.
For stomach ulcers: 700 mg of bismuth subnitrate three times daily for 4 weeks has been used. Also, 300 mg of bismuth subnitrate four times daily, 20 mg of omeprazole twice daily, and 500 mg of amoxicillin four times daily for 2 weeks have been used.
For traveler's diarrhea prevention: 1.05-2.1 grams of bismuth subsalicylate in two divided doses daily beginning the day before traveling and continuing until 2 days after returning home has been used.
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).
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